Post meal double spikes

MisterMints

Well-Known Member
Messages
49
Type of diabetes
Type 1
Treatment type
Insulin
Do any of you get double spikes like this?

My control the last few days has been pretty dreadful, I just can't seem to get the post meal levels back down. And I'm having issues like on the graph with a second spike hours after eating.

Just when I thought my sugars were coming down to normal after dinner, it starts climbing rapidly again. I thought I had injected just a little too much with dinner to bring it down from the already slightly high state it was in. I've had to inject multiple more times than usual today to try to regain some control.

What can I do to avoid these double spikes? What's causing them?

Dinner tonight was a low carb burrito (no rice, just the meat, tiny bit of cheese, dollop of soured cream in a 30g carb wrap) and a small handful of tortilla chips
Screenshot_20181218-223207_xDrip%2B.jpg
 

kitedoc

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Hi @MisterMints, As experience as a T1D, not as professional advice or opinion: Could you be under stress ? (the silly season is a general reason for many of us, or the start of a virus infection etc)? And I certainly can suffer 'hypo' symptoms with BSLs dropping more quickly than usual. I think, (but cannot prove in my case) that the rapid fall in BSL is enough to trigger off my adrenaline despite BSLs being above 'hypo' range and this of course pushes the BSL up again.
And stress means that I have to use larger correction doses of short-acting insulin than usual.
For me, (and you may well be different and thus need to consult your DSN or doctor), the 'secret' was to increase my basal or long-acting insulin as a general hedge against whatever is pushing the BSLs up) and then ease back on the correction doses.
Like pouring oil on the troubled waters. The change takes several days to settle out in my case.
How much the basal/long-acting insulin needs to be altered is individual. another reason to consult your DSN or doctor.
I hope the above gives you non-BSL raising food for thought !! :):):)
 

JohnEGreen

Master
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Looks a bit like the old pizza affect to me mixture of carbs and fats causing an initial spike then drop and then a second delayed spike but then I am not T1 so do not know if this applies to a T1 when having injected insulin.

Ignore me if I am way of base.
 
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MisterMints

Well-Known Member
Messages
49
Type of diabetes
Type 1
Treatment type
Insulin
Hi @MisterMints, As experience as a T1D, not as professional advice or opinion: Could you be under stress ? (the silly season is a general reason for many of us, or the start of a virus infection etc)? And I certainly can suffer 'hypo' symptoms with BSLs dropping more quickly than usual. I think, (but cannot prove in my case) that the rapid fall in BSL is enough to trigger off my adrenaline despite BSLs being above 'hypo' range and this of course pushes the BSL up again.
And stress means that I have to use larger correction doses of short-acting insulin than usual.
For me, (and you may well be different and thus need to consult your DSN or doctor), the 'secret' was to increase my basal or long-acting insulin as a general hedge against whatever is pushing the BSLs up) and then ease back on the correction doses.
Like pouring oil on the troubled waters. The change takes several days to settle out in my case.
How much the basal/long-acting insulin needs to be altered is individual. another reason to consult your DSN or doctor.
I hope the above gives you non-BSL raising food for thought !! :):):)
I don't think it is.

I don't feel stressed, Christmas is all sorted, work is going well, home life is good.

I am perhaps getting stressed that my sugars are all over the place and it's a self fulfilling prophecy but I'm not convinced on that either.
 
K

Knikki

Guest
Are you using Libre with xDrip?

If I was running that high I would double check with finger pricks as I have found in the past that it has said 16.5 when bloods have said 10.5.

Not sure about the double spike mind you, does seem a little odd but sorry can't add anything useful.
 

MisterMints

Well-Known Member
Messages
49
Type of diabetes
Type 1
Treatment type
Insulin
Are you using Libre with xDrip?

If I was running that high I would double check with finger pricks as I have found in the past that it has said 16.5 when bloods have said 10.5.

Not sure about the double spike mind you, does seem a little odd but sorry can't add anything useful.
I am, and was doing fine tests too. They were coming in roughly the same
 

MisterMints

Well-Known Member
Messages
49
Type of diabetes
Type 1
Treatment type
Insulin
Here we go again. Post lunch second spike again today. I over injected, and it was coming down just nicely (in fact xDrip was predicting a hypo in about 90 minutes time during that initial drop). Nothing eaten other than lunch and we're on the way back up again.

