Eating to the meter

[winter2342343]

Hello, wanted to ask a question if I may.

I'm really looking at what foods spike my BG levels and doing intermittent fasting each day, which is really I am not eating anything until about 12:30, no breakfast.

I measured my blood first thing and it was 6.9 mmol/l - took one metformin tablet as I always do in the morning (500mg) around 3 hours later it was 6.2 mmol/l - I decided to test to see what rise a sandwich would have, white bread, bacon lettuce and tomato, an apple and sugar free peach fanta. Tested again a few hours later expecting a rise into 8+ and it was 4.8 mmol/l - so I tested again an hour later and it's 4.7 mmol/l.

I'm not eating badly generally, but I'm trying to finally cut out all my carbs in the form of bread and starch and pretty much go keto or very low carb, so while it was quite irresponsible to have that for lunch I'm trying to see what foods genuinely spike my BG levels. I feel like I've been driving a sports car with my eyes closed by not testing foods thoroughly or often enough.

I've always tested once a week when I weigh myself, test my BG and blood pressure, and then keep a log of that so I can spot any weigh gain or worrying trends. Should I be testing in this way or is it better to rely on the hba1c results as part of my yearly checkup?

Any advice would be much appreciated.

 

[Deleted member 475901]

How many hours later did you test? The recommendation is 2 hours after you start eating to see the highest spike.

 

[lovinglife]

My testing regime when first diagnosed
First thing after having a pee in the morning
Right before breakfast - 2 hrs after first bite
Right before lunch - 2 hrs after first bite
Right before dinner - 2 hrs after first bite

Initially I was looking for a rise of no more than 2, it took a couple of weeks for my “before” numbers to come down but I did start with very high numbers.

After 2 weeks I was looking for 5s to 6s before meals and no more than 7.8 2 hrs later (this is where they purport that damage begins)

Any meals that raised me above my own targets I either didn’t eat again or adjusted portion size depending on what it was.

Further on and now I aim for mid 4s before meals and no more than 6.5 after 2 hrs. I have to stress this wasn’t at the start of my journey, it takes a while for your liver to rid itself of all that stored glucose, once you get to that sorted your numbers if you eat the right foods should drop.

I was on max dose Gliclizide and Metformin at the beginning, as my numbers came down, weight loss etc I slowly dropped meds with the advice of my GP - now I’m only on a small dose of met.

In my opinion a intense testing regime in the beginning is the most valuable thing you can do to see what food does what, eating a keto or low carb is probably the best way to eat. Once you have more knowledge of how different foods/meals affect you and you are confident in a well tested meal/plan then you can relax a little on the testing. I very rarely test now as I only eat about 15g carb a day and all my meals are well tested. I do test new meals and also have a couple days of intense testing now and then just to keep a check

You’ll get there it’s a big learning curve and it’s a lifestyle change not a diet and that can take a little while to embed and become second nature- but it wil

 

[catinahat]

There has to be some structure and consistency to testing to make it worthwhile.
All you learn from the one test a week you do is what your blood sugar level was at that time. It tells you nothing about why its at that level or what level you have been at other times during the week. If you think about it if you don't get some useful information from your test, you might as well forget the meter and just stick a pin in your finger.
Your sandwich for example, test just before the first bite, this gives you your base level. Then if you test 2hrs later it will show you how you have managed the carbs in your sandwich. Anything under 2mmol above the base level is acceptable, over 2mmol means there were too many carbs for you to deal with.
But if you really want to understand what that sandwich did to your blood level, you could test at 30, 60 and 90 min and so on until you are back at the base level.
It might seem like over kill but you would know exactly how high your blood sugar levels got, how long they stayed high and how long it took for your levels to get back to where they started. And of course if you decide to have that sandwich another time you don't have to test it because you have already learned all you need to know

 

[winter2342343]

How many hours later did you test? The recommendation is 2 hours after you start eating to see the highest spike.

Thanks, probably 3 hours afterward.

