Breakfast spikes

[srpm]

Hi all,

Been diagnosed with T2 around 4 years. Was diet/exercise controlled for first 3 years. More recently (about a year) put on slow release metformin twice daily (1 at breakfast and 1 at dinner) and Empagliflozin (1 at dinner).

My afternoon control seems very good according to my freestyle libre. Staying in range and under 10mmol/L even if I’m bad and eat some chocolate/sugar.

I just seem to have these huge spikes after breakfast if I have a naughty breakfast and some carbs like a sausage sandwich. It can go up to 18!

When I was prediabetic I also found it was my fasting numbers that were bad and post prandials were always very good.

I have a moderate fatty liver.

Obviously I’m aware I can improve control with a lower carb breakfast. But I’m more interested in why the control/medication struggles so much with breakfast in particular.

Thanks so much in advance for any guidance.

 

[KennyA]

Hi all,

Been diagnosed with T2 around 4 years. Was diet/exercise controlled for first 3 years. More recently (about a year) put on slow release metformin twice daily (1 at breakfast and 1 at dinner) and Empagliflozin (1 at dinner).

My afternoon control seems very good according to my freestyle libre. Staying in range and under 10mmol/L even if I’m bad and eat some chocolate/sugar.

I just seem to have these huge spikes after breakfast if I have a naughty breakfast and some carbs like a sausage sandwich. It can go up to 18!

When I was prediabetic I also found it was my fasting numbers that were bad and post prandials were always very good.

I have a moderate fatty liver.

Obviously I’m aware I can improve control with a lower carb breakfast. But I’m more interested in why the control/medication struggles so much with breakfast in particular.

Thanks so much in advance for any guidance.

Hi srpm and welcome to the forums. I have no experience of medication myself so may not be best placed to advise you. It might help if you were to let people know what your last few HbA1c results looked like. It strikes me, though, that 10mmol/l fingerprick results are definitely not "in range" - have a look at the attached link.

Normal and Diabetic Blood Sugar Level Ranges

Normal blood sugar ranges and blood sugar ranges for adults and children with type 1 diabetes, type 2 diabetes and blood sugar ranges to determine diabetes.

www.diabetes.co.uk

Some people seem to find that the morning reading is often the highest of the day. If you're adding a lot of carbs on top of that the high figures (18) you're seeing might be expected.

I found this forum to be a great source of advice and support. It helped me take control of my diabetes and put it into remission. Best of luck.

 

[srpm]

Many Thanks.

My most recent Hba1c was 50 Mmol/Mol or 6.7%.

 

[Deleted member 527103]

You morning readings are likely to be affected by Dawn Phenomenon or Foot on the Floor. Our livers start their day by dumping glucose into our blood to give us the energy we need to get moving.

 

[catinahat]

if I have a naughty breakfast and some carbs like a sausage sandwich. It can go up to 18!

Nothing naughty about sausages, especially if you have the high meat content ones. The real villain in your breakfast is the bread, depending on the size of the slices, two rounds of bread could easily add up to around 40g of carbs.
Add your carby breakfast to the dawn phenomenon, and the fact that many of us are more insulin resistant in the mornings, and your high reading seems almost inevitable.
Now if only you had left the bread in its packet and cooked a couple of eggs, maybe some bacon to go with your sausages, your blood sugar would not have reached such lofty levels.
If you think about it apart from a few exceptions most things that we pick up and eat should be placed firmly on your naughty list, sandwiches, pastries, cakes, chocolate.

 

[Deleted member 527103]

@catinahat I find it mentally unhelpful to refer to food as good or bad and would never describe any food as a villain. It is our bodies that struggle with certain foods not the foods that are evil
Referring to food as bad leads to unhelpful guilt.
It is also very important to understand we are all different. Some people may tolerate a slice of bread better than others. This is not a good or bad thing. It is the way our bodies react .
I consider it very important l to manage the health of my full body and mind, not just the diabetes part and, therefore, avoid judgemental language.

 

[catinahat]

@catinahat I find it mentally unhelpful to refer to food as good or bad and would never describe any food as a villain. It is our bodies that struggle with certain foods not the foods that are evil
Referring to food as bad leads to unhelpful guilt.
It is also very important to understand we are all different. Some people may tolerate a slice of bread better than others. This is not a good or bad thing. It is the way our bodies react .
I consider it very important l to manage the health of my full body and mind, not just the diabetes part and, therefore, avoid judgemental language.

@In Response I respect and somewhat share your opinion, food is indeed just food and not to blame for my condition. Although it's easier to think of food that way when you can take the appropriate amount of insulin to negate any adverse affects that food might have.
When your only option is not to eat the food that harms you, food that you have eaten and enjoyed your whole life. Believe me it is much easier mentally and emotionally if you can convince yourself that certain foods are bad.

