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Is going over 9 after eating potatoes OK?

Discussion in 'Type 1 Diabetes' started by cz_dave, Jul 4, 2015.

  1. cz_dave

    cz_dave Type 1 · Well-Known Member

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    I am still quite new to diabetes, so I would like to know whether the following BG levels are OK. I suppose it is expected that potatoes will cause a rapid spike. I have eaten 2 boiled potatoes (200g) and chicken (not too fat) for dinner today. I have injected 2U of Novorapid right before eating (I am still in my honeymoon phase, so this corresponds to my insulin/carb ratio, which is 1:25).

    Because I had only rarely eaten boiled potatoes in my diabetic life, I wondered what the effect would be and did frequent tests with my meter after eating my dinner:

    19:30 - 5.7
    19:40 - injected 2U Novorapid and started my dinner.
    19:51 - 5.9
    20:11 - 8.5
    20:20 - 9.4
    20:25 - did a few pushups as I thought my BG was a bit too high
    20:30 - 8.3
    20:37 - 7.1
    20:54 - 7.3
    21:15 - 6.5
    21:53 - 5.2

    The spike to 9.4 took me a bit by surprise. Or, should I consider it "normal" given the fact that it dropped back again?

    P.S. I suppose I could have injected a few minutes earlier but then I had experienced a few hypos injecting too early in the past, so I am a bit weary of this.

    Any comments?
     
  2. Clivethedrive

    Clivethedrive Type 2 · Well-Known Member

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    Hi cz_dave, you might like to read dr r bernstein's diabetes explained 4 th edition....he has been a t1 for 45 yrs his recommendations are to get to 5.5 mmol and try and stay in that area,i had high levelsof bs back in sept'14, along with nerve damage to the feet , but since going lchf and staying to his recommendations,my bs now av' 3.8 mmol am fasting. Keep posting and you will get all the help you need.
     
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  3. Cashmere

    Cashmere Type 1 · Member

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    I wouldn't worry about these results. You were back down 2 hours later. You could always eat one less potato next time to see what happens :).
     
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  4. urbanracer

    urbanracer Type 1 · Moderator
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    From my perspective for what it's worth, you've started your meal before your rapid insulin kicked in. Inject 20 to 30 minutes before you eat and it will probably cap the spike at a lower level.

    Check this out.....
    http://www.diabetes.co.uk/forum/threads/injecting-before-eating.45340/
     
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  5. shelbyyyy

    shelbyyyy Type 1 · Active Member

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    I just done the dafne course and was told to never check my blood until 2 hours after I've eaten because your insulin hasn't had time to work therefore that's probably why they were a little high
     
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  6. teacher123

    teacher123 Type 1 · Well-Known Member

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    As @urbanracer said, injecting 15-20 minutes beforehand can make a big difference. When I started taking insulin I was doing the same: injecting and then eating straight away which led to higher numbers than normal. You will find out what best suits you in the coming weeks, just trial and error :)
     
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  7. noblehead

    noblehead Type 1 · Guru
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  8. cz_dave

    cz_dave Type 1 · Well-Known Member

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    Thanks everyone for the valuable insight.

    @Clivethedrive I agree this would be the best solution and I tried to go LCHF but could not handle it. Any suggestions are much appreciated. Here is the related post.

    @Cashmere Yes, cutting on potatoes is probably the best solution. Or, in fact potatoe puree works a little bit better for me I find (with added milk which perhaps limits the spike a bit - not sure though).

    @urbanracer, @teacher123, @noblehead Good point for sure to inject 20 mins before a meal with high GI food like potatoes, I will try it next time.

    @shelbyyyy I am not sure. Sometimes my BG is OK 2 hours after but higher than I would like before or even after.
     
  9. pinewood

    pinewood Type 1 · Well-Known Member

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    Answering the thread question about whether it is "okay" - in my opinion, the answer is no, it is not okay to spike above 9, regardless of how short lived that spike is. A fit and healthy non-diabetic would not spike to 9 so if your aim is tight control and trying to keep your levels as similar as possible to what they'd be without diabetes, then you should try to keep your postprandial levels down as much as you can. As others have suggested, key to this for me has been injecting my NovoRapid at least 20-30 mins before eating.
     
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  10. cz_dave

    cz_dave Type 1 · Well-Known Member

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    @pinewood thanks for answering my question. In fact I was instructed by my endocrinologist to inject 20 mins before eating. However, on a few occasions I went too low when I started eating and so I switched to injecting immediately before eating.

    Today before dinner I injected and started eating just low carb stuff and only after 30 mins from injecting I ate some carbs. I indeed did not even go over 7 but I also took a bit of a dip to around 4.3 BG level 30 mins after injecting and it did not feel very good.

    So, my follow-up question is how do you ensure you do not hypo when injecting 30 mins before eating?
     
