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Blood Sugar Spike

Discussion in 'Type 2 Diabetes' started by valuator, Feb 20, 2020.

  1. valuator

    valuator Type 2 · Active Member

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    Sorry if this has been asked before, but all my searching refers to where your BS should be 2 hours post eating. If the goal is a rise of no more than 2.0 mmol/l between the first bite and 2 hours post eating, what about the time in between? In other words, are we worried about the peak or the point in time 2 hours post?

    For example, if I just used my meter, I could eat a bowl of pasta and go from 6.5 at first bite to 8.5 two hours later....which would seem acceptable, except that my Libre would show that I spiked to 15.0 during that time.

    My gut tells me I should be trying to manage both the peak of the spike as well as the reading after 2 hours?
     
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  2. catinahat

    catinahat Type 2 · Well-Known Member

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    Listen to your gut @valuator it talks a lot of sense
     
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  3. ianf0ster

    ianf0ster Type 2 · Well-Known Member

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    What makes you think that 8.5 is acceptable for a T2? It may be acceptable for a T1, but they have to avoid over injecting Insulin.

    The target upper limit for a T2 is around 7.8 to 8.0, depending upon how cautious you are. A reading of 7.8 after 2hrs (for a low carb meal, or 1hr for a high carb meal) is generally accepted as highly unlikely to cause any diabetes complications such as neuropathy, retinopathy, amputations, blindness. So if you knowingly eat more carbs or higher GI carbs than usual you really out to be testing at 1hr, then 1hr 30min and then 2hrs. If you eat high carb with substantial fat, then you need to extend this beyond 2hrs since the fat will slow down the effect of the carbs.
    The 8.0 is often quoted by medics as being something more 'achievable' - though they are assuming 'standard care'.
     
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  4. valuator

    valuator Type 2 · Active Member

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    OK, let's pick a different example. Go from 5.5 to 7.5 after two hours. But with a considerable spike showing on my Libre during that time. Are we concerned about being high for 2 hours or just where we end up?
     
  5. Resurgam

    Resurgam Type 2 (in remission!) · Expert

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    I can't help with the question as I would never eat pasta in the first place because it is not something I need to think about as being food - I just do not have grain on the menu - I do eat bread with 4 gm of carbs a slice, but very rarely - so far this year I have eaten 5 slices of it.
    I look for under 7mmol/l after eating, at the 2 hour mark but I just do not consume foods which spike my BG.
     
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  6. bulkbiker

    bulkbiker Type 2 · Oracle

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    Obviously its better to avoid the spike completely by not eating food that causes it..
     
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  7. Jim Lahey

    Jim Lahey I reversed my Type 2 · Well-Known Member

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    Peaks and valleys aren't good, especially in the higher ranges. Sustained higher levels are worse, but large ups & downs really need to be avoided where possible. Then of course there's the rarely discussed factor of insulin toxicity if you are always overproducing, but that isn't measurable at home. The safest strategy is to not consume food that causes spikes, but that is a very personal thing and no one can make those choices for you.
     
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  8. valuator

    valuator Type 2 · Active Member

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    These days the spikes are mostly caused due to experimentation. Trying to figure out "what can I eat".

    I fear I am not asking the correct question. Is something that causes a rise of no more than 2 mmol at the 2 hour mark "safe" or "not safe"? I feel like the Libre is maybe giving me too much info and causing me to over-think?

    Let's take sweet potato....I know a lot of people report being able to eat a moderate amount, with the finger prick at the 2-hour mark showing a rise of no more than 2 mmol. So they put it into the "safe" category. Is this correct even if there was a larger spike within that 2-hour window? (which you would only know about if you are wearing a Libre or equivalent).

    Sorry if it sounds like I am being difficult....it is hard to give up foods I love to eat, so I want to make sure I fully understand what is good vs. bad. :(
     
  9. Jim Lahey

    Jim Lahey I reversed my Type 2 · Well-Known Member

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    No. It's the maximum you should be concerned with, whether it peaks at 60 minutes or 180 minutes. However, if it falls quickly that is at least a half-decent sign.
     
    #9 Jim Lahey, Feb 21, 2020 at 6:56 PM
    Last edited: Feb 22, 2020
  10. valuator

    valuator Type 2 · Active Member

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    Thanks!

    For me, I seem to either get a pretty substantial spike, or else no rise whatsoever. Which is pointing me towards a pretty strict LCHF lifestyle.
     
  11. bulkbiker

    bulkbiker Type 2 · Oracle

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    Personally I'd say not safe. And your experimenting ain't helping your health much either..
     
  12. mm93fm

    mm93fm · Member

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    The reason you won't get a straight answer (I suspect) is because: no-one knows. There is no research or data on this. The majority of the research dealing with long-term complications (which is the thing we are all trying to avoid) looks at HbA1c, not Libre readings.

    However, common sense would suggest that avoiding spikes would be a good thing, and a low carbohydrate diet would be good.

    Going forwards, it might help you to keep a detailed log of Libre readings (spikes and all) and see how this correlates with HbA1c in 2-3 months' time.

