162: Q&A - “Why do I keep crashing 2 hours after a meal?”

0:00This is the Empowering Health Podcast. If you're a female living with type 1 diabetes and you care about your health, you're in the right place. I'm your host Andy Balog and I specialise in helping you men just like you never get all themes nutrition, exercise, sleep and blood sugars so you can feel confident and in control in your body and your life with T1D. Let's go. Welcome back to the Empowering T1D podcast. Today's podcast episode is another Q&A episode and this episode comes from Isaac on Instagram who DMed me and said why do I keep crashing as in my why my blood sugars keep crashing after meals and I really wanted to dig into this one today because obviously this is something that we've all dealt with at some point you might be dealing with it right now maybe you dealt with it a week ago it happens all the time right because as we eat different foods different things can happen to our blood sugars and if you're in a phase right now

1:03where you are trying to improve your blood sugar control and you're really focusing in on things you're going to notice this happening all the time especially when things aren't dialed in properly like your settings and things like that which is probably what led you to this podcast in the first place so if you're new here hi this is the Empowering T1D podcast I'm Andy I'm a T1D nutritionist and personal trainer and diabetes coach and I have had type 1 diabetes for over 20 years and this is one of the kinds of podcast episodes I do this is a Q&A episode I also have you'll be able to find it under my episode list I've got just tackling deep diving episodes as well which the most common type of episode we talk about confidence building we talk about bolicing strategies we talk about exercising with type 1 we talk about every single aspect of living life with type 1 in terms of how you can be healthier how you can be a better version of you and we also do monthly conversation style podcasts which are a bit longer with one of my mates

2:08and one-on-one clients Aaron so go and go and listen and dive in if you're new here but I digress today's episode is really important because again it's something that we've dealt with with all of us are going to deal with at some point if you haven't yet you're going to okay because it's all part of the learning process the troubleshooting process of living life with type 1 and eating food so what is happening when you are crashing a few hours after eating it's in short you have taken too much insulin so I know that sounds really really basic and like well yeah but what do you mean that's the reality of it when you break it down it could be in a number of different ways so let's let's come up with a meal as an example so let's say that you had sushi sushi has short grain white rice which is quite fast to digest and the carbohydrates in them break down pretty quickly in your system so it's going to hit you pretty quickly obviously there's some nuance in

3:12there based on what kind of sushi you're having has it what kind of protein the protein amount does it have protein at all what kind of things it has in there but on the whole it's going to hit you pretty quickly and any sweet sauces that are added on there are also going to speed things up again okay so it's going to hit you pretty quickly let's say that your total bolus for that amount of carbs that you had in your sushi was I'm just going to keep it really simple let's say it was two units okay so you gave two units and two hours later you crashed and we ruled out that it wasn't just a nuanced situation you've done this at least once and you crashed again how come you're going low well in this instance if you gave your insulin all up front like I want to mean by that is you know you didn't do it as an extended bolus or something on an insulin pump in short that amount of insulin that you took was too much for you so is it too much based on just the food or did you happen to be active after you had that meal all in all you took too much

4:19insulin for those factors but if you were sedentary like you just sat around after having your sushi then you went low two hours later that means that your carb ratio is are off my friend or your insulin sensitivity factor settings the amount of insulin in other words that you're taking to correct any blood sugar that may have started with before you even had your meal one of those two things is off if you throw exercise or any kind of activity I'm talking you cleaned up the kitchen after you had your meal or you mopped the house or you did some organizing or you went for a walk or you went to the gym whatever kind of activity and there are so many different levels of activity they're all going to have different effects but quite honestly any kind of movement that you may have done even something as simple as a mobility routine stretching yoga these low impact things can really impact your blood sugar by lowering them so if you added any of these in

5:22after you took your bolus well that is a big factor that is definitely something that could have led to you going low and if you've again done this more than once and the same patterns have come up those are the two main things you're going to be looking at well three I guess you've got insulin sensitivity factor carb ratios your activity level after eating or and this is where it all comes back to the very beginning and the basics that we talk about on here all the time is are your base settings even right do you have too much background insulin going on in the first place long acting basil which whatever you want to call it those things are first and foremost to check so if you're like well where the heck do I start with this that's why I always promote going back to basics so I have my free basil basics guide that is in the links below next you want to get the better bolus in guide that is the next step into kind of being enlightened about all the different aspects we could be looking at how we can bolus better for different foods how we

6:23can bolus better in general for different things that we have to do like again considering exercise considering the different types of foods and drinks that we have and all of these different things that's the next product I'd be looking at and those are really entry level products these are the first few things I always tell people to try out before they do anything else and once you've done those things the next thing that I would recommend that you do is jump into my thrive membership join that because that has the steps step by steps on how to actually tackle all of this insulin testing because insulin testing is honestly going to be your best friend with type one like if you can nail that because let's be real even when you nail your insulin settings and dosages which you should you should definitely work to do that it's not a it's a transient thing it's going to ebb and flow slightly over the years at different ages different life stages that you go through

7:23and you need to know how to troubleshoot properly and insulin testing is a big part of the troubleshooting we have to do in the short term and in the long term with type one and that can be something as small as the kinds of adjustments you would want to be making daily versus monthly but like if you're a female especially monthly like so many changes happen in the month you want to know how to adjust for those yearly you know depending on what age you are and what's going on in your life so insulin testing the utmost important thing with type one so you want to go to the links below check out those resources come and join me and thrive and hundreds of others and start to do your insulin testing and you will never ever regret it you will never look back you'll be like what was I doing how did I even manage before that because it's going to be life changing for you when you realize how much easier managing type one is when you have your dosages dialed in so I hope that answers your question Isaac and if you listening have found

8:24this helpful as always I would love for you to share it over on Instagram stories tag me at the T1D nutritionist or share it in the DMs with your friends your type one mates people that you know with type one or just into the interwebs where someone with type one might possibly find it and find it as helpful as you did all right so I appreciate you listening and I hope you have a good week all right I'll talk to you next one bye if this podcast has inspired you and you're ready for change you can apply to work with me by clicking a link in the show notes or go to empoweringhealth.com.au and click apply for coaching if you like this episode please leave a five star review and share it with other T1Ds you know so I can continue to help others you can also find me on Instagram at the T1D nutritionist and I'll catch you in the next episode the empowering health podcast is for educational purposes only and does not constitute the practice of medicine or other diabetes health care services I am not a doctor or a diabetes educator and this is not medical advice the use of information on this podcast or materials linked from this podcast is

9:26at the user's own risk the content of this podcast is not intended to be a substitute for professional medical advice diagnosis or treatment users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professionals for any such conditions.