Advice on BS levels/spikes

[Beansprout]

Hi all. I was diagnosed about three months ago, assumed type 2 (hba1c of 112). While I had an initial meeting with the nurse, I feel like I was largely left on my own to figure this out. I was given a pamphlet that was very generic and ridiculously low on usable information. When I asked about how this works being mostly vegan, the nurse, unfortunately, didn't have any at advice all. Same story when I asked about what my blood sugar levels should be for daily testing. I was shown a generic graph of normal vs diabetic blood sugar levels that had no numbers on it at all! When I asked what level of increase I should aim for after meals, there was again no advice. Sorry I'm whinging. There's a question in here somewhere - maybe even two.

1. What level of increase do you aim for after meals? I've seen a few posts that recommend a rise of <2 mmol 2 hours after eating. However, should the max spike be 2 mmol or is it just important that my total blood sugar increase is less than 2 @ the 2 hour mark?

This leads me to a second question. I've been wearing a Freestyle libre for a week. While I think its reading is a bit low (~1 mmol under finger pricks) I'm taking it as canon and love the data. However...

2. I'm confused about whether I should eat large meals less often or frequent small meals. If I eat three large meals a day my bs spikes higher, but there is a longer period of low between meals. E.g. bs goes from 6 to 10 after each meal, returning back to 6 after say 3 hours until I eat again. If I eat frequent small meals, my bs stays between 7-8 most of the day.

If the advice is three small meals a day, I can't hear this at this point.

Anyway, interested in what guidelines people use around bs levels and spikes. Many thanks.

 

[xfieldok]

Quite a few people on the forum do OMAD or one meal a day. Some eat twice a day.

What are you eating in a typical day please?

 

[EllieM]

Though many of the folk on here are keen meat eaters there is a low carb vegetarian forum, and that does cater to vegans

https://www.diabetes.co.uk/forum/category/vegetarian-diet-forum.71/

Do you actually need/want to lose weight? The T2 assumption will be because of your age - in your position I'd push for a GAD and c-peptide test to rule out T1.

Courgettes and cauliflowers are awesome vegetables and I love courgetti spaghetti (spiralise the courgettes and fry them to substitute for pasta) . Others swear by cauliflower rice.

my bs stays between 7-8 most of the day.

As a T1 (50 years since diagnosis and still healthy ) I would be pretty happy with this, but I suspect you may be aiming for lower, specially given your age.

What are you eating in a typical day please?

This is a good question, we may be able to make suggestions to lower your carbs without entirely derailing your meal plans.

You don't have to starve on a low carb diet.

Good luck.

 

[Mr_Pot]

Hi all. I was diagnosed about three months ago, assumed type 2 (hba1c of 112). While I had an initial meeting with the nurse, I feel like I was largely left on my own to figure this out. I was given a pamphlet that was very generic and ridiculously low on usable information. When I asked about how this works being mostly vegan, the nurse, unfortunately, didn't have any at advice all. Same story when I asked about what my blood sugar levels should be for daily testing. I was shown a generic graph of normal vs diabetic blood sugar levels that had no numbers on it at all! When I asked what level of increase I should aim for after meals, there was again no advice. Sorry I'm whinging. There's a question in here somewhere - maybe even two.

1. What level of increase do you aim for after meals? I've seen a few posts that recommend a rise of <2 mmol 2 hours after eating. However, should the max spike be 2 mmol or is it just important that my total blood sugar increase is less than 2 @ the 2 hour mark?

This leads me to a second question. I've been wearing a Freestyle libre for a week. While I think its reading is a bit low (~1 mmol under finger pricks) I'm taking it as canon and love the data. However...

2. I'm confused about whether I should eat large meals less often or frequent small meals. If I eat three large meals a day my bs spikes higher, but there is a longer period of low between meals. E.g. bs goes from 6 to 10 after each meal, returning back to 6 after say 3 hours until I eat again. If I eat frequent small meals, my bs stays between 7-8 most of the day.

If the advice is three small meals a day, I can't hear this at this point.

Anyway, interested in what guidelines people use around bs levels and spikes. Many thanks.

Regarding question 1. A non-diabetic would probably be back to their pre-meal level 2 hours after starting eating. To judge the suitability of a particular meal it is usually recommended that you should not be more than 2 mmol/L above the pre-meal level after 2 hours. In time by eating low carb meals you will reduce insulin resistance and get a rise much less than 2.

 

[JoKalsbeek]

Hi all. I was diagnosed about three months ago, assumed type 2 (hba1c of 112). While I had an initial meeting with the nurse, I feel like I was largely left on my own to figure this out. I was given a pamphlet that was very generic and ridiculously low on usable information. When I asked about how this works being mostly vegan, the nurse, unfortunately, didn't have any at advice all. Same story when I asked about what my blood sugar levels should be for daily testing. I was shown a generic graph of normal vs diabetic blood sugar levels that had no numbers on it at all! When I asked what level of increase I should aim for after meals, there was again no advice. Sorry I'm whinging. There's a question in here somewhere - maybe even two.

1. What level of increase do you aim for after meals? I've seen a few posts that recommend a rise of <2 mmol 2 hours after eating. However, should the max spike be 2 mmol or is it just important that my total blood sugar increase is less than 2 @ the 2 hour mark?

This leads me to a second question. I've been wearing a Freestyle libre for a week. While I think its reading is a bit low (~1 mmol under finger pricks) I'm taking it as canon and love the data. However...

2. I'm confused about whether I should eat large meals less often or frequent small meals. If I eat three large meals a day my bs spikes higher, but there is a longer period of low between meals. E.g. bs goes from 6 to 10 after each meal, returning back to 6 after say 3 hours until I eat again. If I eat frequent small meals, my bs stays between 7-8 most of the day.

