One hour postprandial range

I have a good idea of what kind of number I’d like my son to be at the 2 hour postprandial period, but lately, we’ve had reason to check at the one hour mark because of various activities. What is your ideal number (or range) at the one hour point?

We’re experimenting with timing of his insulin, and ultimately, he always ends up where we would like him to be, but I’m not certain that he’s ideal all along the way. If his two hour number and his next pre-meal number is where we’d like it to be, should I be concerned about the 1 hour point? He doesn’t have a CGM, so we just rely on the data points we get from finger sticks.

Thanks for your insight!

Depends on how old he is. Young kids move around so much that if we focus on a targeted 1 hour postprandial, there is a high risk that he will go too low by 2 hours. Kids fluctuate so much that I dont think the 1 hour postprandial will be a good goal marker to set until he’s done growing- by around age 16 or so. I"m not a doctor, just trying to give you a little advice.

For my one hours, I shoot for anything between 120-160. If I’m lower than 120 at one hour, then I have the risk of going into the 50s by 2 hours , depending on what I ate for that meal. I shoot for 80-110 for my 2 hour.

Depends on your child’s insulin duration. If duration is 4.5 to 5 hours, as ours was with Novolog, she would have to be 200 at the 2 hour mark to come down to 80 to 100 in 4.5 to 5 hours. Now, with Apidra, she can be 150 or 160 at the two hour mark. We were told 200 at the one-hour mark, 150 to 160 at the 2 hour mark and Apidra leaves her system at 3 to 3.5 hours after use. We could not lower the postprandials without keeping her home, checking and feeding IOB at a certain point (which we will do if she is home after dinner), essentially giving a small snack two hours after eating which does not need to be covered. When at school or out, we want her to come down to target without intervention on her part. I believe a lot of this is individual, and you will be able to figure out how insulin matches the digestion of food generally (each child is somewhat different), and then possibly how it matches individual meals. Observation and time will enable you to figure this out. Apidra has been a huge help in this regard. P.S. Your endo will be able to look at the records and give you a target based on how your child reacts to insulin. This will change as he/she gets older.

I think it depends too – on what your child ate, his insulin sensitivity, activity, etc. I sort of eyeball the one hour numbers, just to see if the meal dosing was adequate. I can usually see glaring problems, for example if my daughter is 300 at 1 hour PP and only has 2 units on board I know that isn’t going to cut it. Our endo has always said the PP numbers don’t matter too much, I don’t agree 100% with this. I think you are smart to start watching for trends.

I think the reason why we do the tests at 2 hours is because after a meal the blood sugars can and will shoot up and it takes the insulin a couple of hours to kick in and start working.

Nobody has perfect numbers after one hour, or even 2 - I can go high on a piece of toast and insulin and it takes a while to work, but I know it will come down eventually.

Of course kids are a different kettle of fish. They are growing, they have different rates of absorbtion, they are active (or not) and their hormones are different to adults, and of course their age and size has a lot to do with things. I should think if you were trying to get normal levels at 1 hour, there is a high risk of him going hypos a couple of hours down the line.

By all means test before activity but do not take the 1 hour test too seriously. It will go down.

Thanks to all of you. So, what I’m understanding from you is that, if his number prior to his next meal is in the range we’d like it to be, and, the times we check at 2 hours are good, don’t worry so much about the 1 hour number. Generally, when we’re testing at 1 hour it’s to figure out whether he will need to eat to avoid a low with exercise rather than because we’re concerned about him spiking too high, so I think I’ll try to not worry so much as long as he’s coming down to where he needs to be once the insulin has had a chance to do its job.

Thanks again and have a fabulous weekend.

Thanks. How do you know the duration of the insulin? I guesstimate based on numbers I’ve read in various books, but I don’t have any idea if the estimates I use are accurate for my son. He rarely has a high that is high enough for correction, so I feel like our dosing is good, but I don’t know how to accurately determine duration. Is that something your endo determined or did you figure it out?

Thanks for your input.

I think there’s a graph of suggested duration on the brochures that come with insulin bottles? Or this one I found online:

If he is going to be doing exercise, say, football, then it would be good to have a sugary snack before and perhaps at half time. Don’t worry, he will burn it off with exercise and insulin.

Duration is a bit individual. Just trial and error. I know that if I have a big dose of two different insulins due to being high in the morning at 9am, and then have a busy morning I will be ready for sugar at about 2pm if I do not get around to eating between times.

Thanks. I’ve seen similar charts and there are some guidelines in the Think Like a Pancreas book - those are what I’ve been relying on for figuring out how much insulin is still working at any given time. I was just curious how someone would know that their insulin takes 3 hours to finish versus someone who says theirs takes 4.

I was doing some reading in advance of meeeting with pump reps next week, and I read something about the pump being programmed to calculate IOB based on your individual duration. Other than the general range of humalog taking 3-4 hours to finish, do they somehow take that from the general to the specific for an individual? For instance, can they figure out that, in your case, your insulin lasts 3 hours but in person B it lasts 4? It seems like that would be hard to determine without some kind of blood test showing your personal circulating insulin? Am I thinking too much for a holiday weekend?

So yours would vary based on the size of your dose? Is your need for sugar the indication that your insulin has finished?

Thanks - he seems to vary based on the sport. Running makes him go up and drop laterso he snacks after; basketball drops him like a rock, so he has to eat before and during. He was diagnosed after football season, so we don’t know yet what that does to him. He has some exercise guidelines our endo gave him to determine if he needs to snack. So far, those guidelines seem to be working - when he follows them!

Have a good weekend and thanks for sharing your thoughts!