My son and I go round and round on this issue! How much post meal spike is ok? He is 22 with a history of 3 major hypo seizures (one life flight, one glucagon, one ER) Therefore, he has an overwhelming fear of lows that controls all his decisions. Who could blame him? He overrides all the doctor’s numbers, with “I’ll get low”. He WILL NOT bolus pre-meal. When I question a huge BG spike, he says, “I bloused, it’ll come down”. I don’t think it should spike more than about 85 points if the blouse was right. Any advice appreciated!
Hi Hockeymom,
I believe you ask a question that truly the best person to answer would be your health care provider. They have your son's specific medical concerns and can determine a safe meal rise plan; it varies from person to person when your looking for specifics. The fear of whether or not long term complications will develop due to BG's spiking is a fear for many of us, ideally you like to avoid major spikes and bottoming out. It's the best way to avoid complications; both extremes can also cause a rebounding effect which can be a vicious circle.
One thing I try to keep in mind about Type 1 diabetes when making decisions is that I lack both the insulin to keep BG's in optimal range and the control to produce the right amount of glucose internally to level me out if I begin to drop. This guides my decisions both ways.
So knowing what direction my BG's are going is truly valuable. Trying to be level or stable before bolusing is ideal, not always easy to achieve though. Also, timing of insulin action and when your food metabolizes cause rises and falls even if you have the right ratios of both insulin and carbs, they just might not be timed the same.
Personally I might try to target the fear of lows by finding ways to being more comfortable that he is staying within a safer range in both directions.
One tip I use when targeting an issue is to do 2 BG tests 30 minutes apart to see what direction I'm headed before bolusing, especially if I'm borderline towards a low range.
Over the last 29 years I still to this day do random 6 hour testing blocks with multiple testing to see how the timing of my insulin and my food intake match up. Different foods give different results. I watch the meal rise and timing that my insulin begins to level me back out. It sounds time consuming but when I learned how my own body reacted I was able to come up with better prescribed plans with my HCP's and I felt more confident in making decisions in managing my plan. It's not something I do every day but it helps to ensure my plan is either working or not.
Hope this helps.