Confusion over spikes-need advice

[chocoholicnomore]

Hi All

I am a newbie still trying to get to grips with all this. I thought that I was getting the hang of it until today.

During the week I have been testing when I get up at 07.15 and it's usually around 7.something. This was my first week of testing so, although the readings aren't brilliant, I am still in early stages and haven't worked out yet what to do about morning readings. Anyway, after breakfast I go to work. I have a cold meat sandwich made with low carb bread (nimble) for lunch. I then test again when I come home about 3pm and it's usually about 5.something. Result! (or so I thought)

As it's Saturday today and I have been at home all day, I have been able to test more. On waking it was 6.8. However 2 hours after breakfast it was 8.8 and then 2 hours after lunch (3pm) it was 5.9. I ate the exact same breakfast and lunch as I have been doing during the week.

The morning and 3pm readings were same as during the week but the extra reading 2 hours after breakfast was high.

I assume this means I have probably been spiking all week without knowing it. Should I change what I eat for breakfast? Should I take meter to work and test more frequently?

Also, can anyone tell me the definition of a spike? I know it is spikes that can cause all the diabetic complications but is that only if spikes occur alot and what would be considered alot? Is 1 a day as described above considered too much?

Please excuse me if my questions sound stupid but I am really struggling to understand exactly what I am aiming for. The diabetic nurse just told me to come back in 3 months, cut down on my sugar intake and base all meals around carbs. I bought my own meter after reading this forum. I have ordered a carb book but it hasn't arrived yet. I am wanting to go low carb as I need to lose weight.

I am the type of person who needs answers and also needs to understand what I am supposed to be doing and why. I know I need to test 2 hours after each meal but am not sure what to do about the figures and when I need to change things. (e.g. what would the figure need to be for me to know that I can't eat whatever it was that caused it?)

As I said I have only been testing for a week but my average reading is 8.1. I am not sure but I thought that was pretty good as my fasting reading on diagnosis was 13.8. Does the average figure count for anything?

I am not normaly stupid or easily confused but this whole thing is baffling me. I am also new to forums and have been trying to find the answers here before posting but with no luck.

I would really appreciate any advice/answers.

Thanks in advance.

 

[borofergie]

During the week I have been testing when I get up at 07.15 and it's usually around 7.something. This was my first week of testing so, although the readings aren't brilliant, I am still in early stages and haven't worked out yet what to do about morning readings. Anyway, after breakfast I go to work. I have a cold meat sandwich made with low carb bread (nimble) for lunch. I then test again when I come home about 3pm and it's usually about 5.something. Result! (or so I thought)

I say "result". These readings seem very similar to mine, and I got a 5.2% at my last HbA1c.

There is not tha much you can do about the early morning readings. They do come down a bit in the end (but mine are always in the 6-7mmol/l range).

As it's Saturday today and I have been at home all day, I have been able to test more. On waking it was 6.8. However 2 hours after breakfast it was 8.8 and then 2 hours after lunch (3pm) it was 5.9. I ate the exact same breakfast and lunch as I have been doing during the week.
I assume this means I have probably been spiking all week without knowing it. Should I change what I eat for breakfast? Should I take meter to work and test more frequently?

It's probably the Nimble, I don't know what it's like because I've never tried it, but lots of us use Burgen soya and linseed bread which has a low GI (I'm not really in to the whole GI thing, but it's really tough to find a low-carb breakfast in a rush).

Don't beat yourself up over an 8.8mmol/l when you are getting 5s in the afternoons. If you are worried about it, then test at work for a few days. You might find out that the 8.8 was a bum reading.

Also, can anyone tell me the definition of a spike? I know it is spikes that can cause all the diabetic complications but is that only if spikes occur alot and what would be considered alot? Is 1 a day as described above considered too much?

Depends on who you are. For some people it's 10+ at 2 hours. I don't like to go over 7mmol/l at 2 hours (and if possible, not at 1 hour either).

