Hi,
After meals I tend to spike. My CDE keeps telling me that I should be above 145, 2 hours after a meal. She seems to think that it's ok to be up to 250.
Does this make sense? How high should I go up?
Thanks

Jess, I know my daughter's target for after meal is 250, but she's 3, so all of her targets are higher than adult's. Do your other targets seem high to you also, or just the after meal?

First let me say that I am not giving medical advice, merely telling you what works for me.

I find that the more carbs I eat, the higher my post meal spike. Consequently, I try to eat a meal with more protein, some healthy fat, and less carbs. The protein and fat flatten out the spike, but cause it to last longer.

I also try to bolus 10 - 15 minutes before I start eating. This isn't always possible, but when I can manage it, it helps curtail the post meal spike.

I almost never go above 200 since I started using the CGMS. It alerts me when I start to go high. I then do a correction if I don't have enough insulin on board to cover the higher BG.

Linda B.

You will have to set your own goals

I try to keep my BG below 140mg/dL as much as possible. I do go over 140mg/dL after some meals but not anywhere near 250
and my goal is to spend 90% of each day (24hrs) between 70 and 140. I’m on a very aggressive treatment plain but I think ADA
guide lines for a adult is 70 to 180. Everyone has high blood sugars these are only targets I have been over 300mg/dL this month
already but my average numbers are good...I’m happy with them.

If your eating too many carbs at one meal your BG is going to spike. Just keep cutting back on the carbs until you find out
how many you can comfortably eat without going over your target whatever that numbers is. I can only eat about 30g of carbs
without going over 140mg/dL...60g will put me over 200 most of the time...do I always eat 30g or less...no...;-)

Thanks for your replies. I'm a teen and I've been in a diabetes clinic for kids since I was diagnosed (15 years ago). I think that the targets they set for everyone are higher because they are worried about lows.
The problem is, too much focus is put on lows. I have never had particularly good control, no matter how hard I try. I'm trying to improve and rely less on my CDE. With that said, I will try to cut back on carbs, hopefully it will help me spike less.

I pretty much alway spike up to 250 unless I bolus real early with a square bolus set got 1 hour.

I eat 44 carbs for breakfast , 85-100 carbs for lunch, and 75-80 carbs for dinner. I rarely go over 190 post meal. Last A1C was 6.7. You can get a high carb meal to work just takes a large bolus for me and low basal. My fat intake and protein intake is lower than the recommended daily allowance.

Good to know it can work out even with high amounts of carbs. I like eating carbs.

I also tend to eat high carb and I usually don't have high peaks. Going to 180 isn't very common for me and I can usually stay under 160. If the meal has a lot of fat it is much more difficult to predict the peak and when it will happen. I try to bolus in advance. I find that even a little mild activity after eating helps a lot to avoid high peaks.

Has anyone tried the "super bolus"? Basically, it's the opposite of the extended bolus. You take the whole bolus plus maybe an hours worth of basal up front and suspend the basal for that hour. It's supposed to curb the spike without going low later. I don't have a link but it's out there if you google it. Like the esntended bolus you have to figure out throught trial and error how much you can super bolus. I think ppl do an hour or two and many use the "Fill canula" feature for it so the basal part isn't added into the IOB, but some just up arrow until they reach an ammount that represents thier food bolus and an hour or two of basal, then just do a temp basal of like 5% for the hour or two, basically susepending the basal for that time.

I haven't tried it on dd for her breakfast spike, but I'm consideing it since those waffles pack a wollop.

I do Super Bolus any time I see my CGMS rise rate climbing. It works for me if I catch it in time, but if I'm slow on the trigger it doesn't totally cap off the spike.

I've only done one hours worth so far...I may branch out into a two hour super bolus soon. I'm still getting used to a TAG system of carb counting these last few months. I want to get that under my belt before I add too much more into the mix

Ressy