Spikes after eating

[endocrinegremlin]

This is definitely getting into more advanced management than the OP should consider for now, but I don't worry about that - if I'm high and still have insulin on board from my last bolus, I'll not let that stop me injecting more. Obviously the stuff left in the body needs taking account of, but I reckon corrections go both ways (insulin or food) at any time. This approach does need a lot of testing though, or of course libre/CGM.

They asked I answered.


Also I would disagree. Any new diabetic should be told to allow their insulin to pan out before reacting. It is what their HCP need to move forward.

 

[evilclive]

Disagree? I did carefully say "more advanced management than the OP should consider for now", which agrees with your "any new diabetic".

 

[LooperCat]

Disagree? I did carefully say "more advanced management than the OP should consider for now", which agrees with your "any new diabetic".

Yeah, some of the management techniques we’re using are quite advanced, and I personally rely heavily on technology to tell me exactly how much insulin I have on my system, so I’m quite happy to stack doses (@Jazz97 - that means taking correction doses before the last dose has worn off). My team were quite concerned until I showed them exactly how I do it. It’s early so I can’t remember what you’re using, Jazz, but I’d recommend downloading the MySugr app and logging every bg test, every meal (with its carb content) and every dose of insulin. It’s a great way of logging and the basic version is free. Are you using Libre?

DAFNE and most of the online course for carb counting suggest we start with a dose of one unit of insulin per 10g carbohydrate. It’s also assumed to start with that one unit will drop your level by 3mmol. I’m actually mostly still sticking to those ratios as they work for me in the later part of the day; in the morning I’m more like 1u:7g and 1u:2mmol as I’m a bit resistant in the morning. YDMV is a phrase you’ll see around the place - Your Diabetes May Vary

For now I’d keep things simple, and with the aid of your DSN, get these levels down eating what you were before. Once you’ve got to grips with that, then you can start fiddling to work out a regime that works for you. We’ll help all we can!

 

[Jazz97]

Yeah, some of the management techniques we’re using are quite advanced, and I personally rely heavily on technology to tell me exactly how much insulin I have on my system, so I’m quite happy to stack doses (@Jazz97 - that means taking correction doses before the last dose has worn off). My team were quite concerned until I showed them exactly how I do it. It’s early so I can’t remember what you’re using, Jazz, but I’d recommend downloading the MySugr app and logging every bg test, every meal (with its carb content) and every dose of insulin. It’s a great way of logging and the basic version is free. Are you using Libre?

DAFNE and most of the online course for carb counting suggest we start with a dose of one unit of insulin per 10g carbohydrate. It’s also assumed to start with that one unit will drop your level by 3mmol. I’m actually mostly still sticking to those ratios as they work for me in the later part of the day; in the morning I’m more like 1u:7g and 1u:2mmol as I’m a bit resistant in the morning. YDMV is a phrase you’ll see around the place - Your Diabetes May Vary

For now I’d keep things simple, and with the aid of your DSN, get these levels down eating what you were before. Once you’ve got to grips with that, then you can start fiddling to work out a regime that works for you. We’ll help all we can!

Unfortunately do not have libre. I want one, but I think the nurse said I have to be diagnosed for 3 months before I can be considered for one. At least I wont have to worry about the fact that you have to be testing 8 times a day. I'm currently testing almost every hour.
I've been told not to stack doses, at least for now. Especially as my BS seems to drop over night. She did say that they might consider changing me from lantus to levemir if this keeps happening.

So yeah, on three meals a day, four hours apart and just trying to snack on things like beef jerky, pork scratchings, and cheese. I did try a hard boiled egg the other day, but that pushed me up just a little.

I wish I knew what my ratio is. Would make things a lot easier.
The only problem with counting the carbs, is I dont understand if that's all I should be counting.... Eg the egg... should I be counting protein as well? Do i need to have more insulin for foods which have more sugar? Is there a difference for fast acting or slow acting carbs?

Of course I'm going to ask the nurse all these questions on Thursday, but everything is a waiting game at the moment

 

[Chris Bowsher]

It's overwhelming to start with, especially in this modern age of information and technology at your fingertips. You sound very similar to me in mental approach you want to know everything and get it sorted ASAP which is great as you will get on top of it quickly. But just take it one day at a time and give yourself chance to absorb this is most definitely a marathon not a sprint.

and make sure you have fun at uni.

 

[Deleted Account]

I'm being told to eat normally (and that I will continue to be able to eat normally) by the nurse, and then i come on here and everyone is low carb.