Please excuse me if my questions sound stupid but I am really struggling to understand exactly what I am aiming for.

It sounds to me that you're doing just brilliant. You have a few "wrinkles" to iron out, but the whole thing is a learning exercise. Just keep testing and you'll soon turn the 8.8s into 6.9s. The low-carbing should help you lose some weight too, and that definitely helps your control too.

It took me a few weeks to get where you are. Even now (after 7months) I still muck it up sometimes.

 

[chocoholicnomore]

Thanks Borofergie.

Your reply is very encouraging. After reading about spikes causing complications I got a bit worried. Thanks for putting my mind at rest.

I know it's a learning curve and I will probably muck up loads of times but this forum and your advice has been worth it's weight in gold. Couldn't have managed without it!

Thanks again


PS

It's probably the Nimble

I had the nimble bread for lunch and it was 2 hours after that my reading was down at 5.9. That's why I thought nimble was OK to have. Breakfast was oat granola.

 

[Daibell]

Hi

First, many of us would disagree with the advice given by your diabeteic nurse ref basing all meals around carbs. There is no factual justification for this advice that the NHS relentlessly gives and carbs of the high GI variety are as bad for you as sugar. Many of us keep the carbs low and of the low-GI variety and have proteins and fat as a reasonable part of any meal. Have unsaturated fats, of course, when you can. The web has lots of sites that advise on low-GI carbs. I personally always try to keep any BS spikes below 10 mmol. This isn't always easy but with diet, exercise and the right medication you can achieve it most of the time. Don't give up on chocolate! Go for the 85% dark chocolates and keep the portion size reasonable; I have a few pieces almost every day!

 

[bedshaped2000]

the oats in the granola are slow releasing. do a 3 hr check after breakfast. how much bread do you have for lunch. i can only handle 1 slice of burgen at 10.9g of carb. if i have 2 slices my sugars rise and stay up for a while. granola is normally full of dried fruit which also will spike you. try adding brazil nuts flaxseed pumpkin seeds to iron out the spike. ive found the only cereal i can handle is 30g of lizis granola packed with flaxseed and nuts. if i take the nuts and seed away my sugars spike and rise. if you are having a sandwich with nimble thats about 16g of carb before you have filled it. the burgen will have just under 22g of carb but will slow release because of the fat from the seeds and the high fibre it has. as a rule every meal i have and snack is between 10 to 15g of carb so 1 slice is more than adequate. get out of the habit of 2 rounds of sandwiches because normal bread would be 68g of carb 4x 17g before the filler. also get some scales and weigh your cereal. if you weigh what you normally have then weigh the rda amount on the back youll see you where having double the amount. rda for coco pops for my kids is 30g so why when you buy the small packets in alsorted packets do they come in 45g boxes.

 

[Dougie22]

I was diagnosed at Easter and had many of the saqme questions as you've posted above (what exactly constitutes a spike, how many or often is dangerous, etc.). In my case (and maybe yours too), I have had a working life of problem solving (define it, measure it, come up with a solution, implement, review) and wanted to apply this approach to my T2. Unfortunately, I've had to accept that it's not like that.

The truth, I very strongly suspect, is that no one really knows a lot of these answers, partly because there's been insufficient research (most research being drug oriented) and partly because we are all so different anyway.

I've taken the view that diet, exercise and losing weight are all sensible in any scenario, and that reducing my carb intake can't hurt either. On the other hand I'm trying to avoid unnecessary medication as I believe it can harm me.

You sound as though you are on the right track and I wouldn't stress too much over the fine detail.

The broadly accepted long term measure of control is your three or six monthly HbA1c result. Fasting readings seem to vary a lot by person and, at least in my case, aren't as reliable.

Just one other thing to say, also from my professional life, - "There's no such thing as a stupid question", so keep asking.

 

[chocoholicnomore]

Just wanted to say a big thank you. You have all given me loads of great advice.