For her dinner, she usually gets 2 units of humalog, and 35g of carbs. The carb amount has been slowly creeping up over the last few weeks to 45g (I'd rather give her more carbs than try to measure out 1/2 units). We give her the insulin about 5 minutes before she eats at dinnertime, and her BG going into dinner ranges from 80 - 170.
About 1 hour after dinner, we start to see arrows down on the CGM. Sometimes there's a small spike, but a lot of times (like tonight) she stays even through dinner until she starts to fall. But when she starts, she falls fast. Like 100 points in less than 30 minutes.
A lot of times, we don't catch the crash until she's in the 60s (tonight we caught it at 80). We give her carbs (10-15g), then 3 hours later she's in the low to mid 300s and stays there most of the night. A few nights ago we had to correct her in the middle of the night (we've probably only done that 3 or 4 times since her dx), and last night we gave her the correction up front (because she was in the 300s) with her bedtime dose of NPH. And she STILL only came down to the mid 200s and cruised there throughout the night.
So tonight we lowered her dinnertime insulin to 1.5 and she still crashed. We gave only 7g of banana to bring her up. Right now she's out with Fred visiting a neighbour in the hospital, so I have no clue what her BG is, but she was holding steady at 103 when she left.
So what the what is going on here? The food she's eating isn't out of the ordinary. Tonight it was tortellini soup with some bread and yogurt for dessert. Last night it was sandwiches, grapes, yogurt for dessert and chocolate milk. It's almost like there's a delay in her food absorbing.
Everything else is normal as can be. I am just scratching my head over this one and would love any insight that anyone has to offer.
Edited to add: thanks everyone for the comments. If it were a food absorption issue, wouldn't it happen at every meal? Why just dinner? The food she's eating is the same as she always eats. And we haven't contacted our endo or CDE because; A) today is not the day to fax in logs, B) they won't talk to you without looking at your log, C) the CDEs are useless and I haven't talked to one in over a year and a half and, D) you have to go through a CDE first to get to the endo. Yeah, the system sucks.
Last night she was in the mid-300s all night and woke up at 242. Gotta figure this out.