 

[winter2342343]

There has to be some structure and consistency to testing to make it worthwhile.
All you learn from the one test a week you do is what your blood sugar level was at that time. It tells you nothing about why its at that level or what level you have been at other times during the week. If you think about it if you don't get some useful information from your test, you might as well forget the meter and just stick a pin in your finger.
Your sandwich for example, test just before the first bite, this gives you your base level. Then if you test 2hrs later it will show you how you have managed the carbs in your sandwich. Anything under 2mmol above the base level is acceptable, over 2mmol means there were too many carbs for you to deal with.
But if you really want to understand what that sandwich did to your blood level, you could test at 30, 60 and 90 min and so on until you are back at the base level.
It might seem like over kill but you would know exactly how high your blood sugar levels got, how long they stayed high and how long it took for your levels to get back to where they started. And of course if you decide to have that sandwich another time you don't have to test it because you have already learned all you need to know

Thanks this is useful. What I don’t get is should my BG baseline reading be the same every day, does it sort of reset overnight or will there be variance? Say if I ate a cherry bakewell (if only!) and that raised my BG level would that spike gradually increase my overall fasting level?

 

[catinahat]

Our blood sugar levels are quite dynamic constantly reacting to our food or lack of food, our activities, our stress levels, even the weather can have an impact.
Fasting levels are almost impossible to predict and even harder to control, they are usually the last to come down.
There is this thing called the dawn phenomenon, its not really a phenomenon, its just your body doing what it's evolved to do.
First thing in the morning as your body prepares to wake up, some hormones are released, these hormones signal your liver to release some of its stored glucose to give you a shot of energy so you can chase down your breakfast.
The problem for us is our insulin resistance, it means that our insulin is not very efficient at getting that glucose out of our blood and into our cells and muscles where it's needed.
So the only really effective way to improve your fasting numbers is to improve your insulin resistance.
This is where your cherry bakewell comes into the picture, every time we eat something very carby our pancreas releases insulin, the insulin doesn't work too well because we are resistant to it, our blood sugar stays high so more insulin is released and so on until the sugar level comes down. By the time the sugar has been dealt with our bodies are awash with insulin.
That causes our insulin resistance to get worse, think of it like alcohol, if you don't drink, 1 glass of wine will get you tipsy, if you drink very day 1 glass will have no effect, you could say you have become resistant to alcohol.
If you avoid things like cherry bakewell's, you avoid high blood sugar and the excessive amounts of insulin. Eventually the lower amounts of insulin should result in an improvement in your insulin resistance.

 

[KennyA]

Thanks this is useful. What I don’t get is should my BG baseline reading be the same every day, does it sort of reset overnight or will there be variance? Say if I ate a cherry bakewell (if only!) and that raised my BG level would that spike gradually increase my overall fasting level?

Everybody's blood sugars vary all the time. They are affected by many other things than food and drink, although these will usually be the big players. I found a list someone had complied of over 40 factors - ambient temperature, illness, stress, exercise, etc.

The other thing is that our bodies react in different ways, so what happens to you won't necessarily happen to me, and vice versa. I learned a lot more about the ups and downs of blood sugars by using a constant glucose monitor for a mnth - if it works right it will give you a complete picture of how your body deals with carbs/sugar. Note - the CGM works on interstitial fluid rather than blood so your fingerprick readings will probably not match the CGM, and there's a bit of a lag in glucose getting to the Interstitial fluid.

Example - the CGM showed me that if I drink hot milk (in a latte, this was) I will quickly get a very large and short-lived spike that will be completely gone by one hour, let alone two.

Your other question - rises in blood glucose are perfectly normal after eating and to be expected. The question is does your insulin response system take you back to baseline by the two hour mark? To my mind "spikes" are very large and very quick rises. If they fall very quickly as well, so your body's exposure to a high sugar level is comparatively short, this is to my mind a good thing.

There are also problematic slow rises in bg following some foods that keep me elevated for long periods of time - for me that would include pastry and potatoes. Even though the high point may not be all that high, the body is exposed to a higher blood sugar level for a much longer time - something I try hard to avoid.

 

[winter2342343]

thanks for the responses- really interesting!

 

[HSSS]

How many hours later did you test? The recommendation is 2 hours after you start eating to see the highest spike.

actually that’s typically at around an hour, depending how much fat and fibre is present though as these can delay the highest point. Some things will spike even faster than an hour.

2 hrs is when in a non diabetic has usually returned to close to pre meal levels after the highest point earlier, so we attempt to do likewise.

 

[BorisP]

Hello, wanted to ask a question if I may.

