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What's your ideal 2 hour pp range?

Discussion in 'Parents of Children with Type 1' started by Kaylas mom, Dec 30, 2012.

  1. Kaylas mom

    Kaylas mom Approved members

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    I have been thinking about this.. What range should we be looking at 2 hours after meals? The pump is set with a 3 hour active insulin duration. So why are we checking at 2 hours? 2 hours usually is around 190 to 250 then 3-4 is back to 120-130.. I have been looking at making some changes but not sure if her I:C ratio should be changed if she is back in normal range 3-4 hours after eating?
     
  2. TheFormerLantusFiend

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    I don't correct at two hours but if I'm high at two hours, then I figure I ate too soon after injectin insulin- something went wrong in the first place.
    I have never habitually tested two hours after eating, and was never asked to.
     
  3. Megnyc

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    I use Apidra currently and assume I should be in range within 2 hours after eating. Generally I check 1 hour after eating (I have my pump set to buzz then). I test and enter that into the pump to see if I need more insulin. Basically I am making the assumption that all the carbs have hit within an hour and that if I don't have enough active insulin to bring me down then I need to add more. Ex: I ate dinner an hour ago (chicken/cheese quesadillas 14 carbs). Dexcom says I am 178 straight arrow. I stick that into my pump and it says I need .2 units more to bring me down to my target of 100 accounting for active insulin. Apidra lasts about 1.5 hours for me (DIA in pump=2 hours) so that way I know I will be in range by 2 hours after eating. I don't think you could do this with humolog or novolog though.

    Anyway, I don't think if your insulin lasts 3 hours you could expect to be in range at 2 hours if you are not dosing an hour before eating.
     
  4. JNBryant

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    My son uses NovoLog, and our previous endo never told us to check 2 hrs after meals. I never really agreed with him, so I started doing it on my own and found that at the 3 hour mark, the insulin really starts to taper off and doesn't do much to bring down those numbers. If I check my son around the two hour mark, I like to see him anywhere between 150-190. If he's slightly higher than that, I don't worry too much because the insulin still has an hour left to go, and I at least know that he's headed in the right direction. Like LantusFiend stated earlier, if by the time the duration of the insulin has passed and he's still too high, it was most likely because I didn't dose him soon enough before he ate. I typically dose my son at least 30 minutes prior to eating, that way the insulin has a chance to start working before it gets overwhelmed by the carbs.

    My son's patterns used to be identical to the one's you're seeing with your daughter. He'd always be in the mid to high 200's at two hours, and then at the third hour he'd be back to where he should be, or at least pretty darn close. The moment I started dosing 30 minutes before meals, the numbers all fell into place and I saw better results than I had been seeing for months.
     
  5. Lee

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    80 points higher then the pre#.
     
  6. Kaylas mom

    Kaylas mom Approved members

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    Thanks everyone. She is issuing novalog. I guess I need to ask next appt why aren't we checking at 3 hours instead of 2 hours.
     
  7. momofone

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    Our 2 hour goal is 180 but lately we're finding that we have an almost flat line on our CGM. We'll take it while we can get it. We were taught by Gary Scheiner that the check you do at the 1 hour mark tells you if you timed the bolus correctly and the 2 hour check tells you whether you were off on your dose. Obviously, there are other factors that come into play but, in general, with a fairly straightforward meal, that is what we were taught.
     
  8. Jordansmom

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    Early on our Endo had us on a schedule of testing two hours after one meal a day for three days, then we rotated to the next meal. It was to see if the carb ratios were correct. If the number was above 180-190 we adjusted the carb ratio. If the number was close to range already or low, we decreased the dose. Technically he expected that to be a permanent testing schedule, but we changed Endos, switched to Apidra, and started on the Dexcom.
     
  9. JamieP

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    Our goal for 2 hrs after he starts eating is <= 140. This check is to make sure he's not spiking too much from the food. It helps me determine how to adjust my prebolus timing for a specific meal. I look at 4 hrs to determine is the I:C ratio is correct. It sounds like your I:C ratio is good. Do you prebolus at all? It makes a huge difference. Gary Scheiner wrote a great arcticle, "Strike the Spike" that is very good. I'll attach a link. I think he talks about checking at 1hr-1hr 15 min after the meal. The targets are higher than our 140 since the timing is much closer to the meal. Our Endo said that she prefers the 2hr mark as sometimes it can be really high at 1 hrs, but be back down by 2 hrs and she is not worried about those quick little spikes. Alternatively, it might not be fully spiked at 1hr if the meal was fairly fatty.

    Hope this article helps:

    http://www.diabetesselfmanagement.com/articles/high-blood-glucose/strike-the-spike-ii/1/
     

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