I am experimenting with Apidra and I have a question. My goal is to avoid a spike over 120 (I am having stomach issues that seem related to spikes, so the only way to figure this out is to cut them out!). I've chosen two "Foods", the first is a bean/frito/lettuce thing probably about 25 carbs with fats (cheese, olives, oil dressing); the second food is WW toast, 1T honey, 1T butter (prob 50 carbs). (In case you're wondering, I happen to really like both of these foods and haven't eaten them in a while!!) So, here is what happened:

Without apidra on toast meal: starting BG 107, highest point 220 at 65 min, 155 at 90 minutes, was probably back in 120's at 2 hours.

Taking 1.5 unit apidra 5 minutes before same toast meal: starting BG 112, high spike 161 at 40 min, 78 at 120 minutes.

Taking 1 unit apidra with bean meal: starting BG 103, high point 145 at 40 min, 2 hours - 101.

Taking 1 unit apidra 10 minutes before bean meal: starting BG 97, high point 122 at 45 min, 84 at 120 minutes.

Here come the questions....it looks like I either didn't take enough apidra for toast meal, or maybe should've taken it a few mins earlier if I want to keep it under 120...but I'm thinking more apidra would've continued the drop at the end?

The bean meal looked good I thought when I took it 10 minutes before eating. I start to get concerned with BG goes into 80's because I'm SO not used to seeing that, but I guess I should relax on that. I also felt hungry, but not hypo.

Would really appreciate any comments re: timing of fasting acting insulin, higher glycemic foods versus moderate, any other comments are welcome.

Thanks.

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Replies to This Discussion

I can't really comment about insulin, because I'm not taking any.
My guess is that you wouldn't want to take more insulin, because you might drop too low before the insulin action stops working....

So far as seeing numbers in the 75-85 range - those are ranges that I'm able to frequently see if I keep to a low carb diet (though not usually as a PP number)

Thanks KS. I'm glad you replied as I sent you a message a while back. I'd really like to know your daily diet if you don't mind sharing, either here, or in a PM. It's been a struggle for me to maintain weight on the low carb, not to mention it's not a very pleasant diet. I have added an avocado every day which has helped me gain 5 pounds, which is great! I stopped exercising to save calories, but am back at it again. As a former vegetarian, I do miss my beans so much and I really don't like meat. I'll need to decide if the insulin hassle is worth getting a few more carbs. I'm still waiting on Kovler. Both my daughters tested recently and we were surprised to see high BS there too with prediabetic hba1cs. So with my two girls, that makes four generations of diabetics/prediabetics in my family. Personally I think me, my daughters and my dad should qualify as diabetics as our BS's rise above 200. I don't think you can even call us prediabetics as we are normal weight and not insulin resistant. It is a really frustrating thing, but I've told myself to stop focusing on the diagnosis and decide how to deal with the reality.

P.S. From my research apidra is the fastest working/clearing insulin. In my tests, it seemed to begin working at 20 min and cleared 1.5-2 hours when my BS stopped falling and began to rise. I don't plan on using more than a unit, or perhaps 1.5 units if I continue on with it.

I recall a comment along those lines when you sent a friend request...
I approved the request, but never noticed any followup...
Of course, I could have missed something this past month - work has been crazy.

My weight has held in a pretty consistent range since December (152lbs +- 4lbs). I'm less concerned with "weight" and more concerned with "body composition" or "body fat %". If anything I'm trying to increase lean body mass while holding (or reducing) overall body fat.

So far as my Diet - I tend to fall into some pretty consistant patterns.
I end up eating ~6 times a day on average.
Overall, I like the low carb diet (but it was an adjustment to give up rice/wheat/potatoes). I've always liked meat and cheeses - so that makes it easier.

Breakfast (~20g net carbs): Breakfast Smoothie
1/4 banana, 4 frozen strawberries, 6 frozen rasberries, 4 ice cubes, 1oz heavy cream, 1/4 cup Greek yogurt, 1 scoop protein powder, 2 tablespoons cocoa, liquid sucralose (Blended until smooth.)

Mid-Morning Snack: ~2oz of Almonds or Peanuts

Lunch: Large Salad
(Lettuce, Spinach, Cucumbers, Onion, Carrots, Broccoli, Bacon, Sesame Seeds, Blue Cheese or Ranch Dressing)

Afternoon Snack: 1-2oz of Almonds or Peanuts or 6oz Tuna or Atkins Bar

Dinner: Highly variable…but I try to keep it <25g of net carbs Post Workout Snack: 1 scoop Whey protein with Heavy Cream and water, or Lean Turkey and Cottage Cheese

This isn't to imply that I eat this as my meal *every* day...
My lunch is a salad probably 4 days a week. Once a week, I'll head over to taco bell for some crunchy tacos, and deal with a spike to ~120mg/dl.
Of course, the more consistent I am, the more my bg levels like it.

As you are relieved to be putting on some weight, what are your weight targets?

So far, I've been lucky - in so far as my spikes are small (<120mg/dl) if I keep my carb intake low. I've been curious about whether or not I would spike with Honey... but I haven't decided to run a controlled experiment. I still haven't decided when/if I should try to get genetic testing done for my kids.

