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.
Recently I have been noticing some odd BG behavior. Last weekend while on the way to my daughters dance recital (she's 6 and a little princess) I experienced a low of 37. I normally check my BG before and about two hours after each meal but I started to feel odd about an hour after eating. My wife was driving and I noticed that I was feeling hot and sweaty even though the car A/C was set for 60. My thinking felt fuzzy. I pulled out my glucometer (my hands had started shaking by this time ) and stared at the reading for a moment. 37. My wife must have noticed something was wrong because she said, "Everything OK?". "No", I said, I need sugar.
We scrambled around to find some hard candy. We have two young kids and yet there was no candy to be found in the car. I normally carry a backpack with my glucometer, test strips, lancets, Novolog Flexpen, flex pen needles, and BD glocose tablets. I carry the backpack everywhere. That day I decided to take the meter and leave everything home. My wife found a packet of sugar from her last trip to Dunkin' Donuts and saved the day.
This has never happened before. The previous day I had a similar experience after eating dinner. My BG was down to 49. Today, it's happening again, about two hours after lunch. BG is 85. Wait! No. It's now 100. Wait no!!
Did I take too much insulin? Not likely. I took the same amount I always take for this amount of food.
Too much fat in the meal? No more than any other meal. 11.7g. I had a Weight Watchers meal, Texas Toast and an Apple.
I am tracking my insulin and BG readings on the SugarStats.com web site and will be able to create some interesting reports that may help shed light on what's going on.
Shortly after I was diagnosed I was given a free meter by the hospital. It was a big bulky thing that required a bucket of blood and a day to register a reading. Since them I have purchased the FreeStyle Flash Blood Glucose Meter (one for home and one for travel) from Abbott Laboratories. It take readings in about 7 second and require but a tiny drop of blood for a reading. My endocrinologist has software into which he can download the data and graph my blood glucose over time ( albeit snapshots in time ).