I'm really looking at what foods spike my BG levels and doing intermittent fasting each day, which is really I am not eating anything until about 12:30, no breakfast.

I measured my blood first thing and it was 6.9 mmol/l - took one metformin tablet as I always do in the morning (500mg) around 3 hours later it was 6.2 mmol/l - I decided to test to see what rise a sandwich would have, white bread, bacon lettuce and tomato, an apple and sugar free peach fanta. Tested again a few hours later expecting a rise into 8+ and it was 4.8 mmol/l - so I tested again an hour later and it's 4.7 mmol/l.

I'm not eating badly generally, but I'm trying to finally cut out all my carbs in the form of bread and starch and pretty much go keto or very low carb, so while it was quite irresponsible to have that for lunch I'm trying to see what foods genuinely spike my BG levels. I feel like I've been driving a sports car with my eyes closed by not testing foods thoroughly or often enough.

I've always tested once a week when I weigh myself, test my BG and blood pressure, and then keep a log of that so I can spot any weigh gain or worrying trends. Should I be testing in this way or is it better to rely on the hba1c results as part of my yearly checkup?

Any advice would be much appreciated.

Hi there,

BG testing while on medication will ONLY tell you if your medication is working or not! in your case it does its job (Metformin is shoving all excess BG into insulin resistant cells) weight gain is not always indication of uncontrolled diabetes but the HbA1c reading is the only medically approved test tool to measure your T2D disfunction. According to the above numbers (Metformin aside) you could be classified as pre-diabetic or not at all diabetic. What is your HbA1c? is it much higher than 6? Don't wait a whole year to test it! Depending on the level of your disfunction and if you are new to medication or not you should have this test every 3 to 6 months. everyday pricking tells you only your momentary BG situation which changes by the minute.

Please be advised that below you have answers from people who are NOT on medication!!! Please be aware of this fact. They are regulating their diabetes with only food. They are the ones who might have a spike if they eat a chocolate fudge cake sprinkled with dry honey and raisins. Met usually turns that food into diarrhea. Bless it but it but unfortunately it does not cure anything...

This quote from below in your answers from "lovinglife" tells you everything there is to know about the liver (the main organ storing and releasing glucose into the blood) - " it takes a while for your liver to rid itself of all that stored glucose". So, even if you control your spikes (which is always a good thing to do!) you should educate and protect yourself longterm high BG and the key to that is the LIVER.

*****DESCLAIMER : I AM NOT A DOCTOR AND THIS IS NOT A MEDICAL ADVICE> IF YOUR DOCTOR AGREES WITHE ME PLEASE UPVOTE MY ANSWER! I HAVE T2D AND I AM FIGHTING IT EVERY SINGLE DAY. NO MORE CAKE FOR ME EVER

 

[BorisP]

actually that’s typically at around an hour, depending how much fat and fibre is present though as these can delay the highest point. Some things will spike even faster than an hour.

2 hrs is when in a non diabetic has usually returned to close to pre meal levels after the highest point earlier, so we attempt to do likewise.

Hi HESSS,

the person asking the question is on MEDICATION! when on Metformin, food fiber has no effect. Even more so, over 29g a fiber a day is medically proven to reduce the effectiveness of Metformin. So keto AND Metformin together is a very tricky thing (why have the one AND the other)

 

[lovinglife]

Hi HESSS,

the person asking the question is on MEDICATION! when on Metformin, food fiber has no effect. Even more so, over 29g a fiber a day is medically proven to reduce the effectiveness of Metformin. So keto AND Metformin together is a very tricky thing (why have the one AND the other)

Have you any evidence of this? Please can you post some links to the medically proven information regarding fibre as I’ve never heard of this.

Also why is keto and metformin tricky? I’ve been doing it for at least 8 years with no problems as have others here. In fact the majority of forum members low carb/keto, some of them diet only, some on metformin, some on other drugs and even some T1 & T2 on insulin, again do you have any links to evidence backing this up

 

[HSSS]

BG testing while on medication will ONLY tell you if your medication is working or not

Testing works regardless of medication. It shows how much glucose is in your body right now. It got there largely from the food you eat but also from your liver. The medication (if any) then deals with it in various ways according to which medication it is.

