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Can someone explain spikes please

B

blue pippy

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11
Hi everyone

I would really appreciate some help with this. I really don't understand spikes and my health professionals keep giving different answers.

At present I am considered not to have diabetes, this is based on my fasting glucose result and a HBA1C of 5.5 in July this year. I have only managed to achieve this result from extreme low carbing and small portions.

A diabetic nurse told me I was likely to be pre diabetic when I told her of my results of between 7.0 and 11.0 but she also told me that I shouldn't have even insisted on seeing her considering my HBA1C was so good.

Another doctor told me that if my fasting glucose was ok, leave the notion of diabetes alone because "you don't want to be sucked into the diabetes mill before necessary".

My own GP has just given me a strict talking to because of my low weight, saying that this was more of a threat to my health than high blood sugars. My GP said its not how high my readings go that matters, its how it evens out over time. Although she has told me as long as I eat normally (balanced diet containing carbs), do not test myself and put weight on she will let me have another HBA1C in January.

I am getting quite low about all this as I frequently have had results of 8.0 - 10.0 two hours after normal carby meals ie chilli con carne with rice, lasagne, stirfry with noodles. I even had 12.9 on a tuna and mayo sandwich. My results do jump around sometimes though, some days I can have 4.9 for special K but on another day it will be 6.8, I can also eat a chocolate bounty bar and have a result of 6.4, why is this? I really do not want to damage my health and from reading your forum I thought high results were bad????!!!
Are high results and spikes different things?
 
Hi there,

A "spike" is simply a high blood glucose reading - if you imaging drawing a graph of your blood sugar over time, if you get a high reading it'd look like a "spike" on the graph. That's what you're seeing when you get a result of 12.9 after your sandwich for example, and yes they are bad! What you want (and what non-diabetics have) is a nice even graph with no spikes.

Your doctor is right that the most important thing is your overall control (which is why HbA1C is such an important test), but the fact that you're getting these spikes indicates that you're insulin resistant and personally I would be taking steps to address this now. The doc is bang on the money that you don't want to get "sucked into the diabetes mill" - and the best way to avoid that is to take control now before things deteriorate!

You yourself say that you can see carbs spike your blood - so the prudent course of action is to reduce your consumption of these carbs! The things that'll have the largest impact are refined carbs - things like bread, pasta, rice and of course sugar. Potatoes and fruit can also have a similar effect. I'd suggest you limit or avoid these foods for a while, and replace them with better options - meat and fish and plenty of veg. Don't be afraid of eating fat - nuts and seeds, whole eggs, plenty of oil in cooking or salad dressings, avocados etc. are great sources of calories that won't spike your blood and will help with your low weight. If you want fruit, try to go for berries or melons - i.e. very watery fruit that don't contain much sugar.

Eating like this, with fewer carbs (and those you do eat coming from non-refined sources) will level out your blood reading a lot and may well reverse your insulin resistance. Seriously, you could completely avoid any further problems by addressing your diet now!

You mentioned issues with low weight, and you also need to take this into account - you need to make sure that you fuel yourself properly. Don't be afraid to eat food!!! It's no good stabilising your blood glucose if you make yourself ill in another way - but the two don't have to go hand in hand! Make sure you replace the carbs with protein and fat so you're getting plenty of calories to maintain or increase your weight depending on what you're aiming for. I can't comment on this much further, but it sounds like this is a priority for your doctor so it implies it's something you at least need to think about...? One thing to bear in mind is that being lighter isn't a way of protecting against diabetes. Type 2 diabetes is a disorder of glucose metabolism and isn't caused by obesity - it's more related to refined carb intake and how your body handles that.

As far as testing goes, you've got a few choices - either continue to test but just don't tell your doctor; stop testing for a while; or fund the HbA1C tests yourself (you can get postal tests for about £17 which aren't quite as accurate as the tests your could do, but willl give you a very good indication of whether or not it's going up.) Obviously this is entirely your choice, but if I were in your situation I think I'd improve my diet by lowering the refined carbs; make sure to increase my portion sizes and stabilise my weight using extra protein and fat; and get another test before discussing it with your doctor.

Hope that's helpful. It sounds to me like you've got every chance to take control of the situation now and avoid any future problems. Good luck, have a good read through the forums for more ideas, and do feel fre to ask any more questions!

Cheers,
Nick.
 
Hi bluepippy,

I can't really add much to Nick's very comprehensive and sound advice.

I've been a Type 2 diabetic for nearly nine years but I've normalised my blood glucose levels by changing the things that I eat - in particular reducing the starchy carbohydrates that I'd been advised to eat. However, these days I'm like you, my blood glucose levels are so well controlled that normal tests wouldn't detect that I'm diabetic because my fasting blood glucose readings are always below 7 and generally below 6 - also, my last HbA1c was 5.3%. However, I'm still daibetic that never changes.