Thanks for the daily menu; you do a good job of variety and keeping your BG level. Looking at that, it's apparent to me that I need more diversity in my diet. In the past fruit of any kind didn't work for me, but I'm thinking I should try again. What were your high's before going low carb? I'm pretty sure crunchy tacos spike me, but then again that was with beans, and you probably eat beef which I'm sure makes that difference. It sounds ludicrous, but I've seriously considered intense therapy (like EMDR, hypnosis) to help with the meat eating. I gave it up in my early 20's because the idea (dead animals) bothered me so much. Thankfully, I've been able to eat chicken and turkey, but like I said, reluctantly, and I have to keep my thoughts in line. I'm just squeamish, unfortunately. I don't have weight targets per se; I am 5'6" and currently 116. I'm okay at this weight, but if I don't pay attention, I can easily lose a pound or two a day and I'm tired of having that pressure. I bought almond flour, but need to find a recipe to use it. I also tried Splenda this morning in coffee and it was fine. I've been starting every day with 30-50 pt spike on the sugar in coffee.

Regarding the toast/honey, I just found out that WW toast is just as bad as white bread! For some reason, I thought it was lower glycemic (my doctor told me to eat it). So, now I'm thinking the bread as much or more than the honey contributed to the spike.

It is a good question on the genetic testing for kids. Have your kids had an hba1c or glucometer reading after carbs? Whether I'm MODY or not, my girls are experiencing sugar highs. At their ages (20 and 28), they are not concerned and eat carbs all day long! If I were to get a definite diabetic diagnosis, I think it would make them more aware and hopefully make changes in their diets. I also have a son who won't let me near him with a glucometer, so he could also be having spikes.

Thanks again for the menu, it helps seeing a successful meal plan. Also what brand of protein powder are you using? My BUN level has gone a little high due to my new higher protein diet. However, I think the literature I've read said that it is not a concern when it is due to diet versus kidney function.

I had been fairly concerned about adding fruit, and it was a trade off against the 8oz of milk that I used to have at breakfast.
Over time I learned that I can tolerate carbs the most at breakfast, so I started with berries that have low net carbs (rasberry, blueberry, strawberry).
Adding a bit of banana was an experiment, and isn't something that I do all of the time.
(If my fasting is up at all, I won't.)
So far it seems to be working.

So far as my highs - I started cutting carbs pretty much as soon as I got a meter.
The highest that I caught myself was ~190.... Which is milder than most of my relatives. I've been curious if I spike higher - but have thought better of trying to see how high I could get the meter to read ;-)
My impression is that control degrades over time - so it will be interesting to see what my future holds.

So far as my occasional Taco Bell run, there is a difference between beans and beef tacos so far as carb count is concerned...

Weight wise - I'm pretty consistant.
I did have a spell (high stress) earlier this month where I lost 5 pounds in the same number of days. That was a bit disturbing to me - as I was sure that I lost some muscle mass.

I started to use almond flour around christmas time, and make things all of the time now... Various muffins, cookies, cakes.

When you mention splenda - liquid or crystalized?
I switched to some vanilla syrups that are sweetened with sucralose - and the carb count is much less than crystalized Splenda.
Davinci is one brand, but I also got lucky at my local Ollies Bargain Outlet - and found a generic.

For "toast" I sometimes use "GG Brancrisp". They are somewhere around 2-3 net carbs per wafer.
Spread some peanut butter or cream cheese, and it makes a good snack (or breakfast).

For protein, I've tried a few... and bounce around based on cost.
My favorite so far as been from Cytosport, "Pure Whey"... Cocoa Bean flavored. It is <3g net carbs per scoop. With my kids, I've not been able to do any testing... They are young and want nothing to do with a finger prick.
I don't want to terrify them, and they likely have years before the gene expresses itself.
A saliva test - that I might be able to get them to go for.

Thanks - great tips, I really appreciate it! :) I'm going to do a search on tudiabetes for almond flour recipes too.

The way to adjust your insulin is to take a dose of insulin so that you return to your pre-meal number when the insulin is been fully used up (for Apidra this is 3-4 hours). You can adjust the timing and profile to match the meal that you eat if you have highs. Toast is a simple carb (even whole wheat) and has a quick action, beans are a complex carb and has a longer action. So in general you would advance your injection for toast 10-15 minutes before eating and delay your injection for beans, perhaps when you eat or even after. But everyone is different.

While you can use these sorts of experiments to get the basics down, if you are really MODY-3, you will find that your natural basal insulin levels will often restore mild highs on their own and this can confuse the results of the experiments.

Hi Brian, thanks for your input. My basal insulin levels do restore on their own after every high. My problem (I believe) is that when I have a larger spike like over 150, my body turns on the 5 alarm insulin response and I plunge down and then get stomach upset every time. Everything is fast, the high and the drop, sometimes within 90 minutes. Although I have seen it take 3 hours. My goal is to see if exogenous insulin prevents the spike which prevents my hyperinsulin response and stomach upset. I don't know my grandmother or her siblings' diabetic patterns (as they are passed now), but my dad, and both my daughters have the same patterns I do. Maybe we're not MODY, maybe we're just weird first phase insulin deficient. One clarifying question, it seems you are saying that higher glycemic carbs do not require higher insulin, just earlier timing - is that correct? Also, with the one unit of apidra, it seemed to clear at 2 hours or before, the 1.5 units was closer to three hours-does it make sense for larger doses to take longer to clear? I know these are small amounts, but that is all I need according to my tests. I mentioned to KS I don't know if this insulin thing is going to be worth it for the extra carbs...but it has been nice to eat some "banned" foods the last few days :)

I think carbs like toast require more specific timing in order to avoid the highs, you have to match the insulin peak to the peak of the glucose surge. For beans, not so much.

ps. MODY-2 actually is characterized by high fasting levels and a "delayed" insulin response, you don't go 5-alarm till like 180. Maybe you are MODY-2?

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