Negative for anti bodies - confused by recent lab test

Of for sure… night and day. With bolus insulin you’re trying to match the timing fairly precisely with what you’re eating, which can be just as tricky as figuring out how much bolus to take. with basal (particularly long acting basal like levemir, lantus, or tresiba) timing is not really very significant at all… it’s just like keeping gas in your cars tank… some people get into complex timing with it with pumps but that’s a different strategy (and it’s rapid insulin instead of long acting)

For bolus injection, there are two factors to consider to have “perfect” pp BG:

  1. matching the quantity of carbs to the insulin
  2. the timing of the bolus injection

when the pp BG is high (greater than140), how does one know the “error” was caused by #1 - quantity mismatch or #2 timing mismatch?

Well if it’s high only briefly but goes down later it’s an indication that the food outran the bolus…

If it’s flat or trends low then spikes later it’s an indication the insulin outran the food.

If it just goes up and doesn’t really seem to come back down without additional bolus, it’s an indication it just wasn’t enough bolus

It’s all very fuzzy and never a perfect science but if you’re paying attention and have been for some length of time and you end up with a bad result you can usually piece together the clues enough to make an educated guess what you could do differently next time…

Well if it’s high only briefly but goes down later it’s an indication that the food outran the bolus…------I think that this means the bolus amount was correct, but the timing was incorrect. Yes?

If it’s flat or trends low then spikes later it’s an indication the insulin outran the food. ----- perhaps slow digesting fatty food?

If it just goes up and doesn’t really seem to come back down without additional bolus, it’s an indication it just wasn’t enough bolus - this one is interesting because I don’t seem to be able to get my bedtime BG to 100. It is often 130-150. On certain days when I eat out the bedtime BG could be as high as 180. Yet, the next morning, my fasting BG would be somewhere between 100 to 135. The bedtime BG is measured about 4 - 5 hours after my last bolus. Does it suggest perhaps a little more insulin for the dinner?

I

Correct on all three, in my estimation… more info can be gathered by also testing two hours after dinner to see what’s really going on there with that pattern

2 hour after dinner BG are often higher than the pre meal BG; often close to 150. Does this mean perhaps I need to increase the dinner bolus?

Usually I have less trouble with lunchtime insulin timing and quantity. BG may be a bit high 2 hour pp. By dinner, premeal BG is close to 100.

It is also tricky to perform a “clean” test because I often snack between the meals.

Well based on you saying it’s often 150ish after dinner (which is higher than before dinner) and often still 130-150-180 at bed time, I would be looking into combinations of either eating a little differently at dinner to not increase the blood sugars as much or eating the same but covering it with a little more insulin…

3 Likes