Hi HESSS,

the person asking the question is on MEDICATION! when on Metformin, food fiber has no effect. Even more so, over 29g a fiber a day is medically proven to reduce the effectiveness of Metformin. So keto AND Metformin together is a very tricky thing (why have the one AND the other)

Fibre does not raise bgl as you say but it does slow digestion down a little, possibly making the rise from the rest of the food slower, but longer.

Can you provide the proof you quote of 30g of fibre a day makes Metformin less effective? And that fibre behaves differently when medication is taken?

Why do you think keto and Metformin are tricky together? You imply because of the fibre but I can’t see how. I agree Metformin is often no longer required on keto but I can’t see it’s problematic together either.

the HbA1c reading is the only medically approved test tool to measure your T2D disfunction

Not true. Blood glucose levels are medically approved to show your levels at that moment in time. There are agreed ranges that determine the state of your metabolic function. Eg a bgl of 20mmol will always be classed as in the diabetic range, a level of 5mmol is always normal. Note I am not saying a person is diabetic or not based on a single reading just what that reading itself represents. https://www.diabetes.co.uk/diabetes_care/blood-sugar-level-ranges.html. There are also oral glucose tolerance tests. Whilst no longer widely used there are still some circumstances they are when hba1c is not appropriate. There’s also a test called the fructosamine test, mostly used in pregnancy.

They are the ones who might have a spike if they eat a chocolate fudge cake sprinkled with dry honey and raisins. Met usually turns that food into diarrhea

Metformin will not prevent a food caused spike. It simply doesn’t work that way. It mostly works by reducing the glucose being dumped into the blood by the liver, and a little by reducing insulin resistance in the cells. It doesn’t actively reduce glucose once in the blood. Nor does it magically turn food to diarrhoea like water into wine. That side effect is due to the drug itself disturbing the digestive system. If you are unlucky enough to get it it doesn’t make much difference whether you eat the chocolate cake or not for most people in preventing it.


I’m not sure where you are getting your info but some of it is distorted.

And we are not twitter. We don’t “upvote” anything on this forum.

 

[BorisP]

Testing works regardless of medication. It shows how much glucose is in your body right now. It got there largely from the food you eat but also from your liver. The medication (if any) then deals with it in various ways according to which medication it is.


Fibre does not raise bgl as you say but it does slow digestion down a little, possibly making the rise from the rest of the food slower, but longer.

Can you provide the proof you quote of 30g of fibre a day makes Metformin less effective? And that fibre behaves differently when medication is taken?

Why do you think keto and Metformin are tricky together? You imply because of the fibre but I can’t see how. I agree Metformin is often no longer required on keto but I can’t see it’s problematic together either.


Not true. Blood glucose levels are medically approved to show your levels at that moment in time. There are agreed ranges that determine the state of your metabolic function. Eg a bgl of 20mmol will always be classed as in the diabetic range, a level of 5mmol is always normal. Note I am not saying a person is diabetic or not based on a single reading just what that reading itself represents. https://www.diabetes.co.uk/diabetes_care/blood-sugar-level-ranges.html. There are also oral glucose tolerance tests. Whilst no longer widely used there are still some circumstances they are when hba1c is not appropriate. There’s also a test called the fructosamine test, mostly used in pregnancy.


Metformin will not prevent a food caused spike. It simply doesn’t work that way. It mostly works by reducing the glucose being dumped into the blood by the liver, and a little by reducing insulin resistance in the cells. It doesn’t actively reduce glucose once in the blood. Nor does it magically turn food to diarrhoea like water into wine. That side effect is due to the drug itself disturbing the digestive system. If you are unlucky enough to get it it doesn’t make much difference whether you eat the chocolate cake or not for most people in preventing it.


I’m not sure where you are getting your info but some of it is distorted.

And we are not twitter. We don’t “upvote” anything on this forum.

I can not comment on everything you posted as it could take forever. I will address the points you raised by explaining my situation. There are hundreds of advices on TD2 from nutritionists and doctors (who only prescribe meds and not food diets) and those might help or not.

