Type 2 height or duration of a spike - what do you prefer?

[finsit]

So we understand the high BG levels are dangerous, but staying in high BG for long is even more dangerous. Then comes the glucose variability model where they see how much standard deviation you have from the baseline. My questions is regarding a pretty controlled BG levels and not very high ones. The question is if I eat fats, normally the BG goes up slowly but because of slow release, it stays elevated for long. Now if i am eating the same amount of carbs without added fats, i will have a little higher BG but it will drop down close to baseline much quicker. What does science and data say, is it better to touch 8 mmol at an hour and back to low 6's after 2 hours? or its better to never cross 7 mmol but stay close to 7 for 3 hours? Again my question is within this particular range and not overly high BGs, which we all know are not good. How long BG needs to be in blood to cause complications or glycation above the normal range, any data on this please?

 

[bulkbiker]

Average blood glucose of 7 mmol/l will lead to a 42 mmol/mol HbA1c according to data on this site.
I'd say the longer you are high the more likely you will push up your average. A blip up to 8 for an hour then down to 6 is "less bad" than being at 7 for over 3 hours.
Obviously the best thing to do is eat to keep levels sub 7 at all times.

 

[Resurgam]

It would be interesting to have the ability to check and see how things are affected - but like most type 2s, I have no means to monitor BG continuously and my personal situation means I can't even afford the strips for my meter at the moment

 

[EllieM]

I know it's been linked to before, but here's a link to a study which looked at the blood sugars of 150 non diabetics who wore cgms
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7296129/
Looks like they were between 4 and 6.7mmol/L 89% of the time (less for older participants). Just remember to divide by 18 when converting between mg/dL and mmol/L

 

[In Response]

When I saw the title of this thread, I thought you were talking about spikes into the teens and above.
As people without diabetes can "spike" up to 9, I am surprised you are concerned by a spike to 8, specially as home monitors are not accurate enough to really tell the difference between 7.5 and 8.1.

 

[Rokaab]

Indeed if a "spike" upto 8 was that dangerous, I'd be very dead by now

 

[Ronancastled]

Nobody, in the history of the human species, has ever done damage going from 6 to 8 & back down in a short space of time.
What you're describing in the function of a normal non-diabetic pancreas.

Remember the Dexcom trial where 153 normal subjects wore the CGM for 10 days.
They had an A1c of 5.1%, an average BG of 99mg/dl & they spent 30 mins per day > 140mg/dl(7.8).
That's normal & they're not going blind, losing kidney function, suffering amputations.

Keeping your BG < 8 at all times belongs in the Biohacker forum & not this one.

 

[Juicyj]

Agree with @Ronancastled This is what a 'normal' pancreas would do, so a spike of 8 is really nothing to worry about. Personally I would love to have spikes of 8, but as an insulin dependent diabetic trying to mimic the control of a functioning pancreas with insulin and a CGM I still get spikes up to 14/15 mmol/l, it's not something I worry about as these are temporary spikes, whereas if my levels were uncontrolled and I was struggling to get back into range then I would be concerned.

 

[finsit]

Very informative folks thank you. It's just that i am using this CGM for 14 days so optimising what carbs i should be sticking to as i have been very low-carb and my LDL went quite high (LMHR). I personally thought so as well to have a spike of 8 but short-lived would be better than having 7 sustained for 2-3 hours. In my case, it has all do with fats. Again, i am saying this based on still a low carb diet. I ate 2 tangerine yesterday 110 gm with approx carbs about 15 and I spiked to 9.5, but was back to normal in 2 hours (my normal is 6). Not sure if a mouthful of tangerine is worth this spike? Now im seeing that milk does the same, a quick sharp spike but back within an hour, which i would say is fine. On wholegrain, even 10 carbs, i get spike to 7's and it stays there. I will try to eat refined flour to see how quickly that is flushed out of my blood, it probably has to do with insulin secretion or sensitivity to slow-releasing carbs? Also, does anyone has an idea which mmol levels actually the first phase insulin (the burst) starts?

 

[SuNuman]

Indeed if a "spike" upto 8 was that dangerous, I'd be very dead by now

Me too. X

 

[finsit]

When I saw the title of this thread, I thought you were talking about spikes into the teens and above.
As people without diabetes can "spike" up to 9, I am surprised you are concerned by a spike to 8, specially as home monitors are not accurate enough to really tell the difference between 7.5 and 8.1.

Actually, i was not much concerned after i lowered my a1c to 30's. However, i started adding a bit more carbs every now and then in the last 3-4 months (without CGM) and even though fasting was okay, I was not able to check my PP more regularly, except off and on and it seems some of my diabetic complications (symptoms) returned back within just 3 months including some background retinopathy. That is why i have concluded that probably once you go into remission on low-car, we may become more sensitive to carbs and these peaks ? It does seem like 8 for me still high, not comparing to general public but seeing my own complication symptoms returning back? I think everyone of us has a threshold.

