Concerns over high sugar level after lunch.

three1ne

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Hi people. New here. Registered here to ask a few questions im hoping can be answered.

Before Breakfast 10u Novorapid 5u Levemir
Before Dinner 10u Novorapid 5u Levemir


Ive had diabetes since 18 years old, im now 26. My 6 monthly check ups have always gone well and my average reading taken at the hospital (my 1Ac ?) has always been between 6 - 8 which im told by the doctors is near perfect. They have always been impressed with my levels and ive had my blood sent off to a university in Essex because they believed that I may not actually be insulin dependant. Although I should say that I personally believed I did need insulin and unfortunately I was correct.

This Christmas just gone was my first not working in a busy record shop so decided id enjoy myself over a few weeks by eating what I wanted, drinking and not exercising. Sugar levels averaged out at around 15mmoI/L over those few weeks.

Since Feb ive been exercising again, running every other day for an hour a day. I usually walk for around an hour or do some form of exercise on the other days.

Im starting to run into high sugar levels after lunch and occasionally after dinner. A typical day from the past couple of weeks would be

Sugar level before breakfast
9
Sugar level 2 hours after breakfast
8
Sugar level before Lunch
5
Sugar level 2 hours after Lunch
16


My problem is that I usual run after lunch. If I go for a run when my sugar level is 16, after im done running my level will be around 8 and usually 6 just before dinner which stops me from thinking an injection before lunch is a good idea. Is a level of 16 a problem (for a few hours a day if I am going for a run to counteract it?).

As ive mentioned, I dont run every day so an injection of Novorapid may be 30 minutes after lunch would be a good idea no?

Even a year or so back when my blood was being sent off for tests I knew my sugar levels were sometimes this after lunch. I think because its easier for me to test my levels more regularly has increased my awareness of my high levels.

Out of interest, if my sugar levels are "near perfect" according to doctors but (for example) my sugar level around 3pm is constantly around 15 but fine all other times will that cause any long term problems?

Shaun
 

hanadr

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Hi people. New here. Registered here to ask a few questions im hoping can be answered.

Before Breakfast 10u Novorapid 5u Levemir
Before Dinner 10u Novorapid 5u Levemir

Ive had diabetes since 18 years old, im now 26. My 6 monthly check ups have always gone well and my average reading taken at the hospital (my 1Ac ?) has always been between 6 - 8 which im told by the doctors is near perfect. They have always been impressed with my levels
Unfortunately, there's a section of the medical establishmeetn that thinks that HbA1s of around 7 are good. There are also the more enlightened ones who think that if a non-diabetic HbA1c is4% - 5%then a diabetic one shouldn't be nearly double that.

This Christmas just gone was my first not working in a busy record shop so decided id enjoy myself over a few weeks by eating what I wanted, drinking and not exercising. Sugar levels averaged out at around 15mmoI/L over those few weeks. Oh Dear that's unsafe behaviour

Since Feb ive been exercising again, running every other day for an hour a day. I usually walk for around an hour or do some form of exercise on the other days.Good! that will help

Im starting to run into high sugar levels after lunch and occasionally after dinner. A typical day from the past couple of weeks would be

Sugar level before breakfast
9 Too high! should be below 6
Sugar level 2 hours after breakfast
8 Could be kept down to around 6
Sugar level before Lunch
5
Sugar level 2 hours after Lunch
16 What are you eating for lunch? Let me guess."Plenty of starchy stuff to keep your Bgs level( and high)


My problem is that I usual run after lunch. If I go for a run when my sugar level is 16, after im done running my level will be around 8 and usually 6 just before dinner which stops me from thinking an injection before lunch is a good idea. Is a level of 16 a problem (for a few hours a day if I am going for a run to counteract it?).

As ive mentioned, I dont run every day so an injection of Novorapid may be 30 minutes after lunch would be a good idea no?

Even a year or so back when my blood was being sent off for tests I knew my sugar levels were sometimes this after lunch. I think because its easier for me to test my levels more regularly has increased my awareness of my high levels.

