Spikes

Hi everybody
Can anybody help me with how to get my glucose levels below 7.8 an hour after eating please?
I am in pre-conception care
Pump user
Cut my carbohydrate portions down to below 50 grams per meal
No matter what I do it just doesn't seem to work!

Any advice greatly appreciated.
Many thanks

Not on a pump, but the bolus dosing principals would still be the same I believe...............

Its all about timing, you should consider extending the time between dosing and eating in order to allow the insulin to get started.

However there should be other options available to you like the dual wave function etc..........so you can take a portion of the dose straight away then have the rest delivered over a certain period etc.....

As a non pumper I am unfamiliar with the effectiveness of these functions and everyone is different obviously.......

First step would be to give your dose 15 minutes at least, before you eat, increasing if the spike is too high..........and remember meals with high fat content, like pizza can have a delayed output of glucose....this is where the dual wave function could come in handy..........but I suspect your diet will be low carb and healthy seeing as you are trying to conceive...........

How long have you had the pump and do they have these functions..........?

Hi
Many thanks for your reply.
I have never heard of dual wave function but even the thought makes me want to run away!
My diabetes management has turned into a full time + job. All I ever do is analyse food and my brain can't take anymore. I have been on the pump for 5 months now. I am not sure if the function you mentioned exists on it but I know that you can add a temporary basal to cover events like eating something like pizza. To be honest, I do not really know which foods I need to do that with so I have never used it. I have only started to test post meal this week because following DAFNE I was told to only check before meals. I have no idea which foods do what to me really. I was eating anything I wanted but have cut this down greatly and eat healthier now.

The idea about the timing sounds like something I am happy to try, I will try with my tea tonight and see what happens. If my levels are lowish (e.g. 4) before eating though would this still apply or would that just make me hypo?
Thanks

I would of assumed you had been told about your pump and its functions, and now that your on a pump you can literally keep your levels on target all of the time, its takes work but it is possible...............what were your reasons to go on the pump........

the dual wave can help if your meal is not going to be releasing its glucose as fast as your insulin will be working, these events can sometimes cause hypos an hour or two after eating then highs some time later...........you should speak to your team about possible scenarios of when these functions could come in handy especially in pre conception stages...... That is if they exist on your model of pump. The temp basal is good for times like these too I suppose and if your ill or when your exercising......

regarding the low readings before your meals, most would be uncomfortable to give themselves insulin at those levels and wait before eating, but I have done it, the insulin does not start to drop you blood for a good 10-15 minutes anyway..........as a non HCP I would say try it if the opportunity presents itself, as long as you have hypo resolve to hand just in case..........

with the right training, which as a non pumper I would expect you to have had, control can be as tight as a ducks bottom............

I have attached my results from today which show my lunch time dose going in a 11:20, I then start eating at 12:00, so 105g of carbs, which is a good whack. My highest spike is 8.7 just over an hour later, then it drops back down. Not every meal will behave the same, so that will take time to get experienced with what food/combination of food needs what extent of time..........

I have had no training so far, I know it's crazy but I am attending a trainiing session in May! I will have been on the pump for 7 months by then. I was shown basic functions and have found out a bit of info myself.
I was told that the pump is just another way of delivering insulin and that it still takes a lot of hard work and is not the answer to give me perfect control. It was advised I go on the pump because my sugars were rising every morning and the injections couldn't control it (Dawn rise or something). I must say though, the fact that I now have a glucose metre which links into the pump and then I can upload it all on to the PC is great because I can just send the reports straight to my nurse to review (just getting them to reply is the problem ha ha).
How do I know how fast the food releases glucose? Is that the GI?
I have taken my insulin 15 minutes before my tea today, I had a hypo just before that but treated that and then took my insulin! I will see what happens in an hour.
Looks like I am going to have to start logging what I eat and what happens an hour later then

Yesssssss!!!!!!!!!! 7.5 Whooooooooo
Thank you for your advice!!!!

Spoke too soon gone up to 8.4 two hours later

8.4 isn't bad though, just means you need to tweak the timing a bit more, the results you have recorded are very valuable, so well done.............

You could start logging what you eat, but you wont need to have a different timing for every single meal, you should just get a rough feel for what type/groups of food might require longer/less time injection before eating....

It has shocked me that you have been no in depth training on how to use the pump, because it really ins't a walk in the park from what I have heard. Its seems like an expensive thing to be giving people that cant use it to it full potential, not that you are not, just i general.



I am once again surprised by how easy you got it, I live in Scotland you see and you need to sell your soul to get a pump up here. I too suffer from Dawn Phenomenon, but was never offered a pump...........I think things are changing soon though.........I would love one.......

The GI is how fast an item of food is digested and delivered into the blood as glucose, low GI will be slow and not have a noticeable effect on the blood sugar, so things like yoghurt amongst many others. White bread though is higher and hits the blood fast, so ideally having low GI foods more often makes diabetes management much easier. So with that in mind, you can then think about how fast or slow your meal will be and adjust timings accordingly. It may seem like a lot to think about, but the best way to learn about your specific needs is to test and record, test and record. I assume you record all your BG, CP, QA, BI etc.....?

Did you take any readings after the 8.4?

Thanks for this.

That's true, I can't use it to it's full potential! I was really nervous when I first got it and didn't have a clue what I was doing to be honest. I am a lot more confident now but haven't explored it more than the basics.

I was told that every young person is encouraged to go on the pump now, I am not so young (32) but as I am planning a pregnancy this probably also went towards my case. I had my eye check recently before the pump and the Optician was horrified that I was not on one and said I encourage you to get one straight away and explained about the difference he sees between patients with and without a pump. It is very unfair that different places get different services when it is something so important.

Thats really helpful what you have explained about the GI, thanks. Yes I record all my information, the pump does it too.

My readings last night post meal were:
1 hour 7.5
2 hours 8.4
3 hours 9.3
4 hours 7.9
5 hours 8.2

I do not always have them so high 5 hours later but I do not seem to have a consistant pattern. Some days I have perfect control and others I can't find an explanation as to why its risen.

They results are really good to be honest, yeah you were above target after 5 hours, but not much, and considering you started off higher (7.5), the 8.2 is within most blood monitoring meters error margin. An important fact to note though is that because you considered the timing of your dose, the spike you got was significantly reduced. This is good considering damage to the micro vascular system, which is increased with up and down [yoyoing] results..............

So we want good numbers as well as minor fluctuations to those numbers...........

If your confident with you carb count the majority of the time and you still get inconsistencies, then you could consider doing some basal testing, by the hour if your up for it, as with the pump the basal dose can be tweaked by the hour, so in theory, 24 basal rates programmed in............

Keep up the good work.......