How high can non-diabetic blood sugars rise after meals?

[Popsickle12]

Hi, Just interested to understand the process of metabolising glucose please

 

[Lamont D]

The reason you haven't had a reply is because there are not many non diabetic posters on here.
Then there is the likelihood that is an individual thing.
Our intolerance to carbs, sugars and other foodstuffs and how quickly we metabolize them.
Then it is what we have with the few carbs, how much protein, good saturated fats, which slows the process, and other additives or how we cook and what with.
I spike high with low GI carbs.
I spike higher with high GI carbs.
That is why testing is so important to discover how bad certain carbs affect our blood glucose levels.

For example....
From normal, I would probably spike around the high teens from eating a medium sized spud.
You as prediabetic, from around 7, would spike around 10-11 mmols.

My intolerance to carbs is much worse than yours.

Hope that helps.

 

[Popsickle12]

Hi, thank you so much for this explanation, it certainly makes the science a lot clearer. I do have a BG tester now and I’m finding out what is making my BG spike. It seems to be the obvious-pasta, bread, rice etc. I’m reducing/ eliminating much of this so I know that’s helping. Thanks for replying. Take care.

 

[Lamont D]

Hi, thank you so much for this explanation, it certainly makes the science a lot clearer. I do have a BG tester now and I’m finding out what is making my BG spike. It seems to be the obvious-pasta, bread, rice etc. I’m reducing/ eliminating much of this so I know that’s helping. Thanks for replying. Take care.

It usually is the carbs and the starchy veg.
When I recommend testing around meals,I usually are keeping a food diary.
Not only noting your meals but your pre meal and two hours after first bite.
Anything else you feel significant.

This will help your medical team understand what is happening to you.
This may help with later issues as you go through your journey.

Best wishes, Take care.

 

[KennyA]

When we eat carbs BG will rise as the carbs are digested and pass into the bloodstream. This isn't a "spike" - it's to be expected. The real question is how quickly our systems can clear excess glucose - either used as fuel immediately, stored as fat, or stored as glycogen in muscles, liver and kidneys.

The attached graph is a example of a CGM from a non-diabetic person and you'll see plenty of ups and downs in BG, probably in response to eating and to the liver responding to perceived fuel needs. And have a read of this - a study of what happens to the BG of non-diabetic people after eating:

Continuous Glucose Monitoring Profiles in Healthy Nondiabetic Participants: A Multicenter Prospective Study - PMC

Use of continuous glucose monitoring (CGM) is increasing for insulin-requiring patients with diabetes. Although data on glycemic profiles of healthy, nondiabetic individuals exist for older sensors, assessment of glycemic metrics with new-generation ...

pmc.ncbi.nlm.nih.gov

 

[Popsickle12]

When we eat carbs BG will rise as the carbs are digested and pass into the bloodstream. This isn't a "spike" - it's to be expected. The real question is how quickly our systems can clear excess glucose - either used as fuel immediately, stored as fat, or stored as glycogen in muscles, liver and kidneys.

The attached graph is a example of a CGM from a non-diabetic person and you'll see plenty of ups and downs in BG, probably in response to eating and to the liver responding to perceived fuel needs. And have a read of this - a study of what happens to the BG of non-diabetic people after eating:

Continuous Glucose Monitoring Profiles in Healthy Nondiabetic Participants: A Multicenter Prospective Study - PMC

Use of continuous glucose monitoring (CGM) is increasing for insulin-requiring patients with diabetes. Although data on glycemic profiles of healthy, nondiabetic individuals exist for older sensors, assessment of glycemic metrics with new-generation ...

pmc.ncbi.nlm.nih.gov

Thank you for your information and link, of which the latter was a fascinating read! I had to read it a few times and look up a few terms to understand it. I did get the ‘gist’ of it in the end. This was what my original question was really so thanks for that too. Kind regards.

 

[Popsickle12]

Thank you for your information and link, of which the latter was a fascinating read! I had to read it a few times and look up a few terms to understand it. I did get the ‘gist’ of it in the end. This was what my original question was really so thanks for that too. Kind regards.

