Do you think my I:C ratio seems right....
So for example, Breakfast: my number will go from 100ish before breakfast to like160ish after breakfast but come down to the 90's 3-4 hours later. If I increase my bolus, I can have better post-meal numbers(110-120), but then I go low 3-4 hours later.
Not sure which way is better...I don't want to spike like that, but otherwise I go low later.
Sounds fine to me, I generally look to be @ 175 or less with my 2 hour after meal tests. If I am under 140, I drop my basal rate because if not, I’m heading for a hypo crash. All the usual disclaimers (not a doc, YDMV, etc).
Fair Winds,
Mike
To me 190 at one hour seems great. At two hours it’s a bit high, but rather than change the amount you bolus I would change the timing and do it 15 or so minutes before you eat. I do this for breakfast and it’s the only way I can get postprandial readings in range.
I think aiming for 110-120 at two hours is too low for the average type 1 unless they are on a low-carb diet. Since insulin takes sooooo long to act (even the “rapid-acting” kinds are SLOW compared to natural insulin), it’s difficult to aim for such a low mark at two hours when a lot of the insulin will still be working for the next three or four hours.
Good point with the low carb comment…maybe all of the people that I see have lower post-meal spikes are low carb, which would mean that after their insulin peaks, there isn’t that much leftover since they didn’t take a lot of insulin in the first place…which in turn wouldn’t drop them as low.
I learn something new every day here!
I disagree that 160 is ok two hours after meals. Complications begin at 140 so that is the goal to aim to be under, imho. I agree that bolusing a bit before your meal helps, but if you are going low 3-4 hours later I’m guessing that is the result of your basal being too high. I would bolu earlier, increase the bolus and decrease the basal. Make these changes very small and then sit with them for a few days.
Better not to increase the bolus. Sounds like you get an extra hour or so of a “tail” of active insulin. Your formula sounds correct. If you are 160 for a short period of time but eventually get back to 90’s as you stated then I wouldn’t change a thing. I think others will agree.
Good luck.
Yes, that’s why I am so concerned, because I have heard that any spike is bad…I have tried bolusing before meals, as well as reducing my basal…but I know my basal is correct. I can’t seem to strike a balance here. I eat around 55 g of carbs per meal. What do you do Zoe? Could you give me an example of what you do for a meal and what your numbers look like,
I wouldnt worry about 160, thats seems pretty good for 2 hour postprandial. However you could take your insulin a little earlier before the meal and see if it picks better during that spike, but then you may have to worry about being below 90 after.
The 55 grams of carbs might be the problem, lauren. I find that if I start to get over 50 grams my I:C ratios become unreliable. And I couldn’t possible eat that many for breakfast. Maybe trying to cover that many carbs for breakfast is the problem; if you take enough to have a good post-prandial it puts you low later. I would lower the carbs to under 30 for breakfast.
We are all different, of course, but for me, my I:C ratio is the lowest at breakfast: 1:7 (it’s 1:9 and 1:18 for the other meals). I eat around 30 carbs-eggs, vegies, one slice of good bread, milk for my cappuchino. I bolus 15 minutes before eating and am almost always under 140 at two hours. I don’t know about 3-4 hours because I don’t measure then, but before lunch (5 hours after breakfast) I’m usually in the 80s or 90s.
> If I increase my bolus, I can have better post-meal numbers(110-120), but then I go low 3-4 hours later.
Lauren, I had to make the same decision:
a) Spike higher than 110-120.
b) Eat a snack 2 hours after breakfast to avoid a low.
c) Lower the carb content of my breakfast.
I am very comfortable with my decision to go with b). Eating a snack is a minor hardship. Gambling with complications scares me.
Thanks, Helmut.
I was doing that for a while, but stopped after getting my new job and finding a new routine. I never talked to anyone that ate a snack 2 hrs after a meal, but it’s nice to know that you’re out there! I thought something was wrong with my process so I started questioning it.
Everyone—you are so helpful! Every single one of your comments 
If it comes don again soon, don’t worry about it!
JB.
160 after 2 hours is fine, that’s your peak and it drops in another hour. No worries.
Lauren,
My goal isn’t to go as high as 160 postprandial (if I can help it). Agree with others about experimenting with bolus timing & decreasing carbs at breakfast. I eat very few carbs for breakfast & stick to mostly protein. Protein takes longer to digest, of course, & prevents those lows later. Keeps my morning BG more level.
Your I:C ratio sounds right.
While I like to stay under 140, I am very happy if I don’t ever go above 160.
One thing you might try is giving the bolus 5 minutes earlier and see if that helps.
I just saw that your A1c is 5.9. Sounds to me like you are doing great! I would not stress over the short lived 160s. But that’s my opinion
Thanks for more comments, everyone. I guess I will figure out what works for me at some point! (Trial and error, testing, etc.)
Kristin—I hope my A1c is still good next time. The 5.9 included many lows 
which is why I am in this predicament…I’m trying to live and control my diabetes at the same time—which as you know is not an easy balance!!!
I have found that the only way to NOT go over 160 and to not have lows is to eat low carb, which I don’t do… so for now I am accepting going up to 160 after meals, but I don’t stay there long. I am gradually reducing the carbs…
Yep trial and error! Keep us posted on what works best for you!
What kind of short acting insulin are you taking? Humalog/Novalog always made me go low 3-4 hours later, if I had what I thought was a “correct” carb ratio. I switched to Apidra, and that low 3-4 hours later stopped. For me, humalog/novalog has a weird second peak 3-4 hours later. Switching to Apidra helped a lot! Good luck!
I’m using Novolog in a Animas Ping pump
Hahahaha…I actually really like that quote “Rome wasn’t built in a day.” Thanks!