Out of interest, if my sugar levels are "near perfect" according to doctors but (for example) my sugar level around 3pm is constantly around 15 but fine all other times will that cause any long term problems?.
Which doctors say that your sugars are near perfect?
I would say you are running high nearly all the time. the danger point is 7. anything above that for any length of time is doing damage.
Let us know what you eat and we may be able to help you get those numbers down into the safe zone.
And Yes! some of us do know more than some doctors. It's in our interests to do so. We're living this, not them
 

three1ne

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41
Hi, thanks for the reply.

My lunch is always fairly standard. 2 cheese and ham sandwiches with extra light salad cream. Varying between white/brown bread or rolls. A packet of light plain/salt and vinegar crisps.
Occasionally Ill have a biscuit or scone.

Today for example, my sugar level was 5 at 12:30. For lunch at 1pm I had 3 boiled eggs and 4 rounds of brown bread with flora. Had a fruit scone 20 minutes later. I tested my blood at 4pm and it was 16. I went for a run at 4.15. BL after my run was 8 (5pm). and 6.3 (6 pm - before dinner).

When I mentioned the doctors said I had perfect levels I was talking about the doctors and advisers in the diabetes clinic that I see twice a year.

Your advice in regards to HbA1s, which im not dismissing, is largely contradictory to what im being told at the clinic.

Shaun
 

fergus

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Hi Shaun,

I'm afraid your clinic sounds a bit out of touch. 6-8% is below average in the UK (9%) but a lot higher than a healthy non-diabetic HbA1c (somewhere between 4-5%). To be honest, my clinic was much the same - I still have copies of my blood test results with the doctor's handwritten notes "good diabetic control" next to my HbA1c of 7.6%. Both my results and the doctor's comment were rubbish!

It sounds as if your diet has a lot of carbohydrate in it. Your blood sugars will always be elevated as a result. Can I ask why you only use insulin before breakfast and dinner? With carbs at lunch and no insulin, your blood sugar will be at harmful levels all afternoon surely?

I don't mean to criticise, but we do hear quite a few tales of seriously dodgy medical advice of the forum.

All the best,

fergus
 

three1ne

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Hi fergus. Thanks for the reply.


So what is the best possible HbA1c level a type 1 diabetic could hope for?

As for me not having a lunch time injection its because I was told that my sugar levels were "near perfect" and was told there was no need to change anything. From tomorrow Ill start having an injection before lunch.

Im thinking an injection of just Novorapid of 8u would be good for lunch. With this injection may be it would be wise to have an extra biscuit at lunch time if not I might end up reversing my high sugar levels into a hypo. Comments on that?

Have you confronted your clinic about their advice?
 

timo2

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Hello Shaun,

With some hardcore carb reduction you can expect a non-diabetic HbA1c (around 4.5%).

three1ne said:
Im thinking an injection of just Novorapid of 8u would be good for lunch. With this injection may be it would be wise to have an extra biscuit at lunch time if not I might end up reversing my high sugar levels into a hypo. Comments on that?

Rather than having to feed the insulin, you could just inject less in the first place.

All the best,
timo.
 

three1ne

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timo2 said:
Hello Shaun,

With some hardcore carb reduction you can expect a non-diabetic HbA1c (around 4.5%).

three1ne said:
Im thinking an injection of just Novorapid of 8u would be good for lunch. With this injection may be it would be wise to have an extra biscuit at lunch time if not I might end up reversing my high sugar levels into a hypo. Comments on that?

Rather than having to feed the insulin, you could just inject less in the first place.

All the best,
timo.

Yep, that would make more sense :D May be the extra biscuit for when im running.

So, as silly as it sounds ive never paid too much attention to carbohydrates, just the sugars in foods. Just done a quick calculation online and apparently me without diabetes should have an intake of 369g of carbohydrates. Any idea what my intake should be? Just done a quick calculation in the kitchen and I doubt im eating over that much per day atm.

What is the best meal for lunchtime?
 

fergus

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Type of diabetes
Type 1
Hi Shaun,

A type 1 diabetic can have an HbA1c no different to a non-diabetic if they get their insulin and food right. Mine have been in the 4%s for the past 2 years now.

