Can anyone tell me ...

coby · Oct 9, 2016

Is it the actual spike that does the damage, or is it the amount of time that it remains high?
I spike from around 5.8 to 9.2 after breakfast ... but that's the reading an hour following my first mouthful.
By the time another three quarters of an hour has elapsed ( so under two hours from first mouthful) my levels are always back to about 6.1
I've looked on other diabetic information pages but cannot find this mentioned. Thanks

himtoo · Oct 9, 2016

there is a bit of both in the answer.
the amount of spike is important -- but so too is the amount of time spent outside a normal range ( non diabetic )

the best answer is to try and eat to your meter ( blood testing meter )

4ratbags · Oct 9, 2016

Everyones opinion differs on this one, some.try to avoid spikes while others are.happy if it has come down by the 2 hr mark. I dont think there has been much research done into it.

spendercat · Oct 11, 2016

That is in my view a pretty reasonable response to breakfast for a diet controlled diabetic. As long as your BGs are back to normal levels so soon.
We know that sustained BGs above 7.8 cause damage to our bodies, and that for the duration of that spike damage is accumulating, however, if we can limit that spike to a one hour duration, three times a day at mealtimes, that means BGs are in safe ranges for 21 hours out of 24.
Which is probably good enough to minimise or delay any complications for a lifetime. If you are middle aged.

Squire Fulwood · Oct 11, 2016

If you are into sums then a popular opinion is that it's the area under the curve which means both height and duration of the high. During this time the viscosity of the blood changes and if you listen to Dwight Lundell and co. something else is abrasive to the lining of the arteries.

http://www.theatlantic.com/health/archive/2014/01/a-heart-surgeons-viral-confession/283413/

chalup · Oct 11, 2016

I would be horrified to spike to 9.2 and would stop eating whichever foods caused that personally. There are lots of options for breakfast foods that do not do that. I am not personally interested in slowing the damage, I want to stop it and the only way to do that is to keep BS in the normal range of 4 to 7.8. I am not willing to gamble my eyesight or kidney function for a piece of toast or whatever. For me it is simply not worth it.

coby · Oct 11, 2016

spendercat said:
That is in my view a pretty reasonable response to breakfast for a diet controlled diabetic. As long as your BGs are back to normal levels so soon.
We know that sustained BGs above 7.8 cause damage to our bodies, and that for the duration of that spike damage is accumulating, however, if we can limit that spike to a one hour duration, three times a day at mealtimes, that means BGs are in safe ranges for 21 hours out of 24.
Which is probably good enough to minimise or delay any complications for a lifetime. If you are middle aged.

Thank you spendercat for that enlightening response. I am 66 years old and was only diagnosed in January this year, and yet already have background retinopathy in my eyes, so do not wish this to worsen. I already have Glaucoma ... so my poor eyes are not doing so well !!! Obviously anything I can do to keep control of my blood sugar levels is most important to me. I do appreciate your input.

Anglo_dude · Oct 11, 2016

As mentioned above, I think its the height and length of the spike that combined make the problem.

I've just had my latest HBa1C back and I'm now at 45, so in the pre-diabetic range. This is from a peak of 100 when first diagnosed and then 70-80 under the NHS "healthy eating" plate...

I've got there with a combination of 16 hour fasting (so only eat between 12 and 8, usually 2 meals) and low carb. I have been eating some carbs, but mainly as lunch, so the fasting beforehand mitigates some of the spiking I think.

Personally I spent 4 months testing religiously to see what had the biggest affect on my blood sugar (definitely grains - porridge and bread for me, then root vegetables after that) and modified accordingly. Now I rarely test my bloods as I know what I can eat and what spikes me. I still have the occasional carb treat, but ususally follow it with a decent walk to again limit the impact.

As with all these posts we can only comment on what has had a positive impact for us, and each person has a different food which causes the spike. The best lesson is learn about your own reactions and tailor your diet/healh regime accordingly.

Good luck and all the best!

Oldvatr · Oct 11, 2016

One problem of a spike of any size or duration is that it triggers an insulin response, so the blood fills with insulin for a while. This is thought to increase insulin resistance in T2D, so although it may not increase bgl enough to show up on a meter, it nonetheless is doing damage. A spike to 9.8 IMHO is too much anyhow, and as suggested above, you should eat to meter to find our and eliminate the food item causing the spike. The 1 hr PP should not jump by more than 2 mmol/l

psignathus · Oct 11, 2016

For me personally I do not eat anything that takes me over 7 at any time. Even if I have a few beers at the weekend I do not go over 7 in fact with beer my BS drops as the liver prioritises the alcohol. I would avoid whatever carb is causing that kind of spike if at all possible. As an aside it did take a good 9 months of LCHF and exercise to reduce my insulin resistance to allow beer back into my life. It was like losing a dear friend but then getting them back

Brunneria · Oct 11, 2016

I think we all have to make a personal assessment of risk, and the best way to do that is to learn as much as possible about the whole insulin/blood glucose relationship, what is 'normal' and the consequences of being 'not normal'.

