Anyone have a similar problem (btw, I use the MiniMed Veo with the CGMS) where your sugars jump very high 15-mins to 1/2 hour after eating (it doesn't matter what-it could be chicken soup!) and then stay high until 4-5 hours later, when they suddenly spiral down into a low blood sugar?
And all this while you're counting carbs and taking a proper bolus dose and are on your regular basal!
Anyone know how to fix it?
As T1 diabetics we have lost the capability to produce proinsulin. This dissolves into insulin and amylin. The synthetic insulins do not contain any trace of amylin. Which is important because it has the function to slow the digestion down to give the insulin time to unfold its activity. So without amylin we will always digest too fast leading to huge spikes after eating. For some this will settle with age because the digestion will get slower. For some like me the analog insulins like Apidra and NovoRapid are quick enough to compensate this problem. Others are forced to wait 15 to 20 minutes after the injection/pumping before they start eating. Have you tried that? How high is "very high" for you? Which insulin do you use?
i agree prebolusing my help if you are not doing this already, it is recommended to take your rapid insulin 15 minutes before eating best of luck amy
I definitely would try waiting 15-20 minutes after bolus to eat and limit the carbs per meal also. Just be careful not to wait too long if you're more insulin sensitive from exercise or something else because you can go low from this too.
You can also try using the Super-Bolus. That is taking some of your basal insulin from the immediate future and adding it to your meal bolus. This means using a temporary lower basal rate. This requires some experimentation to determine how aggressively to do this. The idea is taking a large bolus without going low later on.
I use Humalog and high is anything over 13. I have also tried pre-bolusing, but it doesn't seem to do the job quite as well as I'd like. I always thought being on a pump meant that the sugars would remain in range (4-7) even post meal.
I wonder if changing insulins will do the trick. Maybe I have become insensitive to Humalog and it doesn't act soon enough but has a delayed action making me go low much later. Any thoughts?
I agree that changing insulins is a valuable experience. Most endos have vials for free. If it does not work you can quickly go back to the previous insulin. I would recommend to try NovoRapid/NovoLog and then Apidra. If the insulin is too fast then your 2 spike will be good but your 3 hour spike might increase. This is due to slower carbohydrates that will be digested later. The faster insulins usually have problems to cover these carbohydrates. So the balance between the quick unfolding of insulin reaction and the duration of its activity is impotant too.
Are you sure your basal profile is correct? So can you fast 12 to 24 hours without going high or low? I am asking because insufficient basal coverage can mess with your sensitivity to bolus insulin. Sadly the pump does not do anything automatically for you.
As a women you should also keep track of your menstrual cycle. Usually in the week before bleedings women will have a higher insulin resistance but it is highly individual. It might be helpful to identify these patterns to work against them. With your pump you could cover this with a temporary basal increase of 130% or more. Some women find it a great relief to be on birth control pills to reduce the influence of the cycle. Again something to keep in balance with the negative side effects of birth control pills. Just some food for thought.
Alan, what's a Super-Bolus and how do you give it using the Medtronic Pump/Veo? Do you go to the Bolus function or...
Btw, for those of you who are on CGMS, do you wear it for the prescribed 6 (Veo) or 7 (Dexcom) days or longer?
I've hear Dexcom is much more accurate than Veo, but Veo is all you get in India, where I am at the present and I would have bought the Animas/Dexcom if I had any customer support offered for India (1800 or something). :(