When is a "spike" not a spike??......oh that is the question!

[Postleneo]

Just curious what you guys consider to be a spike?? for example this morning for breakfast BS was 7.5 prior to eating.... pre bolused and ate when BS was trending down at 5.8 and checked an hour later.. BS was 10.1. At two hours following breakfast BS was 6.3. Would you consider the "spike" to be at the 1 hr post meal reading... in my case being a "spike of 2.6.... (or 4.3) which ever way you look at it or would you consider i had no such relavent Spike as at the 2 hr post meal mark was just bellow my post meal reading??!!??

 

[slip]

Good question! and a nice example. I guess it depends on which camp you're in as regards 'spikes', and what you're comfortable with. Personally I'd be happy with the results you've posted, I'd have preferred the 10.1 to be a bit lower but we all know what a beast this thing is like! And of course tomorrow you could follow the same routine and get something different.

 

[Postleneo]

Good question! and a nice example. I guess it depends on which camp you're in as regards 'spikes', and what you're comfortable with. Personally I'd be happy with the results you've posted, I'd have preferred the 10.1 to be a bit lower but we all know what a beast this thing is like! And of course tomorrow you could follow the same routine and get something different.

Tell me about it .... had the same breakfast i had the other day at the same time with same pre bolus timing...oats so simple....my backside so simple... dexcom showed only a .5 mmol spike..... with the flat line thought the dexcom had bust!!!

 

[karen8967]

heres an example of my spikes bg b4 breakfast 5.8 2 hours later 13.6 by lunch time should be bk in range this is every morning no matter what i eat

 

[Postleneo]

heres an example of my spikes bg b4 breakfast 5.8 2 hours later 13.6 by lunch time should be bk in range this is every morning no matter what i eat

Ouch...can totally sympathise... had very similar issues when on MDI and the only way i could manage that was through a few basal tests established that from waking, my DP rose my BS by approx 6mmol over 4 hours therefore as soon as i woke gave myself an extra 1.5 unints before breakfast which was the mmol rise devided by my ISF - this really worked for me leading to half decent readings 2 hrs post breakfast.

 

[karen8967]

I will try this thanks for advice

 

[escturtle]

I'm just curious- anyone else ever experience "spikes" in the night hours, between 11pm to 1am, even if they go to sleep with normal sugars? This happens to me only sometimes, so its not a basal problem - and it happens even whether I do or don't eat before bed. I can't find any pattern to these spikes!

ps- how do I convert your mmol numbers to my USA bg readings?

 

[Krowsnest]

I'm just curious- anyone else ever experience "spikes" in the night hours, between 11pm to 1am, even if they go to sleep with normal sugars? This happens to me only sometimes, so its not a basal problem - and it happens even whether I do or don't eat before bed. I can't find any pattern to these spikes!

ps- how do I convert your mmol numbers to my USA bg readings?

The easiest way is to multiply the mmol reading by 18. Alternatively, if you want to know the mmol of the number you see on your US glucometer, divide that number by 18. The University of Colorado also has this handy chart as a PDF: http://www.ucdenver.edu/academics/c...Documents/book-understandingdiabetes/ud29.pdf

 

[NoKindOfSusie]

I am going to get shouted at for this but the simple answer for me is that I don't eat oats, I would no more eat oats than I'd down a pint of rat poison...

 

[kev-w]

I call a spike in excess of 10, I get a couple of late morning spikes and a couple of late morning lows each week, eating the same breakfast (porridge oats, 2 x wholemeal bread & 3 poached eggs) every day, I've no idea what I am whilst asleep.

 

[phdiabetic]

Depends on your own personal targets. For me, a spike has some of the following characteristics: rapidly increasing blood sugar (up arrow or two up arrows on the CGM), high blood sugar (I will start to feel a bit uncomfortable in the 8's, and usually start to treat in the 9's), high blood sugar that won't easily come down (I know exercise almost always makes me drop like a rock. If I've been walking for 20min and I'm not dropping, that's an indicator that something's wrong), hypo correction (often I incorrectly estimate the amount of carbs required to treat a hypo, and end up a little high as a result), stress or basal issues (both of those things make me go up and never come back down!). In all of these situations I am treating the spike before it finishes spiking so I couldn't say how high I would get.

