The obvious question to ask yourself is, how is my blood sugar running? Are you frequently below or above target? Do you struggle to find the right balance? Remember other factors affect your glucose, not just insulin, keep in mind food and physical activity also impact it. Here are some questions to ask yourself to help problem solve what exactly is causing your frequent lows or highs.

If your sugar is high before breakfast 

  1. Did I take my evening lantus or levemir the night before? 
  2. Did I have a late or large night time snack the night before? 
  3. What was my sugar before I went to bed? 

If your sugar is low before breakfast 

  1. Did I take my correct evening dose of lantus or levemir the night before, is it possible I took too much? 
  2. Did I bolus for a high number before bed without eating? 
  3. Was I active last night? 
  4. Did I drink alcohol last night? 

If your sugar is high 2 hour after meals 

  1. Did I take my meal time insulin? 
  2. I am not on meal time insulin, should I be? 
  3. Am I on the correct dose of meal time insulin?
  4. How are large are my food portions?
  5. What do my beverages consist of? 
  6. Have I been combining meals with protein? 

If your sugar is low 2 hour after meals 

  1. Did I take too much meal time insulin?
  2. Did I have any starch with my meal?
  3. Did I take my meal time insulin without eating? 
  4. Was I active after my meal? 

If your sugar is high before meals 

  1. Do I snack in between meals? 
  2. Did I miss my insulin at the previous meal? 
  3. Are my portions at meals too large? 

If your sugar is low before meals 

  1. Am I active in between meals 
  2. Am I on too much meal time insulin 
  3. Am i on too much background insulin such as lantus or levemir? 

If your sugar is good 2 hours after dinner, but high before bed

  1. What do I eat after dinner? 
  2. How large is my bed time snack? 
  3. Am I really hungry after dinner or just eat out of habit, boredom or loneliness?

Do any of the above scenerios sound like you? These are just some examples to keep in mind the next time you are trying to problem solve to find solutions. Everyone responds to medication, food and exercise differently and there might not be an obvious clear cut fix.

The only way to tell if something is working is by checking your sugar and keeping logs, noting before or after meals on your log.   Remember these written sugar logs when you see your endocrinologist or diabetes educator next time, bringing logs to your appointment is the key to getting under control, without these logs your healthcare provider will not be able to make changes. You are not alone, and your diabetes educator and endocrinologist will work with you in order to discover the best options for you.