Up until about a month ago I had big problem controlling my post-breakfast and pre-lunch blood glucose. I would take 18 units of Levemir and 6 units of Novolog, wait 15 minutes, and then eat breakfast. Breakfast for me is a rotation of whole wheat toast, egg beaters, Morning Star meatless breakfast patty, steel cut oats, or Scottish oatmeal.
None of my portion sizes exceeded 60g of carbohydrate but my post-breakfast 2 hour BG would almost always be high; between 160 and 200 mg/dL. My pre-lunch BG would almost always be too low; between 60 and 70. I discussed this with my endocrinologist on my last trip ( I was being fitted with a trial Dexcom unit ) I mentioned this ti him. After "yelling" at me about the hypoglycemia, he recommended splitting my Levemir dosage into two; 8 in the morning and 10 in the evening.
I tried that for a week and my pre-lunch BG was much better ( between 80 and 90 ) but my post-break 2 hour BG was still high. I returned to the endocrinologist at the end of a week ( the length of time the Dexcom sensor was good for ) and we tweaked things further. He suggested waiting a full 30 minutes after taking the Novolog before eating. Within a few days my post-breakfast BG was within the 120-150 range and my pre-lunch BG was still within the 80-90 range. Success!! By carefully controlling the amount and timing of my insulin dosing I have achieved good BG control. My estimated A1c is 5.4 but I will wait for a doctor visit and test to confirm.