Are spikes a problem?

lucylocket61 said:

I saw my DSN today, as per my other post/thread. However:

I also asked about my blood spiking at 9.4 after having pasta and what to do. She said to do nothing, if I follow the NHS diet all will be well and the spikes dont mater. They will just up my meds to accommodate my spikes if I show symptoms.

Is this reliable info?

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It's an honest and frank approach to the NHS method of managing diabetes, eat a high carb diet and we'll treat it with more medication. But the truth is that "more antidote" is not the solution to "more poison". The best solution is not to drink the poison in the first place.

Everyone spikes an hour after eating carbohydrates, but if you do it repeatedly with high carbohydrate meals (and big spikes) then you will absolutely increase your risk of complications (and see your HbA1c go through the roof).

If you must eat pasta, make sure you do it in very small quantities.

It's difficult to avoid some "one hour" spikes, even non-diabetics get them when they eat carby meals.

But the general feeling is that spikes are what do the damage, and if you can avoid them then you'll be better off in the long run.

I eat <20g of carb a day, and my BG almost never spikes after eating (never goes above 7mmo/l. I can't say that I definitely won't get any complications when I'm older, but I think that it's pretty unlikely. In answer to your nurses suggestion to take more meds to cover the carbs, my HbA1c is better than almost anyone on insulin (apart from perhaps Dr Bernstein), and I don't have to worry about hypos.

borofergie said:

It's difficult to avoid some "one hour" spikes, even non-diabetics get them when they eat carby meals.

But the general feeling is that spikes are what do the damage, and if you can avoid them then you'll be better off in the long run.

I eat <20g of carb a day, and my BG almost never spikes after eating (never goes above 7mmo/l. I can't say that I definitely won't get any complications when I'm older, but I think that it's pretty unlikely. In answer to your nurses suggestion to take more meds to cover the carbs, my HbA1c is better than almost anyone on insulin (apart from perhaps Dr Bernstein), and I don't have to worry about hypos.

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I am often surprised to find how litttle HCPs working wih diabetes or its complicaions know about spikes and their effects.
Met a consultant opthalmologist the other week , very experienced but had no idea that bg levels could spike after meals.
Also met a dibetes "link " nurse ie one who specialised in linking reatment of diabetes wth treatment of complicaions of diabetes,
She could not believe hat white bread could cause spikes. You have to wonder what they teach them.

It's a very rare meal indeed where I don't spike. My spikes are never over 6 but today for example my pre dinner reading was 4.2 +2 hours I was 5.1 so although a large spike (I only had a shake) it is not a dangerous spike. Any spike over 7 would have me in absolute panic mode, thankfully it's a long time since I last saw a 7 at any time.

Defren said:

It's a very rare meal indeed where I don't spike. My spikes are never over 6 but today for example my pre dinner reading was 4.2 +2 hours I was 5.1 so although a large spike (I only had a shake) it is not a dangerous spike. Any spike over 7 would have me in absolute panic mode, thankfully it's a long time since I last saw a 7 at any time.

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Yeah, but it's a question of what you mean by "spike". Since we're aiming for < 7 mmol/l @ 2hours, a "spike" of 6 mmol/l is more like a "bump". (I know what you mean though).

Yes, reliable info IMHO, that you cannot rely on the dietary info they give you!
Just try to reduce the height of spikes. Whilst it is nigh on impossible to remove all the spike, careful eating should allow you to minimise them

That's my understanding and people on here sometimes talk about getting their +2hr reading back to the level of their pre-meal reading, but in my experience that almost never happens. Unless there are no carbs in the meal, then my sugars will go higher and I now aim to keep them below 7 at +1hr and +2hrs - this is usually starting at around 4.5 pre meal.

That is technically a spike - because my levels rise - but not a dangerous spike. I think if you're below the magic 7.8 level at the highest of these peaks then you should be happy.

As for trying to use insulin to cover the meal I think it's almost impossible (I'm a type 2 remember, I realise type 1's have no choice). My blood sugar will rise as soon as the carbs are in my mouth but my novorapid will take 20-40 minutes to start working. So I have to predict the effect of a meal well before I eat it and then predict the amount of insulin it's going to need. In my experience this was next to impossible and I likened it to standing up in a rowing boat. I had lots of highs and lows and just lurched through every day trying to compensate.

Since I gave up on the fast acting insulin and used the basal to give me a nice low baseline, the low carbing has been much more effective. All of this progress has been as a result of what I've read here (and from links provided by others). My clinical team are very supportive, but I'm leading them at the moment.

S