I just want to add another "I do not eat low carb" to this discussion.
Whilst there are some people with type 1 who successfully follow a low carb diet, many people with type 1 do not do so.
On this forum, as in general society, 90% of people with diabetes have type 2.
Type 2 is a different condition to type 1 and treated differently. Sometimes, it is a shame it has the same name as it leads to many confusions.

I follow a similar approach to @Knikki - generally eat what I want unless my BG is high and then drop carbs until my BG is reduced.
But, I strongly recommend keeping it simple at the moment, not getting too hung up on the numbers as you get used to the daily routine of injections and testing.
There is so much you could learn that it can quickly become intimidating.

 

[Jazz97]

I just want to add another "I do not eat low carb" to this discussion.
Whilst there are some people with type 1 who successfully follow a low carb diet, many people with type 1 do not do so.
On this forum, as in general society, 90% of people with diabetes have type 2.
Type 2 is a different condition to type 1 and treated differently. Sometimes, it is a shame it has the same name as it leads to many confusions.

I follow a similar approach to @Knikki - generally eat what I want unless my BG is high and then drop carbs until my BG is reduced.
But, I strongly recommend keeping it simple at the moment, not getting too hung up on the numbers as you get used to the daily routine of injections and testing.
There is so much you could learn that it can quickly become intimidating.

Thank you! I think that's what I'm going to aim for. Trying my best to be good at the moment!

 

[smc4761]

Hi @Jazz97 if you ever need any advice about Type 1 this is the place to go to. The thread, Type 1 Stars R US forum is IMHO the best part of the forum with some wonderful people with years of experience of type 1. What these guys dont know about type 1 probably is not worth knowing.

https://www.diabetes.co.uk/forum/threads/type-1stars-r-us.150597/page-754#post-2040310

It is daunting to begin with, there is so much infor to get your head round, try not to panic, you will never manage to take it all in at once, baby steps is the way forward.

The biggest step that needs to happen is probably carb counting. Couple that with regular testing of BG. basically once you know what your BG is you then adjust your insulin dose, based on carb counting and away you go.. it will take a lot of trial and error to get your carb ration and insulin ration right, just be patient you will get there.

I have type 1 for 38+ years and i am still learning and making subtle adjustments each day/week.

Remember you are not alone, we have all been there at 1 point. Any questions please ask away

 

[Jazz97]

Hi @Jazz97 if you ever need any advice about Type 1 this is the place to go to. The thread, Type 1 Stars R US forum is IMHO the best part of the forum with some wonderful people with years of experience of type 1. What these guys dont know about type 1 probably is not worth knowing.

https://www.diabetes.co.uk/forum/threads/type-1stars-r-us.150597/page-754#post-2040310

It is daunting to begin with, there is so much infor to get your head round, try not to panic, you will never manage to take it all in at once, baby steps is the way forward.

The biggest step that needs to happen is probably carb counting. Couple that with regular testing of BG. basically once you know what your BG is you then adjust your insulin dose, based on carb counting and away you go.. it will take a lot of trial and error to get your carb ration and insulin ration right, just be patient you will get there.

I have type 1 for 38+ years and i am still learning and making subtle adjustments each day/week.

Remember you are not alone, we have all been there at 1 point. Any questions please ask away

Thanks
I really want to start carb counting as soon as possible, but looks like the nurse is going to make me wait 6-12 months...

 

[becca59]

@Jazz97 insist, tell her it is your diabetes and you are quite capable. Buy a copy of carbs and Cals. As long as you can weigh food and be strict and honest about how much food you have on your plate. You are at university for goodness sake, so obviously have a fair amount of intelligence. You will start to get better control and fine management easier.

 

[Deleted Account]

I agree with @becca59.
To be honest, when injecting and the closest estimate you can get is within 10g, i didn’t weight my food and I found Carbs and Cals too tedious to use.
However, I quickly got used to eyeing up a plate of food and guesstimating the approximate number of carbs from the high hitters like potatoes, pasta, rice, cake (@Knikki would be disappointed if I didn’t mention cake), bread, ...
It is worth remembering carb counting can only be an estimate * so there is not need to be precise.

*I believe the only way to accurate calculate the carbs in a dish is to burn it and weigh the carbon that remains. A packet may say a slice of cake contains 30g of carbs but you may get the slice with extra cherries or less icing or made with a batch of less sweet sultanas so it is only an approximation.
Add to that your insulin to carb ratio can vary depending on time of day, how much ch exercise you have done, weather, ... so again it is an approximation.
Hence, no need to be precise.
(At least that is my opinion and, so far, my hb1ac has been less than 50 every year.)