The graph you included was also interesting to see. I worry about what my blood glucose is doing on an hourly/daily basis between blood glucose testing results, but trying my best to keep calm about it. Interestingly the graph you posted shows the blood glucose raising to 9!!?

 

[KennyA]

The graph you included was also interesting to see. I worry about what my blood glucose is doing on an hourly/daily basis between blood glucose testing results, but trying my best to keep calm about it. Interestingly the graph you posted shows the blood glucose raising to 9!!?

Yes, I can raise my own BG to well over nine just by having a small latte. 5.2 to 9.6 after 40 minutes, back to 5.2 by 60 minutes. The point is I think that rises and falls in blood glucose are perfectly normal - it's like a car needing and using more fuel to go uphill. Blood glucose levels aren't the result of food alone - our livers will adjust how much glucose is in the blood according to what it thinks we need.

So natural and normal changes in BG hour by hour aren't really much for me to get anxious about: there's not a lot anyone can do to stop livers adjusting BG levels. Worrying about it (or anything) may make the liver increase BG levels - we react that way to stress. And if I'm returning to close to starting BG levels two hours after food, that's fine too.

The issue for me (as a type 2) is that I don't want rises in BG that go on for a much longer time. Personally, I'd be less worried about a short-term rise to 10 that fell back to 5.5 within an hour than a rise to 8 that lasted six hours. The second case shows that excess glucose is hanging round in the blood, and that's what can do physical damage to nerves and capillaries.

 

[Popsickle12]

Thank you for that explanation, all making sense. Take care.

 

[SimonP78]

The issue for me (as a type 2) is that I don't want rises in BG that go on for a much longer time. Personally, I'd be less worried about a short-term rise to 10 that fell back to 5.5 within an hour than a rise to 8 that lasted six hours. The second case shows that excess glucose is hanging round in the blood, and that's what can do physical damage to nerves and capillaries.

I agree. Do you happen to know of any research looking at (or theorising on) the effects of integrals/areas under curves of BG levels and whether the feeling that short spikes are less bad than long raised plateaus (for a given area under the curve) has a scientific basis?

 

[KennyA]

The research I posted above does go into some of that - it's only been comparatively recently with the wide availability of CGMs and use of CGMs by non-diabetic people that anyone seems to have started looking at what "normal" looks like.

When I was diagnosed in 2019 there was next to nothing around about T2 blood glucose or non-diabetic blood glucose levels. There still isn't very much. The assumption was for T2 that it was progressive, blood glucose levels would continue to rise, medication in increasing strength would be necessary, etc. Fortunately this forum provided and alternative view, one that's worked for me. I use the 5th edition of Bilous and Donnelly's Handbook of Diabetes as a guide to what the current medical view is: it now mentions low-carb (which is a change) but is still locked in to medication approaches and the more serious and unusual presentations.

So my view is pretty much that it's the "area under the curve" that's important: you can see BG in non-diabetic people rising sharply and falling equally quickly. For less well controlled T2s the rise happens just as quickly but persists much longer. I think I have an example of that and will attach.

It follows, I think, that all other things being equal, the longer cells in nerves and capillaries are exposed to high glucose concentrations the greater chance there is of glycation and therefore damage.

 

[SimonP78]

It follows, I think, that all other things being equal, the longer cells in nerves and capillaries are exposed to high glucose concentrations the greater chance there is of glycation and therefore damage.

I was thinking specifically about any research into glycation rate (and whatever other damage mechanisms there are) vs glucose concentration - I'm not sure whether or not it's a linear relationship (I assume not is probably the safest bet!) I'll do some Googling and report back. Just idle curiosity!

 

[KennyA]

I was thinking specifically about any research into glycation rate (and whatever other damage mechanisms there are) vs glucose concentration - I'm not sure whether or not it's a linear relationship (I assume not is probably the safest bet!) I'll do some Googling and report back. Just idle curiosity!

I don't know of any directly on that - it's a few months since I last did a pubmed crawl.