This may sound like a daft question but best with me! Is it possible that I'm not chewing my food enough, the body is suggesting what has Andy been broken down by the teeth, but the second spike is caused by it taking longer to work through the larger bits of food?
Screenshot_20181219-152157_xDrip%2B.jpg
 

KK123

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Messages
3,967
Type of diabetes
Type 1
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Insulin
Looks a bit like the old pizza affect to me mixture of carbs and fats causing an initial spike then drop and then a second delayed spike but then I am not T1 so do not know if this applies to a T1 when having injected insulin.

Ignore me if I am way of base.

John, you are spot on! It most definitely occurs in type 1s too, that's why they sometimes split the dose, ie give themselves a second dose of insulin 1 or 2 hours after the meal to catch spike number 2.
 
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scotteric

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Messages
312
Type of diabetes
Type 1
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Pump
Here we go again. Post lunch second spike again today. I over injected, and it was coming down just nicely (in fact xDrip was predicting a hypo in about 90 minutes time during that initial drop). Nothing eaten other than lunch and we're on the way back up again.

This may sound like a daft question but best with me! Is it possible that I'm not chewing my food enough, the body is suggesting what has Andy been broken down by the teeth, but the second spike is caused by it taking longer to work through the larger bits of food?View attachment 30135

Are you sure your basal dose is correct? There is a relationship between basal and food, even though the conventional thinking is that basal is for fasting and rapid-acting insulin for meals. Sometimes if my basal dose is too low, I can have reasonable fasting numbers but see huge spikes every time I eat. Sometimes it's just an extra basal unit or two (or a small increase per hour if you pump) that does the trick. Remember basal needs are not constant; I find many things can cause my basal needs to increase, including change in weather, stress levels, quality of my sleep, activity levels, etc.
 

MisterMints

Well-Known Member
Messages
49
Type of diabetes
Type 1
Treatment type
Insulin
Are you sure your basal dose is correct? There is a relationship between basal and food, even though the conventional thinking is that basal is for fasting and rapid-acting insulin for meals. Sometimes if my basal dose is too low, I can have reasonable fasting numbers but see huge spikes every time I eat. Sometimes it's just an extra basal unit or two (or a small increase per hour if you pump) that does the trick. Remember basal needs are not constant; I find many things can cause my basal needs to increase, including change in weather, stress levels, quality of my sleep, activity levels, etc.
I am fairly certain basal is OK. I've done done basal testing over the last few weeks and things have looked good. In fact, if you look at my graph ahead of lunch today it was pretty much perfectly flat, with an ever so slight decline
 

miriamy

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212
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Tablets (oral)
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Do any of you get double spikes like this?

My control the last few days has been pretty dreadful, I just can't seem to get the post meal levels back down. And I'm having issues like on the graph with a second spike hours after eating.

Just when I thought my sugars were coming down to normal after dinner, it starts climbing rapidly again. I thought I had injected just a little too much with dinner to bring it down from the already slightly high state it was in. I've had to inject multiple more times than usual today to try to regain some control.

What can I do to avoid these double spikes? What's causing them?

Dinner tonight was a low carb burrito (no rice, just the meat, tiny bit of cheese, dollop of soured cream in a 30g carb wrap) and a small handful of tortilla chipsView attachment 30133
I had a similar problem. I discovered that I need to keep the carbs in each meal to below 10, ideally below 8 and I don't get spikes.
 

DCUKMod

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Staff Member
Messages
14,298
Type of diabetes
I reversed my Type 2
Treatment type
Diet only
I had a similar problem. I discovered that I need to keep the carbs in each meal to below 10, ideally below 8 and I don't get spikes.

Hi Miriamy. Whilst some T1s do keep their carbs down, theorhetically they should be able to eat anything they choose and manage their injected insulin around it.
 

miriamy

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212
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Type 2
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Hi Miriamy. Whilst some T1s do keep their carbs down, theorhetically they should be able to eat anything they choose and manage their injected insulin around it.
Sorry, I didn't look to see if they were T1 or T2. I know nothing about T1!
 

DCUKMod

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Messages
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I reversed my Type 2
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Sorry, I didn't look to see if they were T1 or T2. I know nothing about T1!

No worries Miriamy. We've all done that some time.

Your suggestion is an option available to the OP so it wasn't drastically out of place.
 
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