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[IPk] Re: High bgs 2 hours after meal



Hi Laura,

It's hard to be sure, but it sounds as if you are
absorbing the carbohydrates you eat faster than the
insulin is working - so your blood glucose levels
shoots up, and only later the insulin you took for
the meal is bringing down your blood glucose. Some
possible things that might help are (i) take the
bolus a bit earlier before you start eating (I find
less of a post meal high if I take my breakfast
bolus about 15-20 minutes before eating), (ii) try
changing to a different insulin which might act
faster in you (various people have found differences
between Humalog, Novorapid and Apidra, but not the
same in all people), (iii) try using a superbolus -
the basic idea of the superbolus is this: for
example in your case, it looks as if you are
bolusing the right amount of insulin for the carbs
you eat, but it is acting too late - the superbolus
is a way of getting more insulin acting sooner -
currently in the 2-3 hours from the time you take
your pre-meal bolus, you get the bolus (say 5 units
insulin) which is injected at the beginning, and the
basal (say 0.8 units/hour) spread gradually over the
time, so over 3 hours, you have a total of 5 + 0.8 +
0.8 + 0.8 = 7.4 units of insulin, and it seems as if
over the whole 3 hours, you are getting the correct
amount, but you need more of it to act sooner - one
way to do this is to take not only 5 units as bolus,
but say 6.5 units as bolus, and reduce the basal
accordingly over the next 3 hours to 0.3 units/hour
- so over the whole 3 hours you get the same total
amount of insulin, but you get more of it early on,
so the effect should happen faster, and no, it is
not a crime not to inject exactly the correct amount
for the carbs you eat and to switch between basal
and bolus (insulin in your body doesn't have little
labels saying basal or bolus, and your body doesn't
know the difference and will just use it as needed
when it becomes available). I started doing this on
the suggestion of my diabetes consultant, and it
works very well for me, particularly for meals with
a lot of carbs and little fat or protein - not
advised for a meal of a lot of protein and fat. For
a more official and formal and detailed explanation
(and if you want to see that this isn't just my
stupid idea) see
http://www.diabetesnet.com/diabetes_technology/super_bolus.php.

Good luck

Nanette
>Hello, i've only been on an insulin pump for 2
weeks now but i've always had
>this problem, even on injections. After i have a
meal, my blood shoots up
>sometimes right up to the 20's and particularly in
the afternoon it's still
>high at 2 hours after the meal, usually around 16.
It always comes back down
>by tea time though. I'm really not sure what i can
do to help this but it's
>really frustrating cos i'm trying very hard to keep
my levels at a decent
>level to improve my hbA1c and these aren't gonna
help.
>Thankyou
>Laura
.
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