 

[srpm]

Add your carby breakfast to the dawn phenomenon, and the fact that many of us are more insulin resistant in the mornings, and your high reading seems almost inevitable.

@catinahat Thanks for the helpful reply.

Yes, dawn phenomenon definitely affects me.

If I’m more insulin resistant in the morning, would it make better sense to take the Empagliflozin with breakfast alongside metformin? Rather than using it with evening meal?

 

[srpm]

@catinahat I find it mentally unhelpful to refer to food as good or bad and would never describe any food as a villain. It is our bodies that struggle with certain foods not the foods that are evil
Referring to food as bad leads to unhelpful guilt.
It is also very important to understand we are all different. Some people may tolerate a slice of bread better than others. This is not a good or bad thing. It is the way our bodies react .
I consider it very important l to manage the health of my full body and mind, not just the diabetes part and, therefore, avoid judgemental language.

@In Response Thanks for the different perspective.

 

[srpm]

Also been wondering if being on the slow release metformin vs normal metformin works against me in regards tackling the high morning insulin resistance.

 

[Deleted member 475901]

@catinahat I find it mentally unhelpful to refer to food as good or bad and would never describe any food as a villain. It is our bodies that struggle with certain foods not the foods that are evil
Referring to food as bad leads to unhelpful guilt.
It is also very important to understand we are all different. Some people may tolerate a slice of bread better than others. This is not a good or bad thing. It is the way our bodies react .
I consider it very important l to manage the health of my full body and mind, not just the diabetes part and, therefore, avoid judgemental language.

For T2s and prediabetics (leading towards T2) however part of the journey towards remission, and avoiding some of the nastier complications, is facing up to the impact of carb-high foods on our bodies.
For me, that included finding low-carb substitutes for foods I used to love.

 

[Deleted member 475901]

Hi all,

Been diagnosed with T2 around 4 years. Was diet/exercise controlled for first 3 years. More recently (about a year) put on slow release metformin twice daily (1 at breakfast and 1 at dinner) and Empagliflozin (1 at dinner).

My afternoon control seems very good according to my freestyle libre. Staying in range and under 10mmol/L even if I’m bad and eat some chocolate/sugar.

I just seem to have these huge spikes after breakfast if I have a naughty breakfast and some carbs like a sausage sandwich. It can go up to 18!

When I was prediabetic I also found it was my fasting numbers that were bad and post prandials were always very good.

I have a moderate fatty liver.

Obviously I’m aware I can improve control with a lower carb breakfast. But I’m more interested in why the control/medication struggles so much with breakfast in particular.

Thanks so much in advance for any guidance.

So maybe you could try a low carb breakfast, something like high-meat sausage with egg and mushrooms. Or if you want a portable meal then 90s bread split and lightly toasted - I make mine with ground almonds, and it's useful if I crave a BTL.

I found my fatty liver resolved on low carb in spite of eating extra butter, cream, cheese and olive oil. The opposite of what my diabetic nurse expected but I'm not the only one.

 

[Deleted member 527103]

I am not suggesting low carb is not valuable for people with type 2 (and some people with Type 1).
My point is to be aware of the vocabulary used to avoid triggering feelings of guilt and other mental health concerns.

 

[Mrs HJG]

Hi @srpm As all of the above have wisely said, the carbs can/will cause a post-breakfast spike BUT for me stress can magnify the impact - I have the same low carb breakfast everyday, and normally I stay below 7 if I am sitting and working from home, and not going over 6 if I go for a 20-30 min walk afterwards (day off and weekends). However if I have to get in my car and do the commute, my bloods can go over 10; my highest ever was when I had to get the train to London for a big work meeting for the first time since lockdown, and I was very stressed!

Even doing the 'normal' 15 mile drive to the office, which I avoid like the covid plague, causes all the full adrenaline-rush anxiety, (the drive/traffic/office/people!).

Is it possible your post-breakfast routine may be contributing too? My endo is supporting my continued working from home due to the effects on my BG demonstrated by my Libre data, ergo 'office work is bad' Might be worth considering, but may also have no effect on you. It's not always the food, in my experience.

 

[KennyA]

@catinahat Thanks for the helpful reply.

Yes, dawn phenomenon definitely affects me.

If I’m more insulin resistant in the morning, would it make better sense to take the Empagliflozin with breakfast alongside metformin? Rather than using it with evening meal?

Hi - it's not possible for people on this forum to tell you what to do with your medication. That's your decision, and it is always better to make such descisions after a discussion with your prescriber. Doesn't mean you have to do what the prescriber says. People can tell you what their experiences were in the same or similar situations, and you can make your own judgement.

I do wonder, though, if you're expecting something from your medication that it's not actually capable of delivering in respect of insulin resistance?