If you are interested, you can read my story here:

viewtopic.php?f=20&t=10512

As far as I am concerned, it sounds as though you might fall into the same category - i.e. a well-controlled diabetic. Certainly some of the numbers that you quote are higher than would be expected in a non-diabetic person. However, while you keep your level of control where it is then you have absolutely nothing much to worry about.

However, it sounds as though your doctor is more anxious about your weight problem and that he wants you to sort that out first. As Nick says you can eat protein and fats without affecting your blood glucose levels - meat and fish etc are fine. What about nuts and seeds? They are high in calories, full of nutrients and will not do much to your blood glucose levels.

Best wishes - John
 
Thankyou for your replies, they were very helpful and very much appreciated!!!

I have tried to low carb, that is the reason why I am at a low weight, I just can't even seem to eat large portions of low carb without my blood sugar going above 6.5, I tried eating full fat yoghurt and nuts but can only eat small portions if my blood sugar is to stay below 6.5. I give up!!!

Another problem was the expense of protein, has anyone any ideas for cheap, high calorie protein? My poor chap was practically on a veggie diet so I could have more meat and fish.
 
blue pippy said:
Thankyou for your replies, they were very helpful and very much appreciated!!!

I have tried to low carb, that is the reason why I am at a low weight, I just can't even seem to eat large portions of low carb without my blood sugar going above 6.5, I tried eating full fat yoghurt and nuts but can only eat small portions if my blood sugar is to stay below 6.5. I give up!!!

Another problem was the expense of protein, has anyone any ideas for cheap, high calorie protein? My poor chap was practically on a veggie diet so I could have more meat and fish.
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Hi again blue pippy,

At what time are you testing and looking to achieve a maximum of 6.5?

I wouldn't have expected nuts to have caused a problem with blood glucose levels because they are low in carbs but high in calories. If you want to put weight on and keep blood glucose levels down then I would have thought that nuts would be an ideal food to eat.

John
 
blue pippy, there is a lot of information and advice, a lot of it conflicting.

My most trusted sources of information on understanding and managing my condition are not my doctor, but other diabetics who have good control. The advice given to me about starchy carbohydrate sends my blood sugar to unacceptable levels, so, while I am very happy to cooperate to a certain level get what I need (test strips, blood tests, referrals when needed and medication) I'm very clear about the role of my medical support in monitoring rather than advice on managing it.

http://www.bloodsugar101.com was the most useful thing I found in helping me to get a handle on diabetes and managing my blood sugar, even if it is an American website. It is well written and well researched. I recommend it so often that I think people may wonder if I'm on commission :wink: I'd say that website and this one have made a major contribution to me growing old disgracefully.
 
I have the same kind of problem

have noticed similar problems. First I am type 2 diabetic and have been on insulin since a chronic attack of pancreatitis 3 years ago. I am ther first to admit that until this year my level control has not been particularly good with HBA1c reading about 10 (though that is a LOT lower than when my diabetes was diagnosed)

Lately I have been following a low carb regime (not strictly but sensibly) and have seen much better readings over a period where I am keeping the average (dont have recent HBA1C yet) well into single figures and usually a daily average of about 5.5. Over the last few days my levels have dropped lower than normal sometimes as low as 3.5 or 2.8 so I thought I was doing well

Last night after a normal protein based meal my levels went up after two hours to 6.9 (about 10pm) oddly, although I hadnt eaten anything and had been out shopping by 1am they had gone up further to 7.2 and this morning were back down to 6.8 before breakfast (normally with a reading of 7.2 I would have been at around 5.0 in the morning which is higher than normal. I had the exact same breakfast as always - 2 weetabix sweetner and milk and nothing else around 9am and took a couple more units than usual to compensate for the higher than normal morning reading. This would normally leave me with a level of about 4.5 by lunchtime - instead it had gone UP to 11.4 (I checked twice with different fingers in case there were food traces)

It is so frustrating to stick to a controlled diet programme that works only to find for no reason it suddenly peaks to the highest reading I have had in a long time.
 
Hi everyone

Thanks for your further replies!!
John - I am testing 2 hours after my last mouthful of food. I do enjoy nuts especially salted macadamia nuts. However I find them a bit monotonous by themselves so would have them with maybe some chicken, lettuce, a tomato and some cucumber. This would give me a reading of 7.2.
 
blue pippy said:
Hi everyone

Thanks for your further replies!!
John - I am testing 2 hours after my last mouthful of food. I do enjoy nuts especially salted macadamia nuts. However I find them a bit monotonous by themselves so would have them with maybe some chicken, lettuce, a tomato and some cucumber. This would give me a reading of 7.2.
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Hi again blue pippy,

Macadamia nuts are absolutely divine but couldn't eat them salted.

I don't understand why macadamia nuts with maybe some chicken, lettuce, a tomato and some cucumber would give you a reading of 7.2 two hours after finishing eating there's hardly any carbs there that I recognise. I'm confused.

John
 
Hi John.

Bp may have only eaten around 6g carbs in total but what was the pre-meal Bg level ? That can have an effect on post meal readings. If you are high before then that may be the reason ?
 
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