Hi there, I was diagnosed with type 1 a little over 2 weeks ago. I was admitted to hospital following a random blood test which revealed by BG to be 468 and my HA1C to be 12!
Things have come under control quite quickly, and im feeling a lot better than i have in the months before diagnosis!
So my question is: what should i aim for in terms of blood glucose levels? I count carbs and give myself 1unit of novorapid per 10grams of carb at all meals and this seems to be okay for me. When i eat fruit the blood glucose level an hour and then two hours after food are alot higher. For example a meal containing 50 grams of carbs (no fruit) gives me a one-hour post prandial reading of 111, and then 2 hours of 86.
whereas a meal containing 50 grams of carbs (with 15 of those being an apple) gives me a one hour reading of 138, and two hours of 150. Should i increase the carb: insulin ratio when a meal includes fruit?
So in short, for health, what blood glucose levels are your realistic aims for
After meal (1hour…then 2hours)
Hi Eva, welcome to the club! I was diagnosed a little over a month ago so I am still learning myself, but according to things I’ve read and learned here two hours after meals ~140, before bed I try to be around the high end of my target range so for me anywhere between 110 and 130, and fasting I’m not sure but is it ~140-180??? You will learn alot from here. Trust me when I say this if it wasn’t for the people here I probably would have given up trying to deal with this disease.
Oh, you didn’t mention any long acting insulin like lantus or levermir(?), are you on any? I was just thinking that your carb ratio was a little high. Though you could be/ are in the honeymoon period so a background insulin like one of those might not be neccessary as you are still producing background insulin.
I hope you keep asking questions! There are people who have been dealing with this for many many years that know far more than even my doctor does!
Hope this helps a little!
Oh and diabetes isn’t a logical disease, things that would seem to make sense one way aren’t usually the way it is with diabetes!
Hi Eva and welcome. I am glad you found us. You will find a lot of knowledable caring and supportive people here.
Everyone is different. But here are the numbers I shoot for
A1C less than 6
Fasting 100 or less
2 hrs post pradinal 120-140 with 120 or less being the optimal
Bedtime 120 or less (I like the high side and I eat a snack before bed. If I don’t I tend to go low during the night
I take a split dose of Lantus (basal insulin) 15u a.m. and 15u p.m. (just upped from 10u and 10u because a flare of other chronic conditions were causing my BGs to stay high)
Carb bolus of Novolog Breakfast 1u:5g carbs; lunch, dinner and snacks 1u:10g carbs
Correx bolus of Novolog 1u:20mg/dl that I am over my target BG
You will find that everyone has different numbers and takes different amounts of insulin. This really is a designer disease where each one of us is a designer original. Hope this helps.
Wonderful that you’ve gotten things under control quickly.
Fruit can be tricky for many because fructose hits fast. If you want a better indication how fruit effects you, try testing 30 minutes after eating fruit, if you don’t eat fruit with a meal. Except for small amounts of berries, fruit sends me sky high.
Your post meal numbers (without fruit) are great, so you appear to have your ratio correct–congratulations! I would increase the Novorapid when you eat fruit, but do this slowly by half units. You don’t want to overdo & have a low.
FYI–people often have different carb: insulin ratios for different meals, so don’t be alarmed if this changes. Many need more insulin in the morning (if dawn phenonmenon is a problem), less in the afternoon (when we’re most active) & more for dinner (typically the heaviest meal when we’re least active).
Fasting: under 100
Two hours postprandial: 120 or lower (not that I achieve this!)
Welcome Eva! Glad to hear that you are doing so well with you diagnosis. We all know how “life-changing” this is-- so feel free to ask ANY questions!
When I eat fruit (or any other low fat, low protein, fast-acting carb), I give the same amount of insulin, but I wait 15-20 minutes after giving the insulin before eating. You need to be careful with this as it can make you go low before eating. Perhaps start but just waiting 10 minutes and see if you numbers are better.
I actually give my insulin early for almost every meal. If my blood sugar is under 100, I wait 10-15 minutes, if it’s 100-140, then i wait 15-30 minutes, if it is 150-200, I wait 45 minutes, etc. This has helped me manage my blood sugar a lot.
I use Humalog insulin which should be similar to Novorapid. Most people find that the insulin takes 15-25 minutes to start working, even those these are “rapid” acting insulins.
