Where should BG be 2 hours after eating carbs?

Novolog and Humalog are in the same ballpark.
For me, novolog seems to work better, others say humalog works better.

It may be I tailored food choices and timing of bolus/extended bolus to work under Novolog. Then insurance switched to humalog, and bgs got worse. So I prefer Novolog. But if I tweaked my settings/timings, I might get equivalent results under Humalog.

Some report they switch between them, without noticeable difference.

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Interesting theory, that your self-adjusted to Novolog. Itā€™s also my preference. I think Humalog feels like water in comparison, so Iā€™m always surprised to read when someone has a preference for Humalog. But maybe itā€™s just thatā€¦ Maybe weā€™ve all just learned to dose better for one than the other.

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In my early days with higher A1Cs, I was switched regularly by my insurance formulary without noticeable difference.

Once I had improved A1Cs (with Dexcom), then I noticed the difference when switched to Humalog.

Current formulary is Humalog again this year, so hoping there is a new ā€œcashā€ discount program for novolog. The $99 deal was great last year.

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:smiley: Iā€™m sure one day Iā€™ll be doing the same - Iā€™m just holding on to my bread and pasta and rice for as long as I can! It is exciting when I see my BG turn around nicely without any effort when Iā€™m on a protein meal - i definitely see the temptation to switch. That said, I feel I should be able to enjoy and eat what I like (in moderation of course) and be okay with insulin because what is life without being able to enjoy food.

I think i read somewhere that the average carb intake a day is 300g, Iā€™m sitting around 80-130g so it isnā€™t that high in comparison. But if you are on a low carb diet taking around 20g, then yeah, Iā€™m taking in a lot of carbs :smiley: But I take your point.

Iā€™m trying to find exactly what it is that is spiking my blood sugar during breakfastā€¦ i donā€™t eat very much in this meal but i find I bolus the most. Typically every morning I also have half a cup of milk. This week Iā€™m going to eliminate the milk and see whether my sugar is any better as I have a suspicion the milk is making my sugar rise faster.

Oh is Novolog not preferred? :sweat_smile: I donā€™t know, my endo just said take this when I had to change insulin. I think Iā€™m going to ask to try humalog to see whether my body likes it better. I find novolog ineffective at times and can be quite harsh on my BG when its dropping - i find when its dropping, I end up dropping very quickly. I donā€™t recall having it drop so quickly with apidra. Here in australia, our insulin is subsidised so Iā€™m not bound by brands ā€¦ only bounded because the damn pump only supports humalog or novolog.

What would be game changing is when insulin is actually ā€œrapidā€ in that it works immediately, not the 20 min wait - of course it needs to work with the pump too!

I hope that one day insulin brand is not restricted by insurance for you folks- thatā€™s terrible. Digressing a little here, how much are you guys paying for insulin with insurance and how much insulin are you getting for that (eg 25 pens/vials)?

Great thanks! I know there is going to be of variability because my toast and your toast are not the same and also depends on what you put on the toast too. But for benchmark, Iā€™m using wholemeal with a light olive butter spread.

Last nightā€™s test. Iā€™ll run more tests today, but I woke up high (I lowered my basal overnight a tish because I have severe low the night before - prob shouldnā€™t have done that). I have a bunch of correction on board so I canā€™t run one this morning. Youā€™ll see very different results out of me in the AM. Iā€™ll edit this comment and post more as I get them.

It was a piece of toast with butter on it. Took 2 units of Humalog.

Hereā€™s a 2nd bread test in the morning. Notice how much more insulin is required.
But, I ran out of normal bread and only have texas toast (25g per slice). I should have taken 10 units upfront. If I ate that 25 grams in the evening, it would have only required 4 units.

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Back in 2012, when I started to use carb limits to improve my metabolic health, I did start out with a daily target of < 30 grams/day. But I loosened those limits over time to 50 grams, then 100 grams. When my glucose control worsened, I eventually returned to < 30 grams/day.

I think that every person is different but I do believe that in every T1D there exists a threshold of daily dietary carb consumption above which significant BG control is lost if exceeded.

While Iā€™m not here to persuade you to commit to dietary carb limits, I highly encourage you to experiment and using your CGM observations, decide where that carb threshold exists in you. Maybe itā€™s not at < 30 grams but instead at < 75 grams in your body.

When you identify that level, whether you decide to stay below it or not is completely up to you. At least you will then know that a metabolic ā€œsafe harborā€ is available to you whenever you need it.