    It might be (for your body) that one big meal and one big spike a day does not really affect the HbA1c, in which case I wouldn't worry too much about it. However, if you are having 5 smaller meals and 5 small spikes a day, this may represent an overall greater exposure to sugar and cause the HbA1c to rise, and this would clearly be riskier for you.
     
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    #12 mm93fm, Feb 25, 2020 at 6:20 PM
    Last edited: Feb 25, 2020
  13. Munkki

    Munkki Type 2 · Well-Known Member

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    A two-hour reading is sometimes recommended, but measuring every 30 minutes or continuously, as you do, is better. Surely, you do not want the spike at any point.
     
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  14. Roggg

    Roggg Type 2 · Well-Known Member

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    I'm not expert but here's my understanding. The "no more than 2" rise criteria is about how your body responds to the food intake. A rise of more than 2 means your body is not dealing with the incoming macros quickly enough and that's not good, so the glucose lingers in your blood for far too long.

    Completely separately a rise form 6.5 to 8.5 is within the "+2 limit" so you could argue it's okay. I would argue it's not okay, but I would suggest that the 6.5 is the real problem, not the +2. To me being 6.5 before eating suggests insulin resistance.

    I have no idea if the height of the spike is concerning or relevant. I would assume that non-diabetics can have very high spikes depending on what they eat, so I personally would be careful about giving too much significant to what happens in that 2 hour span. There's a reason they recommend a 2 hour reading.

    But this is hypothetical. In reality what your goals ought to be will depend on whether you are insulin sensitive or insulin resistant.
     
  15. valuator

    valuator Type 2 · Active Member

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    Thank you all for the thoughtful replies. I've been trying my best the past week to minimize any spike....I've been treating the Libre as a bit of game....constantly trying to improve the graph.

    I've really come to the conclusion that I can't live within some kind of arbitrary carb allowance. Giving myself a handful of wheat crackers because it fits in that day's allowance isn't worth the spike. Since I've upped the fat in my diet, it's been much easier to resist temptation. I would say my "baseline" has improved by about 1 mmol this week by eliminating any obvious carbs. The proof is there...not sure why I needed to see it on the Libre to solidify my thought process, since I've read about all of your successes on here, but the flat graph (and trying to maintain it) is a great motivator.
     
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  16. mm93fm

    mm93fm · Member

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    Personally, for me, the best way to flatten the graph is Intermittent Fasting (IF). There's just nothing like it.

    I have now worked my way up to "one meal a day" (OMAD) and once a week maybe I have "one meal every other day" (OMEOD). It takes time for the physical, mental and psychological adaptations to occur, but it is well worth it and a journey worth pursuing. I lost a lot of weight with IF and my HbA1c came under control.
     
  17. Caprock94

    Caprock94 · Well-Known Member

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    I've always wondered about this as well. It would seem that even non diabetics have some type of spike after high carb meals. I try not to eat foods that spike me too much, but like Jim mentioned, I take it as a good sign if it at least comes back down fast.
     
  18. Lehany73

    Lehany73 · Member

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    My DBN says I should not worry about the spikes in between the two hours after eating as this would happen to non-diabetics also. I had a Libre sensor for my first 6 months after diagnoses and done the same thing as you. I experimented with trying all these different foods in the hope there was still something from my old diet I could eat. I'm now 1 year in and have finally realized that it's all about reducing the Carbs at every level. Giving up on treats just isn't enough, the sensor has made me realize just how much change was needed.

    Funny, because I put a new sensor in for the first time in 6 months this week as I felt my levels were getting out of control again. This has helped me regain the focus needed for healthy eating as I can constantly read my BG. Can turn into a bit of an obsession though!

    I would be interested to know more about spikes in between meals! They can't be good though!!
     
  19. JohnEGreen

    JohnEGreen Other · Master

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    Came across this may be pertinent.

    "The current goal of diabetes therapy is to reduce time-averaged mean levels of glycemia, measured as HbA1c, to prevent diabetic complications. However, HbA1c only explains <25% of the variation in risk of developing complications. Because HbA1c does not correlate with glycemic variability when adjusted for mean blood glucose, we hypothesized that transient spikes of hyperglycemia may be an HbA1c–independent risk factor for diabetic complications. We show that transient hyperglycemia induces long-lasting activating epigenetic changes in the promoter of the nuclear factor κB (NF-κB) subunit p65 in aortic endothelial cells both in vitro and in nondiabetic mice, which cause increased p65 gene expression. Both the epigenetic changes and the gene expression changes persist for at least 6 d of subsequent normal glycemia, as do NF-κB–induced increases in monocyte chemoattractant protein 1 and vascular cell adhesion molecule 1 expression. Hyperglycemia-induced epigenetic changes and increased p65 expression are prevented by reducing mitochondrial superoxide production or superoxide-induced α-oxoaldehydes. These results highlight the dramatic and long-lasting effects that short-term hyperglycemic spikes can have on vascular cells and suggest that transient spikes of hyperglycemia may be an HbA1c–independent risk factor for diabetic complications"

    https://rupress.org/jem/article/205/10/2409/47044/Transient-high-glucose-causes-persistent
     
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