I would assume a couple more things: that a given blood concentration of glucose will affect different people differently; that it's not simple cause and effect - based on the observation that many of us have full-on diabtic symptoms at comparatively low BG levels, others have no symptoms at much highre levels. And that there may well be several other relevant factors that we don't know about.

If you do find anything, I'd be very interested to see it.

 

[John C 251]

Hi, thank you so much for this explanation, it certainly makes the science a lot clearer. I do have a BG tester now and I’m finding out what is making my BG spike. It seems to be the obvious-pasta, bread, rice etc. I’m reducing/ eliminating much of this so I know that’s helping. Thanks for replying. Take care.

You can also check out Dr Unwins sugar infographics which give an indication of how many teaspoon equivalents of sugar there are in various foods. Just google "Dr Unwin Sugar Infographics"

 

[Chris24Main]

Can I throw in my trusty Ben Bikman infographic?

The interesting bit is in the original question - what does "non-diabetic" mean -

Well, it can be defined a number of ways, but to some extent - it has to mean (for T2, or prediabetic) - someone to the left of this graph, where insulin is working as expected, by effectively clearing glucose from the blood.

So - there is a real case for saying - you know, the glucose spike and area under the curve are all interesting in their own right, but really, the CGM is telling you something about your insulin response, and the long, slow glucose response may mean a lower concentration of blood glucose at any given time (which on it's own is good), but it maybe should be interpreted to say - that means it's taking insulin longer to clear out the glucose, so it means that you have a higher level of insulin, for a longer period of time (which is not good).

I'm not saying that one way is right and the other wrong, but I think it's better to be aware of both, and think about reducing total body glucose and insulin.

 

[Lamont D]

Can I throw in my trusty Ben Bikman infographic?
View attachment 70548
The interesting bit is in the original question - what does "non-diabetic" mean -

Well, it can be defined a number of ways, but to some extent - it has to mean (for T2, or prediabetic) - someone to the left of this graph, where insulin is working as expected, by effectively clearing glucose from the blood.

So - there is a real case for saying - you know, the glucose spike and area under the curve are all interesting in their own right, but really, the CGM is telling you something about your insulin response, and the long, slow glucose response may mean a lower concentration of blood glucose at any given time (which on it's own is good), but it maybe should be interpreted to say - that means it's taking insulin longer to clear out the glucose, so it means that you have a higher level of insulin, for a longer period of time (which is not good).

I'm not saying that one way is right and the other wrong, but I think it's better to be aware of both, and think about reducing total body glucose and insulin.

When I was misdiagnosed in about fifteen years ago.
My graph, was nowhere near the one you showed.
And the doctors never questioned it.
Just after true diagnosis, thanks to my endocrinologist, I was confirmed as non diabetic.
But I still had high spikes and if I did eat carbs for a few days even my fasting levels would be diabetic.
Mainly because of my first phase, which is weak.
But it's not only the insulin. I have been saying for a while as a hormonal response.
Cos, the first phase imbalance in these and other hormones, does effect everything to do with BG levels.
Then take in the usual insulin resistance, insulin overshoot, intolerance and other aspects of the constant higher glucose derived from high carbs.
Non diabetic related to being below the hba1c levels. But it should include a term of non diabetic fasting levels as well. As in remission.
Susceptible to the imbalance, but in real control that improves health.
And keeps the progressive nature of the condition under good control.
With RH, through my experience, being in continuous normal or just above BG levels, has a dramatic effect on keeping my health in a good place. Less overall insulin etc, in your blood.
Insulin is good, but bad if too much.
High circulation of useless insulin, is because of insulin resistance, is what should be checked along with hba1c by doctors before issuing meds or even insulin etc.
Non diabetic is a label that says, your metabolism is working.
And you are aware of the pitfalls.
Avoid the high spikes, is the best advice for someone that has a propensity for metabolic and diabetic levels.

 

[Chris24Main]

Hi @Lamont D ...
I don't think there is anything in conflict here.. that Ben Bikman graph shows how insulin resistance progresses over time.. Insulin is a hormone. Diabetes is hormone imbalance, T1 too little, T2 too much and every other variety some form of issue with hormone imbalance. Check.