What sort of calculation tells you that you need 369g carbohydrates in a day? I'm curious because that's an enormous amount, far higher than even the American dietary recommendations at the peak of their dietary lunacy! :shock:

All the best,

fergus
 

hanadr

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Have a look at "Dr. Bernstein's diabtes Solution"
this book will give you information on controlling t1 diabetes with minimal medication. Benstein recommends 30 grams of carbs per day. You might also like to read my piece carbs 101&102, on this forum, to get a clearer picture of why carbs are important.
I noticed in your last post that you are careful with fats. That's the usual recommendation by the medics in Britain, but actually pretty much irrelevant. Fats don't affect your glycaemic control. There's no evidence that they do you any kind of harm if not combined with carbs. If you want to get those numbers down, keep off the sugars and cut, pasta, potatoes, baked goodsand cereals and rice to the bare bones. you'll need to adjust your insulin down to match and watch those numbers tumble. You'll feel great. fill yourself up with green leafy vegetables.Eat a bit of fat. that prevents hunger.
 

three1ne

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http://www.healthcalculators.org/calcul ... ydrate.asp

A quick count of cereals and my lunch only totalled less than 200 so not sure about that then.

4% is excellent from what you guys have taught me today. I was actually told (in one of my check ups) that my hbA1c of 6.4% was a little too low.

So could you tell me what you eat for lunch or what you think would be good for me for lunch?

If I was to correct my levels and lower my hba1c to 4-6% do you think ive done any serious long term damage to myself?

--Thanks Hanadr. Although that does mean cutting out pretty much all of what I like to eat! Cut it down to 30g of carbs a day? My "Healthy" shreddies bitesize has 45g per bowl!
 

lilibet

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515
Hi shaun
Recommended intake per day is around 230 or 250g is it not? Thats what is says on side of some food labels.

Cant really add any more to whats been said except to say that four rounds of bread, crisps, scones, biscuits, cereal are all things that most well controlled diabetics would avoid like the plague. Along with pasta, rice, noodles to any great degree though some people still have bits of this from time to time. I personally have chucked cereal, crisps and only have one slice low GI Bread(Burgen) for my lunch. I have tiny bits of pasta, no noodles, and tiny tiny bits of rice. I can tolerate new potatoes for some reason, but not baked and I can tolerate wholemeal tortillas but not scones.
The key is to test and as you've already been told running that high in the long term is not healthy, However, its what suits you and what you can cope with that matters.

Its a bit of a bummer to give everything up (as we all know) so your choice is to cut down and see how it goes, or increase your novo to cover the carbs in your grub. However this wont stop spikes which are thought to cause the damage too along with prolonged highs. 6.4 is a good a1c but doesnt cover the 'grey areas', ie post meal readings. As for being told its too low. That obviously happens a lot in the NHS hence Fergus pre emptive post.

They wont be happy until we are one legged blind people, waiting for replacement kidneys and a bloody heart bypass! :evil:

L

PS Also read somewhere that depending on intensity of exercise this can raise blood sugar initially, so maybe need to factor this in. Good luck!
 

fergus

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I plan on living long enough to see the experts who tell us that 6.4% is too low, sued in a very juicy class action for medical negligence!

As for long term damage, you've been diabetic for 8 years and you're only 26. If you have sufferred any damage, much of it is probably still reversible if your blood sugars are brought into line. I've had type 1 for 28 years and have no complications, there are others on the forum who can say the same. I had little idea what I was doing for most of that time so perhaps I've been lucky.

Here's an example of what the alternative low-insulin diet might look like:

Breakfast - Scrambled eggs with cream and cheese, bacon, grilled mushrooms, coffee with cream

Lunch - Chicken breast, mayo, olives, pesto sauce, celery, green salad, glass of red wine.

Dinner - Tuna steak with garlic and soy sauce, stir fried vegetables. Cheeses and macadamia nuts.

That sort of thing could have your blood sugar levels down to non-diabetic levels within a few days, if you fancy it?

fergus
 

three1ne

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lilibet said:
PS Also read somewhere that depending on intensity of exercise this can raise blood sugar initially, so maybe need to factor this in. Good luck!


Hi Lilibet, thanks for your replies. Everyone here has been very helpful and knowledgeable. May be the NHS are hunting you all!

In the above are you saying that exercise can raise sugar levels?
 

lilibet

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Shaun
Plenty examples on the web but this one from John Hopkins university site amongs others says the following

How Exercise Affects Glucose Levels
In most cases, exercise lowers blood glucose levels. As muscles do their work, they obtain energy from glucose stored in the muscle cells as glycogen. When these supplies of glycogen run low, glucose from the bloodstream is used as an energy source. After exercise, the body replaces the stores of glycogen in the muscle cells and liver, which lowers blood glucose levels even more. This drop can take place many hours after exercising.