All I am saying is from my personal experience and research since imho T2D is a disfunction and not a disease. it is a proper disfunction of the endocrine system where too much BG (sugar) is released into the blood stream (being from the liver or foods high on carbs/GI/GL). I am still on meds (vildagliptin plus bereberine) but I am following the teachings of Dr Jason Fung (real doctor trying to eradicate diabetes. I also think he is diagnosing a fasting treatment approved by diabetes.co.uk) and Dr Sten Ekberg (not a "real" doctor but a holistic one. my Metformin mechanism knowledge comes from his videos on youtube and my personal experience. If I post his link here it will be banned).
I was a Metformin "customer" for a year and I am thankful that it exists but I want to do everything in my power to exist without it. I didn't have T2D pre-pandemic and I want to get to that level one day if at all possible.

EVERYONE is different so the more you educate yourself the more you become effective in your BG control. I admire the fact that you have put your diabetes into remission. I would love that to happen to me one day but my starting T2D diagnosis was with morning BG of 14 and HbA1c of 9.8 so I believe that my system (especially my morning liver dump) is all messed up. I had ketones and sugar in my morning urine. it was that bad. I am not overweight (there is no point in losing weight as my T2D liver found a way to suck all the sugar from my muscles and also get it from fat as it pleased. someone came up with the term "slim fat" for that).

Metformin/Vildagliptin helped me reduce my A1c to 5.6 but with significant side effects. I have successfully replaced it with Berberine. No side effects and more energy all day long.
no link so that it's not taken away. pls google : The Side Effects Of Metformin & How To Avoid Them – Dr. Berg (REAL DOCTOR! superstar T2D fighter)

I will upvote everything I feel is significant as you get hundreds of posts here that don't actually tell you anything. If you don't like my behaviour please suggest that I am banned from this forum, as it looks like you are an expert here. but NOT a doctor

People on quora.com including real doctors are much more talkative and hands on on the subject of diabetes. I don't believe that my views are distorted. I have communicated with people all over the world who are fighting their disfunction. Some are young some are old, some managed to come of meds but returned to them plus insulin at an old age (65+) as the disfunction returned to its full nasty "glory" even though they followed strict diets and exercise... others are still alive at 85+ and some only take Metformin. I want everyone I know to try to fight their T2D as much as they can and share their advice.

I will stand by everything I posted :

1.) Re: Metformin does not like fiber (fibre) as it helps regulate BG by slowing down the absorption of carbs. In my case Metformin hated avocado but it was indifferent to pizza and pasta more so to the point where the only time I didn't have constipation with it was when I ate more carbs.
I am counting/limiting carbs but not keto as I have no fat to burn. Just some carbs and protein/fat from food I eat minus what I burn with exercise. I tried keto for few weeks but it wasn't for me as it gave me constipation same as Metformin. Coinsidence? I think not.

Don’t Eat or Drink This While Taking Metformin

Metformin, a diabetes drug, may also help with weight loss, inflammation, and cancer prevention. Here are five foods to avoid while taking it.

honehealth.com

2.Re: Metformin DOES NOT improve insulin resistance. it barely forces the cells to take up more glucose by brutal force. If it really worked that way we would take it as a pill for a while and once insulin resistance improved on its own we would go back to pizza, pasta and cake. But we know better and we reduce carbs and eat more fat/protein and we exercise.
pls google watch and learn: Dr Ekberg : WARNING! Diabetes Treatment Could Actually Kill You!

3.)Re : Postprandial blood sugar levels and medication after eating cake. since you are not on any meds pls be a mate and consume this (if you can, at your own risk) and advise of your BG levels before and after ingesting it. I have forgotten what cake tastes like

Carrot Cake (Plant Based) | Starbucks

www.starbucks.co.uk

let's have someone on Metformin try the above at their own risk (it has 49g of carbs with 29g of sugar and even 4g of fibre). The one's that get diarrhea will prove my point. I dare not think of it. it's like poison to me.

4.) Re: constant pricking and obsessing about momentary BG levels. This is only advisable if you have wild BG swings or you are on insulin. Someone correctly commented that up to 40 different things could affect your morning reading or your BG after eating. You said it yourself, different foods take quicker or slower to release glucose. I have never ever had problems with potatoes. Pasta and pizza once a week less than 150g (accompanied with half of a large avocado) dissolves quite well for me but not sugar in it's pure or refined form. that's been off the menue since 2021.
My sugar after meals is always lower than my morning level as the morning start (liver dump / dawn syndrome) is used up.
Morning reading around 8.5, after any food without sugar and less than 30g of carbs, 6 to 7 , HbA1c 6.1. yes, I have diabetes and it won't change anything if I constantly check my blood levels as I have HbA1c as the one and only true indicator.