In your case (when you get high but naturally come back down again), I would take the highest number to be the spike.

 

[Jc3131]

Currently I've gone out for a walk as my bloods 13.9 an hour after breakfast. The problem is that I take no insulin to cover it as im a honeymooner. If i took 1u i would be guaranteed a hypo. 1u has dropped me 6 mmol in less than 30 mins before.

Im hoping to be back down into a decent range soon as I feel quite sickly. I was 6.2 before breakfast so it's some spike, i normally dont test after am hour but i just didnt feel right.

 

[slip]

Currently I've gone out for a walk as my bloods 13.9 an hour after breakfast. The problem is that I take no insulin to cover it as im a honeymooner. If i took 1u i would be guaranteed a hypo. 1u has dropped me 6 mmol in less than 30 mins before.

Im hoping to be back down into a decent range soon as I feel quite sickly. I was 6.2 before breakfast so it's some spike, i normally dont test after am hour but i just didnt feel right.

Maybe ask for a half unit pen?

 

[Jc3131]

Well I've just got in and tested an hour after my high reading and a 20 min brisk walk. And im 5.5mmol, my body is crackers at the moment. I will ask for half unit pen on Thursday as thats my next appointment.

Now i think i need a snack as im just going to drop below 5 now.

 

[novorapidboi26]

Did you deliberately wait till you were down to 5.8 to eat or where you following your normal lead in time between insulin and eating?

I would have taken the 10.1 as the spike as with novorapid/humalog/apidra the peak action is about 50 -90 minutes...

 

[Wurst]

Anything over 5.5 mmol for me is a spike and unacceptable, this includes before / during/ after meals. Tight control and no regrets all the way for me.

 

[JoeT1]

Anything over 5.5 mmol for me is a spike and unacceptable, this includes before / during/ after meals. Tight control and no regrets all the way for me.

Although I bow to your HBA1C results. Do you find it easy/difficult to stay under 5.5 at all times? Even when non diabetics will regularly rise about 6-7.5mmol on occasions after food? How restrictive are you with carbs etc?

 

[Bluetit1802]

Forgive a mere T2 on no medication, but my impression of what a spike is has little relation to the level at which it peaks, whether this is over 10 or under 7 or whatever. It is the amount by which the BS rises that constitutes a spike. So this could, for example, be anything more than 2mmol/l or more than the amount you set for yourself. I understand it is better all round to stay within a band at all times, and the width of this band could be something like 4 to 8 or whatever you set for yourself, thus maintaining as little variation as you can. You can shoot me down for barging in.

 

[Wurst]

Although I bow to your HBA1C results. Do you find it easy/difficult to stay under 5.5 at all times? Even when non diabetics will regularly rise about 6-7.5mmol on occasions after food? How restrictive are you with carbs etc?

I restrict carbs at the 3 main meals per day but come evening time I can eat all sorts , ice cream , chocolate bars etc and stay below 5.5 mmol with careful bolusing. I exercise daily, currently cycling and rowing (running when my achilles tendon has healed) and this really helps. Keeping the weight off is also important , when I'm over my target weight then it gets trickier in terms of BS control.

Despite my best efforts, I can still get the odd rogue spike over my 5.5 mmol target range.

 

[JoeT1]

I restrict carbs at the 3 main meals per day but come evening time I can eat all sorts , ice cream , chocolate bars etc and stay below 5.5 mmol with careful bolusing. I exercise daily, currently cycling and rowing (running when my achilles tendon has healed) and this really helps. Keeping the weight off is also important , when I'm over my target weight then it gets trickier in terms of BS control.

Despite my best efforts, I can still get the odd rogue spike over my 5.5 mmol target range.

That's great going. I found that the more I restrict carbs, say no more than 15g-25g for my main meals, the easier I find it to stop spikes.

Main gripe currently is the porridge, i'm spiking up to near 8.5-mmol from 5, then dropping back down quite quickly...which I was considering a win.

Exercise is going to be massively important for me, number of reasons

I feel better
Trying to keep off the weight
Seems to spike me slightly during the session, but drop down after
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