Exercise can also have the opposite effect and raise blood glucose. This usually occurs when blood glucose levels are too high (usually over 250 mg/dL) before exercising, which indicates that insulin activity is too low. In addition, very strenuous exercise can stimulate the liver to release extra glucose into the bloodstream, due to an increase in adrenaline.

The Best Time To Exercise
To prevent hypoglycemia, workouts should be timed in relation to meals and medication. A general rule is to exercise one to three hours after eating something. People with diabetes who take insulin should not exercise when their insulin is at its peak. Since exercise can lower blood glucose hours later, avoid exercising just before bedtime to prevent hypoglycemia in the middle of the night.

Before Exercising
If you have diabetes, you should always check your blood glucose levels twice before exercising: once 30 minutes in advance, and again just before starting. This routine will let you know whether your blood glucose is stable, rising, or dropping


American figures should be divided by 18 approx if you ever need to convert. That means 250 is about 14 rounded up. So, maybe something in it, though do think you diet does need tweaking a bit.....

L
 

phoenix

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Hi Shaun, you seem to be taking the same amount of insulin whatever you are eating. Many people find that they have much better control if they adjust the insulin dosage to the amount of carbs eaten. By doing this you can achieve very tight control.
My BG was a little under yours at lunchtime, I ate about 45gms carbs, took the appropriate amount of insulin (for me; its individual) calcualted for that amount of carbs,I was at 6.6mmol 2 hours later and then had a biscuit prior to a 4 mile run. Before dinner my BG was 4.6mmol.
The only difference to you was that I've taught myself know how much insulin I normally need to take.
The NHS has a course to teach you how to do this : DAFNE, (dose adjustment for normal eating) but I understand it isn't available in all areas.
There is an online version by the hospital at Bournemouth at http://www.bdec-e-learning.com/,

as to Hba1c, I do think that how low you can safely go varies from person to person, some people appear to have far less predictable BGL than others, so need a larger safety margin. Mine is normally in the 5's, when I went below 5, I agreed with my doctor that this was too low, ( I was going very low during exercise) and so loosened my control a bit.
 

three1ne

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Missed your reply there Fergus. Think I posted at the same time as you.

Sounds like a good menu there, ill have to substitute the evil tuna for something else though :D
What is the general thought of fruit for breakfast? I tried a week of eating 1 apple for breakfast although I found my sugar level dropped drastically after 2 hours.

Also with fruit, they obviously have natural sugars and sometimes its a nightmare trying to make any sense of an apple having 10g of sugar which i automatically think of as 2 chocolate biscuit bars. Obviously i know there is a difference but id like to know if there is a ratio that can be applied.

So back to your example menu, how would fruit in the morning and then scrambled eggs and chicken for dinner sound? I guess im basically asking is fruit in the morning a good idea.
 

three1ne

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Also a few other replies in the mean time, thanks.

Thanks Lilibet. Phoenix, I run around 4 miles too and if i went out with a sugar level of 6.6 + a biscuit I think id drop dangerously low half way through.
 

fergus

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Personally, I tend to avoid sweet fruits but I do eat lots of other fruits such as tomatoes, olives, avocados etc. To be honest, there's nothing in sweet fruits that can't be got from other sources without the sugar hit! Some of the berries such as strawberries, raspberries etc. seem to be fine for many people.

Don't worry about the tuna, I won't hold it against you :wink: . The essential low carb principles are that any foods from the meats, fishes, eggs, cheeses, nuts, dairy, green vegetables and some fruits are perfectly fine and compatible with good blood sugar control. Basically, the only restriction is the dull, boring and bland starches. It's the most un-diety diet you'll ever find!

This sort of menu will need minimal levels of insulin and reduce your risks of hypoglycemia, provided you reduce your insulin doses to match.

fergus
 

three1ne

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Cheers Fergus and everyone else thats posted. Every single post has been helpful and so quick to respond too. I felt quite naive about diabetes all of a sudden but your posts have helped to set me straight. As of tomorrow ill cut out a large chunk of the bad stuff!