What is HbA1c?

HbA1c is your average blood glucose (sugar) levels for the last two to three months. If you have diabetes, an ideal HbA1c level is 48mmol/mol (6.5%) or below. If you're at risk of developing type 2 diabetes, your target HbA1c level should be below 42mmol/mol (6%).

www.diabetes.org.uk

Thanks for your time. I just tried to fully explain my situation and my understanding of T2D. keep up your fight.

 

[HSSS]

I have no wish to get you banned. Posting legitmate links is encouraged and will not get you banned. I was pointing out we don’t “vote” for posts on this forum, though we do have reaction Emojis. And I do agree in principle with your sentiments. I’m just trying to explain about the testing and Metformin.

Your assertion that Metformin doesn’t like certain foods has no basis in anything I’ve ever read on the subject. Your link uses the phrases “Researchers posit that exceeding 30 grams of fiber in a day may lower metformin levels in the body due to the fact that fiber binds to the drug and reduces its efficacy.” and also admits there is little research on the subject. The source of that quote is a blog type document not a study of any sort and that is without references. Hardly conclusive.

The first links that come up about Metformin and IR https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8836112/. And https://journals.physiology.org/doi/full/10.1152/ajpendo.00287.2021. There are many many more. I’m not suggesting Metformin is a cure, which is what you propose with a course to solve the problem then back to junk carb eating. I’m saying Metformin is known to help the action of insulin in the cells. I too would prefer to achieve the same by diet but that’s not always enough/practical for everyone’s lifestyle. Metformin also apparently has other beneficial effects some choose to take it for.

Keto does have some side effects for some people but they are mostly easily overcome with a few tweaks. Constipation for example is often because with fewer carbs to hold water we more easily become dehydrated in the early weeks. Simply adding more fluids (and the necessary electrolyte) solves this issue for most people that try it. It’s also possible to maintain or even gain weight on keto but adjusting the amount of fats and proteins you eat.

Your point about testing and not being on medication makes no sense to me. Honestly both groups will record a glucose rise for that kind of carb hit. I’ve really no idea why you think otherwise. Just because diarrhoea is a side effect for some on metformin it is the drug not the food that causes that symptom.

As far as testing goes you are falling for outdated information. Sure testing was developed initially for insulin users to avoid hypos and adjust their dosages. However it will show the effects of particular foods on an individual. Once you know what these are then you can eliminate those that are problematic and focus on those that cause no issues. If you aren’t testing foods how do you know which ones are or aren’t a problem to you? This thread https://www.diabetes.co.uk/forum/threads/have-you-been-told-not-to-test-your-blood-sugars.66574/ will show you the arguments in favour of it. An hba1c will give you an overall picture but not identify specifics. You obviously haven’t understood what I said above about other tests and their values. Hba1c and bgl are both useful and show different aspects of diabetes.

 

[Alec G.]

HSSS

Sorry for my ignorance but could you expand on the following that you wrote: "Simply adding more fluids (and the necessary electrolyte) solves this issue for most people". What is the "necessary electrolyte", is it generic or individually tailored?

Many thanks in advance. Alec

 

[HSSS]

HSSS

Sorry for my ignorance but could you expand on the following that you wrote: "Simply adding more fluids (and the necessary electrolyte) solves this issue for most people". What is the "necessary electrolyte", is it generic or individually tailored?

Many thanks in advance. Alec

Well we all need sodium, magnesium and potassium as the biggest 3 electrolytes. When we increase our fluids we can have the effect of flushing them out. Also ditching processed foods often means we are taking less in. Having any of these too low can make you feel terrible. You can get tests but honestly I’ve always worked on the basis if I am ditching carbs I am not scared of sodium that comes with my food and in fact I add a little in ways I never did pre this way of eating. Potassium and magnesium I try and get via foods rich in these but I do have cheap basic supplements in the house to take if I’m feeling off. If any of these are the issue you will rapidly feel the difference.

Have a read here https://www.dietdoctor.com/low-carb/keto/supplements