Just wondering what other people do (or don't do) to avoid post meal bg spikes. Seems it doesn't matter what I eat, I get the post meal spike everytime. BG usually comes back down before next meal, but those 250's after every meal are really frustrating. Since getting the cgm several months ago this problem is more recognizable. I want to have those nice flat lines or maybe even gentle curves, anything but the spikes. I've tried the low GI plans but they have little effect. Anyone have suggestions?

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I have this problem too. I find pre-bolusing helps. Use your CGM to find out approximately when insulin starts hitting your system - for me, it is two hours with Novorapid/Novolog but I have recently switched to Apidra which I much prefer as it's quicker in, quicker out. I also find that the smaller the meal/the less the carb, the smoother the line. Though even zero carb doesn't always help me as I can easily go above 140 on a small no-carb meal (like 2 eggs). Bigger no-carb meals (say 2 eggs+bacon+sausage) can easily send me above 180. I have to laugh at suggestions that reducing carb can iron out spikes. How do you subtract from zero?
Depending on the meal, dual wave bolusing helps avoid that, especially if the meal has a lot of slow-digesting carbs. The biggest thing that has helped me, though, is just limiting my carb intake. I too can easily spike over 250 after a meal with a moderate amount of carbs. Also, sometimes bolusing a bit earlier helps too (like 20-30 minutes before eating).
I have the same problem. I just can't give up carbs.
Pre-bolusing up to 30 minutes before eating has worked for my son...now that is when he remembers to do it :)
I have tried the pre-bolus, I use it especially for eating out (nothing like resturant food to shoot you through the roof). Sometimes the prebolus backfires though. I bottom out before the food arrives and need to eat quick carbs to bring it up - then the food arrives...so in essence I'm "double eating". The bolus seem to work super fast if I'm low and take at leat two hours if I'm high. Why is that? Anybody not eat until their numbers are below a certain level? Does that work?
I usually won't eat at 150 or above which doesn't seem to speed the correction but does prevent further spikes. I eat a great deal of fat as part of my meals including peanut butter, almonds and olive oil which slows things down. Have you checked your basals recently? If your total daily dose is correct but you're taking too much basal, you'll have a tendency to go high first and then have the extra basal slowly bring you back down. If you cut your basal and take a bit more bolus, you'll have a quicker response on the front end.

Maurie
The bolus seem to work super fast if I'm low and take at leat two hours if I'm high. Why is that?

My endo told me that increased insulin resistance is one of the side effects of high blood sugar. In other words, the higher your BG is, the harder it is to bring it down. Groovy. :-/
I have also heard the advice that when adding in a pre meal correction, you should account for the correction not only the dosing, but in the timing. So if you are high before the meal, you should add the corrective dose to your carb dose and take your bolus earlier, 15-30 minutes before eating. If you are low and will subtract from the carb bolus, then you should bolus later, even after eating. Has anyone else used this technique to reduce meal time spikes?
Yes - for highs 140-180 about 20 min over 180 about 30 or 40 minutes early dose. For lows, we will use a combo bolus over 30 minutes. When I have tried delaying the dose for lows, I would sometimes forget the dose until my CGM reminded me - I find a 30 min comboi bolus 0% now works well.
how much are you bolusing at once? I find I need to pre-dual wave bolus for most of my meals. I run into troubles when I bolus more than 2 units at a time. My I:C ratio is 1:5 so, depending on what I eat, I could be bolusing up to 12-20 units for one meal. Depending on a number of factors, such as current BG level, amount of carbs I plan on eating, when I plan on eating, I set the dual wave for 6 or 30 minutes.

My insulin works faster with the dual wave for some reason. It might be that a single bolus of 12 units causes a reaction in my tissue that keeps it from being absorbed properly. When I was on MDI's I would inject 2-3 units 4-6 times in different places all at once to get the proper dosage without over-doing one area.

I've also had it bite me in the butt and drop too low when the food comes out too late or the insulin acts too late if its a last minute decision on going out to eat.
I have a real problem with consistency, especially in the morning. I can wake up at the same time, very similar waking blood sugar, identical breakfast and bolus (about 45 minutes before eating), same post-breakfast exercise. Today my reading 90 minutes after eating was 52. Other days it is as high as 250, with an identical breakfast and exercise. Not sure why.
I agree with what most of the others said. Definitely find the right time to pre-bolus. Find out if there are some foods you just can't eat and bolus for accurately (for me those are cereal, pasta and rice). If you are high before your meal either correct and wait or just add the correction bolus to your mealtime bolus.

Also, if you are always high after meals it sounds like your I:C ratios need tweaking.

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