 

[Glucobabu]

Just wondering how people deal with spikes after eating? Mine always spike, but then will go back down to normal after a few hours. My nurse has said not to worry about it for now, but obviously I am.
Am on a fixed dose, and haven't been told how many carbs i should be eating, just to eat normally. So not looking for advice specifically, but just how others deal with this problem if they have it. Thanks

I think you should make it a priority to get on the DAFNE course as soon as possible. Talk to your DSN or the doctor at your diabetic clinic. You’ll still spike but will be able to deal with it better with the skill of carb counting and working out your ratios.

 

[Alternative Diabetic]

Just wondering how people deal with spikes after eating? Mine always spike, but then will go back down to normal after a few hours. My nurse has said not to worry about it for now, but obviously I am.
Am on a fixed dose, and haven't been told how many carbs i should be eating, just to eat normally. So not looking for advice specifically, but just how others deal with this problem if they have it. Thanks

Carbs make you spike ...Hence better to be on a low carb diet..Cut out anything with refined sugars as that can also spike you..I have spiked for 27 years because when first diagnosed told to eat carbs..I have now gone onto a low carb diet and i hardly spike...

 

[Deleted Account]

@Alternative Diabetic my response to spiking is “define spike”.
I agree a spike of 28 is to be avoided but this may be done with the appropriate insulin dose (both timing and quantity of basal and bolus) rather than lowering carbs.
But lower “spikes” maybe natural - someone without diabetes may get spikes up to about 10.

 

[jane1754]

The odd thing is, they tell us everything backwards. If you don't have diabetes and you have a bowl of ice cream, your pancreas says 'Aha! here comes some ice cream so here comes the right amount of insulin to deal with that' (in a manner of speaking). but if you are diabetic, they tell you to take a fixed amount of insulin regardless of what you eat. That's bonkers to me. So either you have to try to tailor what you eat to how much insulin you've been told to take, which, of course, is somewhat impossible, or you have to do the job of your pancreas and work out how many carbs in your ice cream, and possibly also take into account the exercise you've just done and the stress of the exam you are about to take. The pancreas is so clever, and by and large the diabetic 'experts' are not. I'm fortunate in having a pump and CGM, which do some of the work for me, and I'm trying low carb because otherwise my BG looks like the Himalayas. If you try low carbing, you will have to adjust your insulin to match, but it makes sense to me. Doing an online course, which I did because they wouldn't let me do DAFNE for a year after diagnosis, helped me understand what was going on, and on the basis of that I lowered my intake of potatoes, pasta and other high carb foods because I was still on fixed amounts of insulin. The pump changed all that because it adjusts the amount of insulin to the carbs I tell it I'm having. Hope that helps.

 

[Alternative Diabetic]

@Alternative Diabetic my response to spiking is “define spike”.
I agree a spike of 28 is to be avoided but this may be done with the appropriate insulin dose (both timing and quantity of basal and bolus) rather than lowering carbs.
But lower “spikes” maybe natural - someone without diabetes may get spikes up to about 10.

I agree every Diabetic is different ... Spiking for me was anything up to HI..I am classed as a brittle diabetic..I was put on high doses of insulin when first diagnosed 27 years ago and made to eat carbs ...even though i knew my ratios of carbs to insulin my stomach dumped (Gastroparesis) my sugar was difficult to control, and insulin missed my food hence Hypo most days too !!! 20 years later going on a pump with CGM (Freestyle libre) helped to reduce my insulin requirements but I still spiked even with the help of metformin !! Its only now when i changed my diet completely reducing Carbs (Which I never thought i could do) have i got far better control hence why for me Carbs made me spike ..So I have ditched Wheat, refined Sugars Diet drinks and turned to a part plant based diet and organic foods. Im on 17 units of insulin a day from 48 units when first diagnosed and hardly spike ...I agree though no diabetic is the same ..but Endroconologists treat us like a book with one rule ..I went to a pump training session with a big Drugs company ..When we had lunch i was shocked to see how many diabetics had desserts full of sugar their attitude being just give more insulin....

 

[cireland]

At the end of the day, people will do what is right for them, I am still learning the ropes of MDI but I am not fussed overly about the spikes, I do have much control over them now and very rarely do I go over 10. Mostly I stay in the 8's before coming back down to anywhere between 4.5-5.5 within 2 hours generally speaking. For me this is fine. I am still working out my ratio's as I often go low in the evening (I have a Dexcom G6 and it is great that it alerts me!) I count carbs but I don't restrict what I eat. So while I use 1:10 I think in the evening I should start reducing mine. @Alternative Diabetic if I was there I would have absolutely had a nice dessert as well!