Stay in Target – SET

Overview

SET is the “Stay in Target” pillar of Dynamic Glucose Management. The idea: reduce post-meal spikes by matching the speed of glucose rise with the slow onset of injected insulin. SET does this with three levers: state-based insulin timing (trend arrows), balanced meals, and light activity after eating. This matters because late insulin pushes you into the classic cycle: spike → correction → stacking → delayed hypo → rebound.

After you eat, glucose rises quickly. Injected insulin works slowly. So glucose gets a head start unless insulin timing compensates.

SET is not about being “perfect”. It’s about making meals more predictable so you need fewer corrections later.

In people without diabetes, insulin is secreted into the portal vein and reaches the liver first. That early liver signal suppresses hepatic glucose output quickly after meals.

Injected insulin bypasses this route and reaches the liver later and at lower concentration. So even if the dose is “right”, the timing can be wrong — and glucose rises before insulin effect catches up.

SET is a control framework, not a rulebook. The same insulin dose behaves very differently depending on whether glucose is stable, rising, or falling at the time you dose. That’s why the S in SET is about state: using trend arrows (direction and speed) to decide how much head start insulin needs.

These timings are empirical guides. They work under the conditions they’re designed for and fail when conditions change (meal composition, prior activity, illness, stress, baseline sensitivity). The skill is fast feedback: adjust the lead time and re-test.

The detail

Let’s catch the hare.

This page is diabetes management built on the same boring-but-beautiful principle: if you want stable glucose, you need predictable inputs. SET is what that looks like in a glucose-levelised, CGM-driven way.

The tortoise-and-hare analogy describes the mismatch between how quickly glucose enters the bloodstream after eating and how slowly injected insulin reaches peak effect.

Why does insulin need a head start?

In people without diabetes, insulin reaches the liver first via the portal vein. With injected insulin, that signal is delayed and weaker — making post-meal rises more likely.

But what if the arrows are trending up or down?

This is what the S of SET is about. Timing responds to glucose state, not the clock.

Eat three balanced meals and move after eating?

At least 80% of the time, eat three balanced meals and do ~10 minutes of light activity afterwards.

Practical

If you go low using SET timings, shorten the lead time in 5-minute steps.

If glucose is still high when you start eating, extend the lead time.

If post-meal activity isn’t possible, focus on meal structure and state-based timing.

What’s next

Next step: MATCH.

References

• Three Balanced Meals
• Mealtime Insulin Guide
• The Glucose Never Lies