The best single source i have ever seen for this kind of info (for type 2 diabetics) is the www.bloodsugar101.com website.
Well worth a good read.

coby · Oct 11, 2016

Oldvatr said:
One problem of a spike of any size or duration is that it triggers an insulin response, so the blood fills with insulin for a while. This is thought to increase insulin resistance in T2D, so although it may not increase bgl enough to show up on a meter, it nonetheless is doing damage. A spike to 9.8 IMHO is too much anyhow, and as suggested above, you should eat to meter to find our and eliminate the food item causing the spike. The 1 hr PP should not jump by more than 2 mmol/l

Hi Oldvatr,
I'm trying hard today ... for breakfast I ditched my usual homemade muesli and had strawberries and blueberries with cream ( my 1hr testing was down to 8). Then for lunch I had two slices of seeded bread (from a small loaf ) toasted with cheese on top, and again my 1 hr reading was 8. I know this is still slightly above the recommended 7.8 but will this make some difference do you suppose?

Oldvatr · Oct 11, 2016

coby said:
Hi Oldvatr,
I'm trying hard today ... for breakfast I ditched my usual homemade muesli and had strawberries and blueberries with cream ( my 1hr testing was down to 8). Then for lunch I had two slices of seeded bread (from a small loaf ) toasted with cheese on top, and again my 1 hr reading was 8. I know this is still slightly above the recommended 7.8 but will this make some difference do you suppose?

I am not sure, but it looks like you may be using a Low Carb type of diet/ If so then it usually takes a while to settle down. If this is early days, then you will probably have still got large deposits of stored glycogen in the liver, and this has to be dissipated first by low carbing. This is often the source of what we know of as liver dump, and it can give surprising bgl results at the oddest of moments. However, it looks like you are already recording lower bgl bumps closer to where you want to be, so just keep doing the meter checks, and drop those foods that push it up. You will find things become easier as your fasting (morning) levels drop .

EDIT: Glycogen was written as Glucogen in error

coby · Oct 11, 2016

Oldvatr said:
I am not sure, but it looks like you may be using a Low Carb type of diet/ If so then it usually takes a while to settle down. If this is early days, then you will probably have still got large deposits of stored glucogen in the liver, and this has to be dissipated first by low carbing. This is often the source of what we know of as liver dump, and it can give surprising bgl results at the oddest of moments. However, it looks like you are already recording lower bgl bumps closer to where you want to be, so just keep doing the meter checks, and drop those foods that push it up. You will find things become easier as your fasting (morning) levels drop .

Thank you ... I'm trying hard and do feel more inspired, having seen lower readings today

phil1966 · Oct 11, 2016

It's an interesting question and one that no-one can have a definitive answer to (it depends on your personal preferences)

Even non-diabetics can spike above 7.8 but only for a very short time and only with an extremely large number of carbs

I've been using a freestyle libre for the last 5 months or so and it has given me a great insight into what my body does (it does a reading every 15 minutes). I have my target range set to a top level of 7.8 and have spent 98% of the time below that. I'm not worried about that 4% because it's a tiny amount of time, the spikes typically last less than 30 minutes and it is unrelated to food: I actually seem to get spikes when watching a tense game of football! but for some people it would be unacceptable: every one of us has to decide what is and isn't acceptable

chalup · Oct 11, 2016

That is interesting Phil. I have perhaps a half dozen spikes in the last couple months in the 8 to 9 range and all of them are not food related but illness. The 9 was after not eating for several days. Amazing what stress, for good reasons or bad, can do to our bodies.

Oldvatr · Oct 11, 2016

chalup said:
That is interesting Phil. I have perhaps a half dozen spikes in the last couple months in the 8 to 9 range and all of them are not food related but illness. The 9 was after not eating for several days. Amazing what stress, for good reasons or bad, can do to our bodies.

Stress triggers adrenaline, which is the flight or fight hormone, and this turns off insulin so sugar levels go up because glucose storage mode gets turned off. Similarly, infection also triggers it in much the same way, or so I believe

Sauron · Oct 12, 2016

Oldvatr said:
Stress triggers adrenaline, which is the flight or fight hormone, and this turns off insulin so sugar levels go up because glucose storage mode gets turned off. Similarly, infection also triggers it in much the same way, or so I believe

Perfectly stated

asparagusp · Oct 12, 2016

Stress trigger's Cortisol the stress hormone, which in turn increases your sugar level. I had a test recently and it was slightly elevated.

kokhongw · Oct 12, 2016

I venture to guess that the magnitude of the spikes causes different damages (microvascular) compared to the duration of the spike (macrovascular), that is probably why we have such a wide array of complications.

But we often overlook the effects on the corresponding insulin, IGF1 spikes...

Can anyone tell me ...

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