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[IPk] Post-meal Spikes

I'm having touble achieving a 2 hour post meal BG that's acceptable.
Ideally we should only be a little above pre-meal, say 1 or 2 mm/l,
but I tend to be up to 5-6 mm/l higher and this it too high really.
4-5 hours post-meal I'm back down to pre-meal BG indicating my bolus
is about right.  I can't increase my bolus as this will help me with
my 2 hour BG but i'll go hypo at 4-5 hours.

Page 64 of "Pumping Insulin" talks about this and suggests looking at
timing of the bolus (not too close to eating) and food choices.  I
believe that my timing of bolus (0-15 minutes before eating) is fine
and that my choices of food are fair and reasonable.  The 2 hour
post-prandial highs are "normal" for me and apparently for many
others.  The book says the way to counter this is to program a
temporary basal rate increase and a bolus decrease to help offset the
carb activity.  I believe this should be done to take effect at the
time of the bolus for a period of 2 hours (I'm on Humalog), then the
basal should be returned to normal.

I tried this out, increased my basal rate by 10% for 2 hours at the
time of bolus, and I noticed an improvement in the 2 hour BG for a few
days.  However, this no longer seems to be as effective and my BGs are
seemingly not predictable post-meal.

Note that I did rigorously test and set my basal rates but this was
over a week ago and perhaps it needs to be reviewed as it may be
contributing to my bolus problems.

Any comments would be fantastic as I'm struggling to sort this out at
the moment.


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