If the advice is three small meals a day, I can't hear this at this point.

Anyway, interested in what guidelines people use around bs levels and spikes. Many thanks.

It's not how much you eat, it's what you eat. You can absolutely STUFF yourself without a blip in blood sugar levels if it's carb free, but you'll spike with a tiny little carb-heavy snack. Vegans and vegetarians often have a high carb content diet. It doesn't have to be mind you, but if you're not mentioning a low carb vegetarian diet I'm assuming it's "regular" carb content... Which is high. If you eat often, you keep taxing your pancreas, keep demanding insulin output and keeping your insulin floating around high. That's not preferable when you want to get your insulin sensitivity to improve. So unless you have no weight to spare (some T2's are skinny), you might want to avoid frequent meals/snacks. One meal a day, two meals a day, or the regular three is fine... Just keep an eye on the carb content! Fruit is basically murder for your bloodsugars and your liver, alas. So you want to get your vitamins from your vegetables then, for the most part. (Sorry). Berries are fine, preferably with a full fat yoghurt. I'd say greek, but I assume that's not an option. There's some nice really coconut yoghurts out there too, dunno which brands you can choose from through, being Dutch myself. But what you want to keep an eye on are the carbs... All of them pretty much turn to glucose once ingested, so that nixes a lot of fruits and underground vegetables. There's still a bunch of things to choose from, but being vegan does make things a little limited. And you might have to keep an eye on your vitamins with a supplement here and there, but being a meat-eater myself, I'm just shooting in the dark here. There are low carb vegan people out there (for medical, ethical or religious reasons), and you'll find them in the vegan section @EllieM mentioned. So you're certainly not alone.

The 2.0 mmol/l maximum rise is an aim that tells you whether your body's responding properly to what you've put in it, so it's not being overtaxed and overwhelmed. If it's 2.0 mmol/l or less, your glucose should be getting under control. Healthy people have blood sugars between around 4,5 and 8,5, anything over 8,5 for a longer period of time will cause damage, so that's to be avoided, and if possible, fixed with a low carb diet (or as the case may be, medication).

Perk of being a vegan: You're probably in possession of a rather firm spine. Changing your diet around a little to feature low carb as well as vegan could well be easier for you than it is for the average person.

https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html <-- this might help explain T2 a little, and please forgive all the foods with/from faces, I wrote it with omnivores in mind.

Good luck!
Jo

 

[Beansprout]

Thanks for the replies.

@xfieldok - I'm still testing out what does/doesn't work food wise for me. Having the libre tracking trends had been helpful.

@EllieM - Thanks for the forum recommendation, I'll check it out. As to the weight. Do I want to lose weight? After a lifetime of constant stress, harassment and struggle with being overweight, I'd rather not have to bother. But, sure, I should.

@Mr_Pot - Yes, I'm tempted to stick a monitor on my roommate just to compare our numbers after we eat the same meals. I've read a few articles that suggest a link between bs spikes and long term complications even if the average is ok. Maybe, for now, I'll opt for my option b of smaller meals with less spikes.

 

[xfieldok]

Remember the 20 minute time lag with the libre.

I elected to go keto less than 20g carbs per day. It brought my numbers down relatively quickly. A byproduct is weight loss. The advantage of very low carb or keto is there is no hunger.

 

[Beansprout]

If you eat often, you keep taxing your pancreas, keep demanding insulin output and keeping your insulin floating around high.

That's an interesting point, thanks for this.

I should probably clarify that I'm vegetarian, not vegan. I generally don't eat dairy or eggs, but there are slippages. I don't want to claim a standard I don't meet.

And yes, I've lived on rice and potatoes for a long time. I've been trying to either eat less carbs it swap to lower gi options. I'm aiming at moderate, not low carb, if I can manage it. I've read several of the posts here, I feel like that's an unpopular stance. We'll see how I get on and adjust from there. Really appreciate all the info in your post!

 

[xfieldok]

There are vegetarian and vegan sub forums which may be of interest. Lookup cauliflower rice.

 

[Beansprout]

@xfieldok - Good to know keto works for you. I have done very low carb diets (re: lifelong attempts at weight loss). I won't argue effectiveness, I just haven't been able to sustain it for long periods.

 

[xfieldok]

I found keto hard at first, breaking the carb addiction took around 4 weeks, we will gloss over the incidents involving crumpets and half packets of ryvita.

Then it happened. No appetite, I had to be reminded to eat. It was incredibly liberating.

Keto isn't for everyone, we each have to find our own way. I am all for everyone being free to make their own choice, but I just want to make sure they are properly informed.

 

[JoKalsbeek]

That's an interesting point, thanks for this.

I should probably clarify that I'm vegetarian, not vegan. I generally don't eat dairy or eggs, but there are slippages. I don't want to claim a standard I don't meet.

And yes, I've lived on rice and potatoes for a long time. I've been trying to either eat less carbs it swap to lower gi options. I'm aiming at moderate, not low carb, if I can manage it. I've read several of the posts here, I feel like that's an unpopular stance. We'll see how I get on and adjust from there. Really appreciate all the info in your post!

Well, whether something's popular or not shouldn't matter: what your meter tells you is what counts. (And cauliflower rice really is very versatile ) Basically though, whether something's low GI or not doesn't really make a difference for a T2... For a T1 it might help decide whether to split the dose of insulin or not, but for a T2 it's just all the same, really... Turns out a whole lot of things don't really actually matter all that much, just muddies the water more and makes it more complicated than it has to be. Cut carbs, up fats (yay for avocado's), and you should be fine. And not hungry all the time. It takes a while to figure out what exacty works for you, but your meter'll help.