I aim for not having any diabetes-related complications. Unfortunately, there is no way of telling. There is no test. The best test out there is A1C. But many diabetics end up with complications despite normal A1C. Studies show a strong correlation between variability and complications. There is no lab test for variability. The only way I know how to measure variability is with a CGM. This is why I got a CGM. The CGM allows me to keep my bg in the normal range most of the time. Most likely you did not expect to solicit this answer with your question. Let me give you the unphilosophical answer too: Your numbers are great. No need to worry at all. Even with CGM I have a hard time achieving these numbers. You might still be in the honeymoon phase and good control might become harder to achieve eventually. But you are off to a good start. Keep it up.
That’s great advice from Kristin, waiting 15 minutes or longer before eating after injecting. I was going to ask what your premeal blood sugar was because if it’s above 100 I would think your long acting insulin needs to be raised or you need to adjust from your last meal. As far as whats normal, you can just google it…as for me I aim for 100. Of course anything less then 140 is fine and anything less then 180 isn’t horrible but means you need some adjustment somewhere.
Eva – Your interest in the details of diabetes care will serve you well going forward. It will seem like a lot to learn but that more you know the more freedom you will enjoy.
As others have said, everyone one’s metabolism is different. And even in one individual things change from day to day.
My blood glucose target is 110. If I range up to 140 or even 160 two hours after a meal, I am OK with that provided I drop back to the 110 neighborhood 3 1/2 to 4 hours after a meal.
With the help of my doctor I have adjusted my insulin to carb ratio depending on the time of day. I use 1:4 insulin:carb in the morning. During the afternoon I decrease the ratio to 1:8. Late in the evening it’s 1:9.
One of the most helpful things that I’ve learned is to always be aware of how much “insulin on board” you have. This will help you to adjust your meal and correction doses appropriately.
Before the modern insulin pumps started calculating this number for me, I would approximate that my meal (or correction) dose of rapid acting insulin (I use Novolog.) would play out over three hours. (Some people use 3 1/2 or 4 hours.) So, for example, if I took 9 units of insulin to cover a meal and I tested my blood glucose two hours after the dose and meal then I took into account that I still had 3 units of insulin on board.
This really helps from overdoing on any correction doses.
At any rate, your numbers are great. I wish my numbers always came up that well.
Keep up with your learning about good diabetes management. It will pay off down the road. Good luck
Same here, Sarah. These are my targets and optimal targets for all of us, but Evamaria, don’t freak out if it takes you a lot of time or effort to get there. Your body and your brain have got a lot to figure out together!
My specific targets are to be no higher than 140 at 1 hour post meal and no higher than 120 at 2 hours. The rest of the time, I’m striving to be in the 90-100 range. In reality, I reach the 160-170 range after meals more often than I should, but it’s something I’m working on!
Im currently taking lantus 16units at night, they had me on 24 and then 20 when i left the hospital but ive decreased it first to 18 then 16 because of night time hypos. When i wake its usually low, so i think the 16 is okay for the moment…only time will tell. do you split your long acting dose? or all in one go?
I agree that this forum is great, loads of great advice!
Thanks for your reply, its really great to ‘meet’ someone recently diagnosed as well…its an adjustment isnt it!
Thanks for all the advice guys! It really helps to hear what other peoples experiences and targets are.
Had a pretty bad blood glucose day today: which i attribute to a latte (for which i gave no novolog) had to give correction of 1 unit after
and a fruity tea bread along with lunch (for which i gave a total of 5u…not enough…very heavy bread)…had a reading of over 200 after that lunch…not good! so gave correction dose of 2units…then had hypo…my oh my!
Oh well today was experimental…or lazy i havent decided how i feel yet! im going to miss those enormous caffe lattes…
Think ill be aiming for 100-140 before bed, 80-100 on waking/pre meal, 140 1 hour after meal, then 120 2 hours after meal…im hoping i dont have to low carb but if i cant control this and eat the way im eating then low carb it will be–whatever it takes! (hopefully it wont come to having an ‘atkins’ approach to life)
Im also very interested in this giving the insulin 15 mins before meal, i will try this tonight,
Thank you all very much,
Caffeine does seem to raise BG, aside from the milk or anything else in the latte. You can try decaf & ask them to make it with cream, which has fewer carbs than milk. Hard to give up the things we enjoy.
Do you know what your correction ratio is? Those swings from high to low are the worst.
I guess everyone is different. Your post prandials are fabulous! Since Novolog takes four and-a-half hours to leave DN’s system, we could only dream of reaching numbers like that. We aim for 160 two hours after eating if we are home and watching her, but even at 160 two hours post, we will be feeding the insulin in the third hour. At school, we are forced to accept a 200 two hour post, and she will be in the 80s or 70s when the insulin wears off. We will be trying Apidra soon for that reason. I would be more concerned with lows with the numbers you described, unless you are using Apidra which wears off in two hours, maybe three. Great numbers. I wouldn’t change a thing!