I personally understand your reluctance to give up foods that you enjoy. You grew up with them, identify good times when eating them, theyā€™re a part of your cultural heritage. Food feeds both body and soul. Iā€™ve learned that a personā€™s diet is sacred to them and suggesting any significant changes is akin to suggesting that they change their religion or political affiliation.

Good luck with your diabetes management journey going forward.

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I try to have my glucose level down under 140 within about 1 1/2 hrs. I eat about 275 plant based carbs daily, but I also eat very little fat. I also ride my exercise bike after breakfast and lunch for 1/2 an hr. I feel that the exercise benefits me in many ways, and being retired, I find it easy to do.

I have much more of a problem with hypoglycemia than I do with hyperglycemia.
I donā€™t take much more insulin than when I was eating 30 carbs daily. My A1c is usually around 5.2.

Finished breakfast at 6:45. At 8:00 am I am testing 92 and going down. I ate oatmeal, with part of a banana, a medjool date, and a cup of blueberries. I am a type 1

:sweat_smile:
Thanks for testing that out, sorry to send you high in the middle of the night.

Wow you did well with the bread! Literally no spike at all and it did fall back down 2 hours later - so different to me. Your high in the middle of the night is probably as a result of the yogurt since I donā€™t think the bread would have given you a delayed rise. Your body tolerated the carb well within the 4 hour window.

Iā€™m battling with a bit of a high this morning from my bread. Its stuck at 200 steady arrow for a while now and wouldnā€™t come down despite several correction boluses.
Iā€™ve just hit it with another unit of insulin. urghā€¦ :face_with_head_bandage:

Milk is guaranteed to make my BG spike. I even use it to treat lows and it will reliably raise my BG from the 60ā€™s to the low 100ā€™s from 8 ounces of milk. Itā€™s pretty typical to need a lot more insulin in the morning for food than at any other time of the day. I usually skip breakfast from personal preference but when I do eat in the morning I need more insulin to cover the carbs than I would need for dinner.

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That overnight high is not from the yogurt. Its from a bad basal rate.
You can tell because the yogurt should have stopped raising it within a short period of time. But, it continues to raise throughout the night, despite the fact that I take correction in the middle of the night.

Iā€™m working with 0.10 units per hour overnight. Its a very small amount.
If I eliminate 0.10 units overnight, then we see that high pattern.
But, if I increase by 0.10, then I see lows.
So, Iā€™m having problems similar to you.
Thereā€™s no happy medium. Its making me furious.

But your sugar never came down from that bolus. Could it be that the bolus wasnā€™t enough so that once it got to a certain high, itā€™s stubborn and wonā€™t come down? Plus your basal was too weak which made it even harder to come down. Once itā€™s high, a correction bolus can be like water and not be able to move your bg down. I get this all the time. :sweat_smile:

Your basal change is so tiny is it able to drift your bg like this?

I had to go gluten free and as a result do not have as many carbs. My A1c improved and l also didnā€™t feel as foggy

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Your correct that this is indeed fishy. I have no explanation for this, but its strange indeed. Last night, I bumped it back up 0.10 and went low all night long. Its black magic. It makes no sense and its not supposed to do this.

I feel for you!

Iā€™m assuming your yogurt on BG is tried and tested and consistently gives the 50 point increase? Itā€™s hard because sometimes the same food will produce a different bg rise for me.

Seeing your basal increase is so tiny i immediately thought if this was my chart this was more a bolus problem (probably because for me when there is a spike after food itā€™s usually the bolus that Iā€™m battling with)ā€¦ the basal also contributed to it making it that much worst.

I can see why you would assume that. I have no valid explanation for whats going on, so thatā€™s as good of a guess as anything, I suppose.

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I found that after a while (years) Novolog stopped working as well as it was (I was needing bigger & bigger doses). I switched to Humalog whichhas worked better, and still does years later. FIASP worked great for me for a very short while, now it has little or no effect. I have a history of quick habituation to various drugs, which may or may not have anything to do with it.

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Extended bolus-I went from injections to the Tslim and just assumed I would want the whole bolus right away.I pre bolus already. At DrBBā€™s suggestion I tried the extended bolus and find it very effective. I use it every meal now. I do wish the setting was more obvious. I find it easy to skip it inadvertently.

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There is another post here, about pasta, and it seems many are using an extended bolus for that too.

Iā€™ve only used an extended bolus, with great success, for pizza (or high fat meals) or a Thanksgiving dinner.

Iā€™m going to have to rethink how often I use an extended bolus!

Thanks so much for your input!

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