Well, for reference, the dinner I had prior to that spike was just steak, butter and coconut oil. So, not sure giving up carbs would even be the answer…but IDK. Thanks, I’m envious of me flatline too LOL I wish I could get that all the time. Today, totally randomly, I did my usual coffee only before boxing first thing for an hour, REALLY felt weak and tired, got home and my sugars were in the 20s double arrow up??? I ALWAYS am either steady, or trending down during and after boxing, but today no change in my routine and random spike. It’s so frustrating!!!
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I’ve never heard of Toujeo. I’m going to enquire about it. I didn’t like Tresiba, and Levemir was like I was injecting water…constant highs. Lantus worked, but I feel like I was gaining weight while on it and IDK if it was the Lantus or some other factor, but I wasn’t willing to wait it out to find out.
I had been on Lantus and also tried Levemir too. I definitely think I metabolized them before that 24-hour window. Toujeo has been different. Much steadier. After noticing how much better I responded to Toujeo, I even gave my brother all my old meds. It’s been years since then.
I think my endocrin. had mentioned Tresiba as a possible change now, but I’m trying other avenues before switching insulins.
I haven’t read this entire thread, but your comment ringed a bell! I also have these spikes several hours after dinner! It could be related to high fat or protein in the meal/snack which can take a very long time to metabolize. I usually end up give myself corrections about 2-3 hours after dinner to stave off any spike.
Also, I reliably get spikes in the middle of the night if I eat nuts for a snack prior to bedtime. These spikes are definitely associated with the 4-6 hours needed to metabolize the nuts. I don’t take any insulin for the nuts when I eat them as a snack since they don’t effect me 'til hours later. I usually rely on Loop to auto correct me. But if I eat too many, even Loop won’t be able to keep up w/ those NUTS! I will then manually enter carbs and estimate a bolus for an estimated absorption time. I probably should do this when I eat them! BUT I never PLAN on eating as many as I end up eating!! 
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Uggh, my blood sugars have been tea high since boxing this morning where I felt so tired and out of steam and I just started dry heaving. I have 2.0 blood ketones. I wonder if I am DKA AGAIN!!! I cannot believe this. Calling nurse line now…
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Yikes! Hope everything turns out okay, please update us as soon as you can! You’re in my thoughts and prayers.
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Thanks, I was able to get my ketones down lots of water w electrolytes and insulin, talked w my Endo and have a plan to try (new settings) and him monitoring my pump and dexcom data for the next week with a follow up appointment. I’m really hoping he can help. The stress of all of these issues is probably making everything worse. Sooooooo glad I didn’t have to go back to the ER for a 3rd time in less than 2 months!
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Where the hell do you find an endo willing to do that? Sounds like a good endo.
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Trying, I definitely think it’s the fat content in my diet results in delayed spikes. I like your idea of waiting to take a bolus when eating something fatty, but my goodness I know I’d forget.
I had a really difficult day today and forgot to take a bolus for lunch. Was out walking the dog when it occurred to me. Tested myself and oops… I was 304. Went straight home, took insulin and drank lots of liquid. Right now, I’m done with dinner (salmon and only 15mg carbs) and at 87. Let’s hope I stay steady.
PP777, oh no!!! I hope you’re okay. Glad you avoided a visit to the ER, but it sure seemed you were close to it. Thank goodness for your caring endo. and making some plan to take control. I know boxing is an important & regular activity, so I hope that’s factored into your energy level.
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I hope you even out! And thanks, I’m glad things worked out too and that my Endo is being helpful.
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My dinner last night. Estimated about 5 carbs 
the dressing was a 0 cal/carb Walden Farms and I figured mostly the carbs were the berries. I took 1 unit and walked after dinner. Worked out, but I had a low middle of the night and another in the early morning. I think that’s my basal though.
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@Jubilee, I frequently experience the exact same thing as you describe. I tend to eat around 7pm or later and am often awakened about 1pm with a Dexcom high alert. Then it’s a total guessing game what kind of correction to give because I’m never sure if what’s fuelled the rise in the first place is still doing so. I often get it wrong and end up hypo 2 hours later. Also throw into the mix that I do HIIT at 5pm most days and it makes for a situation in which predicting outcomes is very tricky. I’m at the point where I’ve decided to make the evening meal low/no carb and will see how things pan out over the coming weeks.
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My last night’s dinner was SO well balanced that I never needed a bolus. I checked all evening: 187, 188, 186, and so on.) I was thrilled. Even at my late bedtime, I was only at 144 and took 2 units for which I took 2units of insulin to cover. No lows throughout the night. 