 

[finsit]

Or may be fats blunt the insulin response?

 

[In Response]

Or may be fats blunt the insulin response?

I thought fats slow down the absorption of carbs. Some one with insulin resistance is less likely to struggle to produce insulin for carbs that are absorbed slower than fast acting carbs such as rice or sugar.
A cheese sandwich would have the same amount of carbs in as two slices of bread but the fat in the cheese slows down the absorption and a insulin resistant pancreas is able to keep up with the slower absorption for the sandwich.

 

[finsit]

Yes, its correct fats slow down carbs absorption, but in the absence of high fat, with simple starches, i seem to respond better in getting my spikes short-lived. That was the actual point of this discussion. So the same carbs with fat will cause a spike of lets say 7 and stay there for 2-3 hours and without fats will get me to 8 and then within two hours in low 6's, so i was wondering what way is the best way going forward

 

[LeftPeg]

Yes, its correct fats slow down carbs absorption, but in the absence of high fat, with simple starches, i seem to respond better in getting my spikes short-lived. That was the actual point of this discussion. So the same carbs with fat will cause a spike of lets say 7 and stay there for 2-3 hours and without fats will get me to 8 and then within two hours in low 6's, so i was wondering what way is the best way going forward

There is so little difference between a short spike of 8 and a slightly longer spike of 7 that it isn't even worth worrying about in my opinion.

 

[finsit]

Ok, let's put it this way for the sake of argument. Short spike of 9 vs sustained spike of below 7! Is there any formula, where you can calculate %age of time x glucose reading to understand glycation process?

 

[AndBreathe]

Ok, let's put it this way for the sake of argument. Short spike of 9 vs sustained spike of below 7! Is there any formula, where you can calculate %age of time x glucose reading to understand glycation process?

To be honest, I think you are seeking an impossible anger.

Everybody's body is different. Their insulin responses will vary, as will their ability go free of damage at any given blod glucose level or length of time in any given range.

All you have to do is read enough in the forum to see that person A may find themselves with retinopathy/maculopathy/neuropathy/kidney disease/having suffered a heart attack or stroke after an apparently benign life, whereas there are others who have had sustained periods of very poor control, but seem to be Scot free.

Like all other things, you have to decide for yourself where to set your risk dials and how much contingency you will build in. The harsh reality is there are many, many other things, like cancer, accident or whatever to come along to ruin our lives.

My advice would be to set yourself parameters you can maintain without too many resentments. If that means taking medication, so be it. In my view, it is better to be pretty consistent in our approach than to have alternating great days and dreadful days .

 

[vic hill]

So we understand the high BG levels are dangerous, but staying in high BG for long is even more dangerous. Then comes the glucose variability model where they see how much standard deviation you have from the baseline. My questions is regarding a pretty controlled BG levels and not very high ones. The question is if I eat fats, normally the BG goes up slowly but because of slow release, it stays elevated for long. Now if i am eating the same amount of carbs without added fats, i will have a little higher BG but it will drop down close to baseline much quicker. What does science and data say, is it better to touch 8 mmol at an hour and back to low 6's after 2 hours? or its better to never cross 7 mmol but stay close to 7 for 3 hours? Again my question is within this particular range and not overly high BGs, which we all know are not good. How long BG needs to be in blood to cause complications or glycation above the normal range, any data on this please?

ref your blood sugars lots depend on weather active at time resting looking at TV working nn ect i did know a person who mother kept most of her blood sugars under 10 acitve insulin morn//afternoon all change use as we go food we eat to with me i find lows very slow to increase 90 mins say from 4 up to 10 and highs say 20 120 mins to get to under 10 not much help but VIC 63 YEARS

 

[finsit]

I think this is interesting for me to read and probably gives a bit of idea. so if we talk of polyol pathways, then safe limit is 5.5 mmol so any time spent above that will somehow affect the production of sorbitol and may initiate some sort of complications.

https://en.wikipedia.org/wiki/Polyol_pathway

 

[Deleted member 543160]

I eae a ketogenic/low carb normal full fat diet, and so any rises I see tend to be in the form of "bumps" rather than sharper sugar spikes. Thanks to data gathered from when I used an original Libre sensor for a while.

My Contour Next meter can show finger prick results within user specified ranges for fasting, pre and post meals over various time periods and I tend to set myself a (fairly narrow) target range, aiming to keep my meter readings within these limits. Not as accurate as a sensor, but it provides useful data.

But as I've posted before there are issues other than diet than can raise my glucose levels and these I tend to be somewhat more concerned over due to them being beyond my control.