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Here are two examples that put pattern management to work. The first is a woman with type 1 diabetes. The second is a man with type 2 diabetes.
As you read these examples, look for clues in one of the following areas that might be the cause of unusually high or low blood sugar levels:
Diabetes medicine
Food
Physical activity
Stress or illness
Example 1: Tina, age 27, type 1 diabetes
Tina takes 36 units of Lantus insulin at 7 a.m. Tina also takes between 4 and 8 units of Humalog insulin at mealtimes. The amount of Humalog she takes depends on her blood sugar level before eating and how much carbohydrate she plans to eat at that meal.
Tina makes careful food choices. She follows a healthy, well-balanced meal plan. She also gets physical activity every day after work. Tina checks her blood sugar before meals and before going to bed. Her ideal fasting blood sugar is between 70 and 120 before breakfast. During the day, she tries to keep her blood sugar levels between 70 and 160.
Here's an example of Tina's blood sugar readings for three days. Can you see a pattern in the numbers?
Date: May 5
7 a.m.: 86
Noon: 104
6 p.m.: 96
10 p.m.: 320
Date: May 6
7 a.m.: 136
Noon: 123
6 p.m.: 105
10 p.m.: 296
Date: May 7
7 a.m.: 111
Noon: 197
6 p.m.: 92
10 p.m.: 341
All measurements are milligrams of glucose per deciliter.
What pattern do you see? Tina's fasting blood sugar results before breakfast are pretty close to her target. Her results before lunch and dinner are also within target. However, for three days in a row, her blood sugar results before bed are much higher than the target of less than 160.
What might cause this pattern? Knowing a little bit about how Humalog and Lantus work will help solve Tina's problem. Humalog, a fast-acting insulin, starts to work 15 to 30 minutes after a shot and lasts 3-4 hours. Lantus is a long-acting insulin that begins to work about 1-2 hours after a shot and continues working in the body for 20 to 24 hours.
Eating a larger amount of carbohydrate at dinner or not taking enough fast-acting insulin before dinner could be causing a spike in Tina's blood sugar four hours later.
What is a possible solution? Tina might look at how much carbohydrate she's eating at dinner and make sure she’s counting accurately. Or she might need to adjust the amount of insulin she takes to cover the carbohydrates.
Example 2: Ed, age 47, type 2 diabetes
Ed found out he has type 2 diabetes about three months ago. He doesn't take pills or insulin for his diabetes yet. He's about 55 pounds overweight and has already lost 12 pounds by getting more physical activity and making some changes to his eating habits.
Ed's goal is to check his blood sugar two times a day. When he can, he checks before breakfast and again before dinner. He aims for a blood sugar target between 80 and 140 before meals.
Ed checked his blood sugar for one week. He also made a couple of notes about what he ate for dinner. Can you see a pattern in the following numbers?
Date: Oct. 14
Before breakfast: 143
Before dinner: 130
Before bed: No test
Date: Oct. 15
Before breakfast: 118
Before dinner: No test (ate pizza)
Before bed: No test
Date: Oct. 16
Before breakfast: 253
Before dinner: No test (ate pizza)
Before bed: 220
Date: Oct. 17
Before breakfast: 192
Before dinner: 102
Before bed: No test
Date: Oct. 18
Before breakfast: 151
Before dinner: No test (dessert: pie, ice cream)
Before bed: 263
Date: Oct. 19
Before breakfast: 251
Before dinner: No test
Before bed: 160
Date: Oct. 20
Before breakfast: 153
Before dinner: 141
Before bed: No test
What pattern do you see? Ed's blood sugar is close to his target most mornings, except for when he had pizza or pie and ice cream at dinner the night before. On those mornings, his blood sugar was higher. His blood sugar was also higher before going to bed the night he had pie and ice cream.
What does this pattern show? This pattern shows that food choices can impact your blood sugar in different ways. When he eats high-carbohydrate foods, his blood sugar goes up higher than his desired target
What is a possible solution? To avoid high blood sugar in the morning, Ed can:
Stop eating high-carbohydrate foods such as pizza, pie, and ice cream.
Eat these foods, but in smaller amounts.
Exercise after eating these foods to burn off the calories and help reduce his blood sugar.
Understanding patterns can help you make choices
Testing and keeping track of your blood sugar results and making a note of things that affect those results, can help you see patterns and find solutions for high and low blood sugar levels. Pattern management gives you more freedom and choices in managing your diabetes.