Sorry, what..?
Everything I've read (including from the guide on this website) seems to suggest a spike 2 hours 'post prandial', even for non-diabetics, is the norm.
It says on this site that 4 to 5.9 mmol pre prandial is normal for non-diabetics, and it should be under 7.8 at least 90 minutes after a meal. How can anyone interpret this in any other way than that a spike is completely normal..? Where have you got this idea that it should be back to normal by then..?
My reply: normal *or close to it*. Yes, a good benchmark is for it to be under 7.8mmol 2 hours after a meal. Personally, because my Diabetes is pretty well controlled, I wouldn’t be especially happy with that figure these days, it would indicate I’d had a high carb meal. (Incidentally you mention 90 minutes- I haven’t gone to check but generally 2 hours is specified not 90 mins, and certainly in my case that’s quite significant because 90 mins tends to be when I’m at my highest, for an average meal. Lots of fats would make the spike later; fast acting carbs like white bread or cereal would make it earlier, but usually for me, it’s 90 mins. Back to baseline by 120 mins).
I have worn a Libre 100% of the time since October, so I can be fairly specific about times and trends, more so than someone relying solely on finger tests.
Why do you have diabetes then..?
If the cure for type 2 diabetes was just to eat a bunch of carbs, get an insulin spike, and end up lower than baseline, then wouldn't we all be cured?
My reply: haha that’s the $10 million question, isn’t it?
Type 2 diabetes is thought to be the result of metabolic disturbance bought about by many years of intolerance to carbs causing a cycle of insulin overproduction, weight gain, and insulin resistance. Type 2’s don’t have too little insulin (at least not initially- at some point the pancreas can give up and stop producing, it can also be clogged with visceral fat and not produce efficiently). We have too much, but it doesn’t work properly. Weight loss, a low carb diet, and drugs (I’m on Ozempic, which stimulates the pancreas to produce an appropriate amount of insulin at an appropriate time, as well as metformin, which helps reduce insulin resistance and decrease exogenous production of glucose by the liver) has reduced my insulin resistance significantly.
A couple of real-life examples for you - in October, I had a scoop of ice cream. It raised my blood sugar to 13mmol and stayed there for a couple of hours at least. Last week I had another scoop of ice cream. I started at 6mmol and stayed at 6mmol - didn’t move at all. A couple of days ago, I had a piece of my husbands birthday cake. I did get a rise (I think it was to 8.1mmol) but then it dropped very quickly to quite low - not a hypo as such, but a fast drop, to lower than baseline (this is the graph I attach), the cake was at lunchtime.
It doesn't work what way..? Really short term, as in, having a direct affect on the meal just eaten..? Based on what I've seen over the last week, I think it might.
I'm only generally eating 2 meals a day. Usually the exact same meal twice. The first meal seemed to cause a normal spike 2 hours later, I'm assuming with the help of the Metformin. But the second meal that was exactly the same was causing me a larger spike at night.
So I reintroduced the second gram of Metformin with meal 2 (having previously ditched it because of the "brown rain"), and now I'm also getting a more normal spike with that second meal.
The half-life of Metformin is supposedly 6.5 hours, so wouldn't that make sense..? Unless I've misunderstood the half-life of drugs, a short half-life means it gets in and works fast and then it gets out. Seems logical that a pill taken with each meal is only really helping with that meal. The level of the drug will have diminished by half by the time of your next meal (if there is roughly 6.5 hours between your meals...) and thus wouldn't be as effective.