Nobody 'has' that graph at any point..it shows the response to blood glucose in a normally functioning person over time, measured in decades. so the only part of it which is completely non-diabetic is the part at the far left.. where blood glucose triggers a small amount of insulin which clears out the blood glucose.

This is not a graph of a sugar spike measured in minutes.

The shape of the insulin line then shows that over time, you need more and more insulin to do the same job..
The most importand point being that there is a long long time for most people where blood glucose looks normal, but there is an elevated level of insulin.

We are kind of saying the same thing.. I'm saying we tend to focus on the "how much sugar is bad" per the original question.. I'm saying ... you also need to be aware of the hormone response.

 

[Lamont D]

Hi @Lamont D ...
I don't think there is anything in conflict here.. that Ben Bikman graph shows how insulin resistance progresses over time.. Insulin is a hormone. Diabetes is hormone imbalance, T1 too little, T2 too much and every other variety some form of issue with hormone imbalance. Check.

Nobody 'has' that graph at any point..it shows the response to blood glucose in a normally functioning person over time, measured in decades. so the only part of it which is completely non-diabetic is the part at the far left.. where blood glucose triggers a small amount of insulin which clears out the blood glucose.

This is not a graph of a sugar spike measured in minutes.

The shape of the insulin line then shows that over time, you need more and more insulin to do the same job..
The most importand point being that there is a long long time for most people where blood glucose looks normal, but there is an elevated level of insulin.

We are kind of saying the same thing.. I'm saying we tend to focus on the "how much sugar is bad" per the original question.. I'm saying ... you also need to be aware of the hormone response.

Aah!
Thanks for eduating me in the graph misinterpretation. @Chris24Main ,
It is something that was discussed a while ago, when we had the blogs.
One of the most overlooked aspect of metabolic imbalance is the amount of circulated useless insulin, this can be measured. But is ignored.
We are all aware of insulin resistance but not the outcome of having it.
And how to reduce the amount of insulin along with the abnormally high levels of glucose, because of it.

Always interesting tbo.

 

[Popsickle12]

When I was misdiagnosed in about fifteen years ago.
My graph, was nowhere near the one you showed.
And the doctors never questioned it.
Just after true diagnosis, thanks to my endocrinologist, I was confirmed as non diabetic.
But I still had high spikes and if I did eat carbs for a few days even my fasting levels would be diabetic.
Mainly because of my first phase, which is weak.
But it's not only the insulin. I have been saying for a while as a hormonal response.
Cos, the first phase imbalance in these and other hormones, does effect everything to do with BG levels.
Then take in the usual insulin resistance, insulin overshoot, intolerance and other aspects of the constant higher glucose derived from high carbs.
Non diabetic related to being below the hba1c levels. But it should include a term of non diabetic fasting levels as well. As in remission.
Susceptible to the imbalance, but in real control that improves health.
And keeps the progressive nature of the condition under good control.
With RH, through my experience, being in continuous normal or just above BG levels, has a dramatic effect on keeping my health in a good place. Less overall insulin etc, in your blood.
Insulin is good, but bad if too much.
High circulation of useless insulin, is because of insulin resistance, is what should be checked along with hba1c by doctors before issuing meds or even insulin etc.
Non diabetic is a label that says, your metabolism is working.
And you are aware of the pitfalls.
Avoid the high spikes, is the best advice for someone that has a propensity for metabolic and diabetic levels.

Thank you for this explanation. May I ask what ‘RH’ means? You mention it half way down?

 

[Lamont D]

Thank you for this explanation. May I ask what ‘RH’ means? You mention it half way down?

It refers to my condition.
which is Reactive Hypoglycaemia.
that is the shortened version of which may include quite a number of conditions termed as Hypoglycaemia.
there is a difference between diabetic conditions including T1 and T2. In which the patience may go hypo.
And,
Non Diabetic Late Reactive Hypoglycaemia is just one of the hypoglycaemia conditions.
It is quite a rare condition.
It is totally food related with intolerance to many foods.
And we have our own sub forum, on this great website.