Help me understand spikes/rise in numbers

NewbieHelp

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Hi
Had a little blip at dinner …
2 cocktail sausages… 85% pork
Couple slices black pudding
2 cauliflower hash browns
Baked egg
Mushrooms

Tested just before first bite
Tested 2 hours later … only small increase of 0.5
Tested another 2 hours later and had risen by about another 2.5

Obviously too many carbs for me but why would there be only a slight increase at 2 hours and a huge increase at 4 hours

Thanks
 

Melgar

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Hi there @NewbieHelp , I'm not a diet expert, but I would think the sausages and the black pudding contain fat. The cheaper sausages will also contain filler such as wheat or rice, unless the sausage ingredients say 100% meat. Fats, in general, slow the metabolization process down, so instead of getting a big rise within the hour you will see a slower but lower rise over a longer period of time. I think that would cause that rise several hours later.
 

lovinglife

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I agree with @Melgar that it’s probably the fat in the sausages and black pudding that slowed down your rise, it could have been at lot higher at the 3hr point and at 4 hrs you may have been on your way back down or at that level for even longer

Looking at your meal it could have been quite carby also, I don’t know how many carbs you work to per day/meal but doing a guesstimate on your meal

2 cocktail sausages… 85% pork, not sure of the size of your sausage but 1 85% normal sausage has about 4g carb
Couple slices black pudding anything between 8-13g carb per slice - so 2 slices anywhere between 16 - 26g carb
2 cauliflower hash browns - don’t know the brand or if home made but the Strongs Cauli hash browns have almost 17g carb each
Baked egg no carbs
Mushrooms negligible carbs

So your meal could have had upwards of 55g carb, this along with the fats could explain your slow rise, had you tested at 5hrs it may have been similar to the 4hr test because it can be slower to come down
 

NewbieHelp

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Thanks guys, that makes sense.
Again another lesson learned.

I had expected a bit of a rise as I did look for sausages with the most meat content etc

I had one of the cauliflower hash browns before but was with a meal with minimal carbs…. The combination last night was carb overload

Back on the straight and narrow now!
 
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KennyA

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I think the above solution is definitely possible. However, I wouldn't describe 2.5 mmol as a "huge rise" and it's equally possible that something else happened in the intervening couple of hours to provoke your liver in adding a bit more glucose. That could be exercise, adrenalin, almost anything.

What were your absolute numbers? Theres a bit of a difference going from (eg) 4.5 to 7.0 compared to 10 going to 12.5mmol/l.

Also, don't forget that the glucometer is not 100% accurate - it's supposed to be within 15% of the true value 95% of the time. So a true value of 6.0 could be shown as anywhere from 5.1 to 6.9 and that would be OK in terms of acceptable accuracy.
 

NewbieHelp

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I think the above solution is definitely possible. However, I wouldn't describe 2.5 mmol as a "huge rise" and it's equally possible that something else happened in the intervening couple of hours to provoke your liver in adding a bit more glucose. That could be exercise, adrenalin, almost anything.

What were your absolute numbers? Theres a bit of a difference going from (eg) 4.5 to 7.0 compared to 10 going to 12.5mmol/l.

Also, don't forget that the glucometer is not 100% accurate - it's supposed to be within 15% of the true value 95% of the time. So a true value of 6.0 could be shown as anywhere from 5.1 to 6.9 and that would be OK in terms of acceptable accuracy.
My reading was 7 just before meal
Was 7.5 2 hours later …. Lulling me into a false sense of security
Then was 9.9 another 2 hours later
 

KennyA

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My reading was 7 just before meal
Was 7.5 2 hours later …. Lulling me into a false sense of security
Then was 9.9 another 2 hours later
A value of around 8.7/8.8 could theoretically generate both those results - 7.5 and 9.9. They would be at the opposite ends of the range so probably less likely, and it would imply that your BG stayed steady in the high 8s for some time, less likely again.

You could repeat the meal and test again, but it might not really be worth it. If you'd started with 7 and got the 9.9 at +2 hrs, you'd probably come to the same conclusion on the amount of carb in the meal.

If it was me, and given the level of carb, I'd definitely expect the +2 to be higher than the initial one (I don't get the "pizza effect" where fat slows glucose uptake) but for it to be undetectable by 4 hours. I'm less bothered by a short higher rise than I would be by a lower rise that hangs around for some time - if your BG falls quickly, no matter where it's been up to, it's a sign that your insulin response is doing its job.
 

NewbieHelp

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A value of around 8.7/8.8 could theoretically generate both those results - 7.5 and 9.9. They would be at the opposite ends of the range so probably less likely, and it would imply that your BG stayed steady in the high 8s for some time, less likely again.