All was fine on my CGM until 6:00am, when my blood sugars rose and rose until I woke up. I usually give myself 1 1/2 units to cover my pre-dawn effect. (My husband thought I could use the added sleep given yesterday’s upsets.) I didn’t detect that rise until I was at 187 at 9:30am!!! Ugh! And so my highs began. I added extra at breakfast, then lunch was at 167. Took my usual dose, but added a walk. Now at 88 with a downward arrow on my CGM. Ugh! I’m thinking a tiny animal cracker cookie could fix that, since I know it won’t take much to settle it. It’s so tempting to add more, but I know better. Balance, balance. Balance = to avoid that dreaded roller coaster!
Bananaman – One lesson I learned was that I should cut back on my fat/carbs at dinnertime. (i.e. no ice cream – darn. And if I do, expect a delayed rise.) Not cut back completely, but for sure try to avoid those evening highs that require 7+ units! Those high numbers and insulin responses are usually fine with my system, and I’ve handled them plenty of times, but that’s not good for my longterm control. Better instead to really think about the carbs AND fats which don’t show up until hours and hours and hours later. I set my iPhone with alarms to remember to test/bolus. (PS, I used to have a Dexcom, but hated those middle-of-the-night alerts because it took another hour of alerts before it was acknowledged. To me, I’m used to keeping a low number profile since I was diagnosed as diabetic when I was pregnant and it was SO important to stay low. Now I use the Libre 14-day instead. At least with a CGM, I have never required my husband to wake up at 3:00 or 4:00 and plead with me to drink some OJ.)
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I have far too much experience with this, as Lantus was the bane of my diabetic existence for the longest. I hope it’s just the rate you’re at, and not the basal itself. I had so much trouble trying to find a sweet spot with my Lantus dose, and I never got that. I thank God I was able to get put on a pump because long acting just never really wants to work the right way for me. I had control, but I would always wake up around 3-4am because my Dexcom was singing me the song of its people. 
Definitely work on fixing your basal rate, though. I learned on here that if your basal isn’t right, nothing else will be and it’s true.
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My son will eat tons of carbs but his day-to-day is quite erratic. So if he eats ricotta pancakes for breakfast, that’s like 70 to 80 g right there. But then he also likes eating those sausage patties, which has 0 carbs.
We don’t restrict carbs though. He needs them to grow.
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As you know, we are the same. Liam eats anywhere between 100 and 250 carbs per day as he eats what the rest of the family eats and we bolus for them and move on with our days.
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That’s definitely an endo question. It would scare me, terrify me, for that to happen yet I think it probably has happened in the past when I was too young to test - I just felt bad and didn’t know why. At 20 (well, at 16) I’m heading for the ketone test device. It’s a symptom of failed basal for those of who use a pump; doesn’t happen on MDI with a basal insulin, which is part of the reason many people don’t like pumps. I don’t know if you use a pump but if your do a temporary blockage might explain what you experienced.
It is scary. I’m watching my wife who has, over the last few months or so, started to show all the symptoms of high and low bg; she tests because of her family history and the availability of test strips from me. For her it is scary because she has seen what happens with me and knows what is going on, for me it is scary because I don’t understand what is going on with her (she has an HbA1c of 6.3% with a family history of T2).
For other people, people who don’t have to deal with this or can simply dismiss it as old irritable people, it’s nothing to worry about; I get tired, sometimes I’m a bitchy, right, what’s to complain about? But my feeling, watching my wife, is that she is going through things now that, back in the early '70s, I felt too but didn’t have the faintest ****ing understanding of what was going on. So I’m scared.
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What about using an extended bolus for foods like that? Same as many people do for pizza because of its higher fat and carbs.
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Beacher, Thanks for confirming what my thinking. I always, always end up giving myself another added bolus every evening. The only time I didn’t need to do that was when I had so few carbs the other night, but then started the next morning at 187!! I decided to eat as I want, test and give myself an appropriate bolus, and wake up, as I did today at 92.
Even though, it surprises me how much I insulin I need to add at 11:00pm to cover a meal that I finished hours earlier. Example: last night’s dinner was salmon cake, corn, and toast. Gave myself 9.5 units, but BS started to go up and gave myself another 7.0 units. At bedtime, I was at 144 and gave myself another 2 units! Same routine the night before that consisted of a whole wheat wrap with a Tbs beans/rice + 1 Tbs cheese + 3 oz. fried/breaded pork + onions).
I struggled to figure out what I’m doing differently now compared to 2 years ago when I gave myself only one bolus of ~10 units at dinnertime. Herein lies the difference that may explain it: CGM. Back then, I think I’d discover my super high number at bedtime and bolus so much that occasionally I’d have many overnight lows. Those graphs have made all the difference in my control. At least that has changed and I haven’t had any LOWS in the middle of the night. Now if only I can figure out the evening cycle better.
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I find good fresh sweet corn to be very glycemic and pre-bolus 30-40 minutes before eating it if I can. But after the mild spike I get (last night from 100 to about 140), it starts to come down a bit fast and then I often need to eat a few more carbs because I still have insulin on board. I hope this helps you.
PS I estimate the carbs in an ear of corn to be around 10 percent of the ear’s cooked weight (give or take a little).
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