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Dealing with spikes?

newest

Well-Known Member
Messages
65
Location
norfolk, england
Type of diabetes
Type 1
Treatment type
Insulin
Dislikes
cricket
hi, I am hoping to get some advice on how to control my bloodsugars, they keep spiking, I am doing everything I am told by my specialist nurse, counting carbs, weighing food and sticking to the limits set by her, they were the last a1c at 93, last month down to 80, I have to have the a1c at 69 in order to have a much needed hysterectomy, I am in constant pain in my abdomen, huge setback this month I got sunburnt quite bad, I didn't know this was not good for diabetics, also I have now a cold, lips are full of coldsores, I know my a1c will have risen again, so fed up by it all, I was diagnosed august2013.
 
Sorry you're feeling so rough, newest. Diabetes can be really hard at times and when you have other issues as well, it can be very wearing. I hope you can get everything sorted out so that you're feeling better.

Your DSN can help with specific problems, but to control spikes you could consider things like injecting your bolus slightly earlier so that it catches the spike better. I do that for my breakfast and it works well.
 
@daisy1 will be along shortly to provide some advice.

It would help us if you could share your insulin regime and meal plan so we could help.
 
You have done fantastic to reduce your A1c from 93 to 69, well done!

Whatever you do don't fall into the trap of not bothering because you suspect your latest spikes will effect your next result, you maybe pleasantly surprised! Concentrate on getting over your cold, your goal is closer than when you started so keep going.
 
Hi and welcome. Can you let us know what the limits were that the nurse gave you? Also what insulin regime are you on and do you have any excess weight. I can't think why sunburn is bad for diabetics; it's bad for everyone.
 
Hi and welcome. Can you let us know what the limits were that the nurse gave you? Also what insulin regime are you on and do you have any excess weight. I can't think why sunburn is bad for diabetics; it's bad for everyone.
 
hi, the limits on the carbs are 40 breakfast,40 lunch and 50-55 evening meal, I have 10 units apidra breakfast,10 units lunchtime and 12 units evening meal, then 13 units basal before bedtime. apparrantly if you get bad sunburn your body trys to heal it quickly,therefore taking it's attention away from the diabetes, i'm with you on that one, makes no sense to me either
 
hi, the limits on the carbs are 40 breakfast,40 lunch and 50-55 evening meal, I have 10 units apidra breakfast,10 units lunchtime and 12 units evening meal, then 13 units basal before bedtime. apparrantly if you get bad sunburn your body trys to heal it quickly,therefore taking it's attention away from the diabetes, i'm with you on that one, makes no sense to me either
also weight plummeted badly, just starting to pick up, I am now 8stone
 
Sorry you're feeling so rough, newest. Diabetes can be really hard at times and when you have other issues as well, it can be very wearing. I hope you can get everything sorted out so that you're feeling better.

Your DSN can help with specific problems, but to control spikes you could consider things like injecting your bolus slightly earlier so that it catches the spike better. I do that for my breakfast and it works well.
hi, thanks for that, I didn't realise I could do it earlier, I thought it had to be done the same time each night, I haven't long been on this insulin, but will try this tonight.
 
You have done fantastic to reduce your A1c from 93 to 69, well done!

Whatever you do don't fall into the trap of not bothering because you suspect your latest spikes will effect your next result, you maybe pleasantly surprised! Concentrate on getting over your cold, your goal is closer than when you started so keep going.
it's not down to 69 yet, that is what I have to achieve, last month it was 80.
 
Hi @newest, how long before eating do you inject your Apidra? Many of us have found with the assistance of CGM that we need to inject fast acting around 30 mins before eating in order to reduce spikes.
 
Hi @newest, how long before eating do you inject your Apidra? Many of us have found with the assistance of CGM that we need to inject fast acting around 30 mins before eating in order to reduce spikes.
I was told I had to wait 15mins before I could eat, and what is cgm?
 
hi, thanks for that, I didn't realise I could do it earlier, I thought it had to be done the same time each night, I haven't long been on this insulin, but will try this tonight.

No problem :)

Go very cautiously and gradually if you make any changes to your insulin and injection timing. If you're at all doubtful or concerned, check with your DSN first, especially as, you say, you're new to this insulin.

Good luck :)
 
I was told I had to wait 15mins before I could eat, and what is cgm?
CGM is continuous glucose monitoring.

What we've tended to find is that the timing of the short acting insulins is such that they take a lot longer than the HCPs believe they do to act, meaning that if you take them 15 mins before eating, carbs in your food start to spike your blood glucose before they kick in. By injecting earlier the insulin action and carb timings are better matched.
 
The suggestion to inject ahead of your food is an excellent way of reducing postprandial spikes, so many of us on the forum have benefited from this advice as most quick-acting insulins take around 15 mins to work, but you do have to be careful if the meal has a high-fat content as this can delay the absorption of the carbs.

Gary Scheiner ( Think like a Pancreas) wrote a good article some time ago called Strike the Spike, here it is if you want to know what he says:

http://www.diabetesselfmanagement.c...blood-glucose-management/strike-the-spike-ii/
 
@newest

Hello and welcome to the forum :)

In addition to all the excellent advice you have received above, here is the information we give to new members which I hope will help you to smooth out some of those spikes. Ask more questions and someone will help.


BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you’ll find over 150,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.
There are two approaches to controlling your carbs:

  • Reduce your carbohydrate intake
  • Choose ‘better’ carbohydrates

Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes-and-whole-grains.html

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 8.5 mmol/l
Blood glucose ranges for type 1 diabetes (adults)
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 9 mmol/l
Blood glucose ranges for type 1 diabetes (children)
  • Before meals: 4 to 8 mmol/l
  • 2 hours after meals: under 10 mmol/l
However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

  • structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
  • self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to bloodglucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic

Note: This post has been edited from Sue/Ken's post to include up to date information.
 
CGM is continuous glucose monitoring.

What we've tended to find is that the timing of the short acting insulins is such that they take a lot longer than the HCPs believe they do to act, meaning that if you take them 15 mins before eating, carbs in your food start to spike your blood glucose before they kick in. By injecting earlier the insulin action and carb timings are better matched.
thankyou so much I will certainly try this, I don't feel so alone now, knowing I can ask for advice from people who actually know how I feel, it is frightening when first diagnosed, I really didn't know anything,and wasn't told anything other than don't eat chocolate cake, I was so afraid of food, everything I ate sent my b/s soaring, my weight plummeted, I went from a dress size 12 down to a 6,in a matter of wks, I am now starting to regain a bit of weight, but the b/s were still up and down, hopefully now they will stabilise.
 
b/s has improved immensely since adjusting timings on insulin, and lowering carbs, before bed last night my b/s was 7.8, dsn had said if levels are below 8 then to have 2 rich tea biscuits before I go bed which I did last night. b/s this morning were 12?? should I have had the 2 rich tea??
 
b/s has improved immensely since adjusting timings on insulin, and lowering carbs, before bed last night my b/s was 7.8, dsn had said if levels are below 8 then to have 2 rich tea biscuits before I go bed which I did last night. b/s this morning were 12?? should I have had the 2 rich tea??
The advice you should have received is:

Do a basal test.

With modern insulins, you don't get the same peak overnight in insulin operation, so snack before bed is normally unnecessary.

Basically, what you should do is set an alarm at two hour intervals overnight and check your bg levels overnight. I suspect that you'd find you remained mostly flat given the response to two rich tea biscuits.
 
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