You could repeat the meal and test again, but it might not really be worth it. If you'd started with 7 and got the 9.9 at +2 hrs, you'd probably come to the same conclusion on the amount of carb in the meal.

If it was me, and given the level of carb, I'd definitely expect the +2 to be higher than the initial one (I don't get the "pizza effect" where fat slows glucose uptake) but for it to be undetectable by 4 hours. I'm less bothered by a short higher rise than I would be by a lower rise that hangs around for some time - if your BG falls quickly, no matter where it's been up to, it's a sign that your insulin response is doing its job.
Yeah that’s makes sense

Definitely won’t be trying all those things together in the one meal as I don’t like seeing the numbers spike like that

I’ll try to stick to what I know doesn’t cause huge spikes ….

Thanks folks
 
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KennyA

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I wouldn't call that a spike. Just a normal and expected rise given the carb content.

Example - a small latte will take me from around 5ish to 9.5 in 30 mins/ half an hour as shown by CGM. That's from about 12g carb from the milk lactose. It's gone by 90 mins. Just what you'd expect.

Edit: meant to attach this bit of research. It shows what happens to the BG of non-diabetic people after eating various meals. You'll see they typically have big BG rises after eating, it's not a diabetic thing.

 
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Melgar

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@NewbieHelp I have an example of a 'spike' in blood sugars. Spikes usually mean that your blood sugars rise sharply. I have attached one of my cgm graphs to illustrate what a spike looks like. It's not a great example, but you kind of get the picture. I ate a slice of GF toast. GF bread, or gluten free bread, ( I have coeliac)tends to be half the size of regular bread. I buy a particular brand, Promise multigrain. I'm not a big bread eater, but on this occasion I had a slice. You can see the steep rise. Unfortunately, it does not show the descent. When I took the screen shot my blood sugars were still ascending.

IMG_5525.png
 

NewbieHelp

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I wouldn't call that a spike. Just a normal and expected rise given the carb content.

Example - a small latte will take me from around 5ish to 9.5 in 30 mins/ half an hour as shown by CGM. That's from about 12g carb from the milk lactose. It's gone by 90 mins. Just what you'd expect.

So is the fact this would cause a large rise in 30 mins be an issue…. Or is it acceptable as it’s gone by 90 mins?

As a example:
If I test before a meal and let’s say it’s on the range of 6.5-7 …. But by the test 2 hours later my numbers are maybe range of 7 - 8. I would assume that meal is relatively ok

But should I be testing at the hour mark to see if there is a huge spike?
 

Melgar

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@NewbieHelp , this is my view about having high rises in blood sugar after food. One should try and avoid those choppy up and down sugar levels, especially if you have issues with glucose metabolism / impaired glucose intolerance. This why I like the cgm devices, you can see those choppy graphs, as I call them. Unfortunately, you cannot see these so called 'spikes' or high rises with glucometers. Technology has moved on and we have cgm devices. I'm not advocating going out and buying cgms every two weeks when you have T2 as you are not trying to manage blood sugars through insulin therapy like a T1 must, but I suggest, once in a while, after reducing carbohydrate intake in each and every meal, you will reduce the likely hood of having high blood sugar levels in the interim between when you first test preprandial and when you test postprandial. Purchasing a cgm once in a while to see what's going on over a 24 hours period will help you.

Reducing carbohydrate in each meal you eat will decrease the likely hood of have those elevated blood sugars an hour after eating. Simply testing an hour after eating with a fingerprick would be very hit and miss. My own blood sugars will rise to peak, sometimes 90 minutes to 2 hours after, depending on the fat content.

To put simply, Avoiding high carb meals is key to a smoother graph profile. Of course, there will be a rise after eating a meal, but managing how high those rises go, is down to diet in most cases. That is why low and very low carbohydrate meals are so good at smoothing out those possible blood sugar peaks.

In a metabolically healthy individual the pancreas will deal efficiently and effectively with glucose levels. Of course, there will be a rise, but in non diabetics, blood sugars are swiftly dealt with.

Here is a quote from a research paper titled : Postprandial Glucose Spikes, an Important Contributor to Cardiovascular Disease in Diabetes?

" ...... epidemiological research now suggests that postprandial high glucose “spikes” as opposed to high average glucose levels are a more important determinant in CVD development in diabetes. Therefore, we argue that new glucose lowering strategies should be more directed against the reduction of postprandial spikes, than of HbA1c and/or average glucose, ..."

Significantly dropping carbohydrates in every meal you eat, and avoiding sugary drinks will give you confidence that when you test your blood preprandial and 2 hrs postprandial it would be very unlikely there would be a significant rise in blood sugars between those two test points when testing with a glucometer.

I hope that helps.