  11. cz_dave

    cz_dave Type 1 · Well-Known Member

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  12. sp41700

    sp41700 Type 1 · Active Member

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    @Clivethedrive I agree this would be the best solution and I tried to go LCHF but could not handle it. Any suggestions are much appreciated. Here is the related post.

    I have just gone and read your LCHF post. You have not failed. You just need to set yourself a realistic and achievable objective ;)

    I too looked at the LCHF but I just couldnt get my carb low enough. My average carb sits at 120-130g per day.

    For me being an unhealthy overweight 20 year T1D staying under 9 within 2 hours of a meal would be almost impossible by eating potatoes. It is very difficult for us using a manual method to emulate the complexities and speed of the pancreatic response system which is one of the reasons we are advised not to test within 2 hours and not to worry too much about the spikes providing your bg readings before and 2 hours after are within range and your HbA1c is good. By my definition if those readings are OK your spikes must be OK!

    However all is not lost and it is possible to slow down the bodies response to supplying glucose from the carbohydrate that you have eaten by changing the carbohydrate. I recently changed my diet to a lower carb diet. I did a hunt for recipes and came across this one:

    http://www.bbcgoodfood.com/recipes/spanish-meatball-butter-bean-stew

    It swaps the carb in potatoes for the ones in the peppers, butterbeans and tomatoes. I ate this twice in the last week. The first time I forgot to reduce the carb by the fibre and bottomed out within an hour. The second time, leftovers, I peaked at 8.3 which for me, I was pretty impressed with :D
     
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  13. pinewood

    pinewood Type 1 · Well-Known Member

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    Unfortunately it's all trial and error and it will take time to work out what works best for you. Not only will you have your own time before eating that is optimum to inject but it also depends on a whole host of other external factors - how active you've been that day, whether you're sedentary or moving around after eating, the GI rating of the carbs. It all takes time to work out. At the weekend I injected my usual ratio of insulin to carbs 20 mins before eating. All was looking fine but I didn't factor in the fact that straight after eating (which was at a restaurant) I'd be walking around 2 miles back home. Cue the massive BS drop and hypo. In that situation I still think injecting 20 mins before was the right thing to do, but I should have reduced the amount I injected in light of the activity after eating.

    The reason you're injecting beforehand is to target spikes and to try to make sure the insulin action closely matches the digestion of the food. If you're going hypo then your insulin:carb ratio may need to be looked at or the food itself was such that the advance injecting may not have been appropriate. For example. when having a high fat meal the fat delays the digestion and in those situation (pizza is a good example) I would not inject so far in advance and would split my bolus into 2 or 3 spaced out injections; the first immediately before eating and the remaining 2 usually at 1.5 hours and 3 hours after eating.

    Sorry, this isn't much help - I'm still learning myself but it really is trial and error. If you can try to understand the underlying physiology it's easier to apply it to how you eat.
     
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  14. urbanracer

    urbanracer Type 1 · Moderator
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    [QUOTE="cz_dave, post: 892110, member: any comments?[/QUOTE]

    Hi cz_Dave,

    Cannot add much to the comments made by @pinewood . It is trial and error and our own differing personal requirements mean that we can't give you exact figures to work from. Indeed your own requirements will vary over time anyway so don't expect everything to stay the same as it is today.

    I think we all have spikes from time to time and the frequency will (hopefully) reduce with experience. Changing the timing, lowering or raising your insulin by a unit, eating a couple of extra grams of carbs, activity levels, etc, all things you can play with if you have the confidence to do it by yourself.

    EDITED:- Just don't change more than one thing at a time or you won't know where the biggest effect is coming from.


    Good luck.
     
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    #14 urbanracer, Jul 6, 2015 at 1:14 PM
    Last edited by a moderator: Jul 6, 2015
  15. Wurst

    Wurst Type 1 · Well-Known Member

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    I have always been of the belief that spikes are dangerous and could lead to complications if they are frequent over a period of time. With this in mind a spike of 9.4 would be a total disaster for me even at the 1-2 hour point.

    I aim to be under 5.5 mmol at all times before , after and during meals / snacks, rather difficult in this heat though. If you know what is spiking you then simply don't eat it and find an alternative. Instead of potatoes i eat cabbage , instead of bread i eat low carb fiber crackers etc etc
     
  16. pinewood

    pinewood Type 1 · Well-Known Member

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    Whilst that's very admirable even some very fit non-diabetics will peak above 5.5 mmol after eating and I don't believe any study has shown a link between spikes to the 6-7 range and any diabetes-related complications. I think the general consensus is to try and not peak above 7mmol; but appreciate everyone has their own targets.
     
  17. cz_dave

    cz_dave Type 1 · Well-Known Member

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    @pinewood By the way, how do you measure your BG? Do you have a CGM device?

    @pinewood, @urbanracer, @sp41700 Even with all the tweaks I find it quite a challenge not to go over 7 mmol when eating foods like bread, potatoes, rice, etc. And that's in a situation where I still have quite a bit of my own insulin.

    I think eliminating these high GI foods is probably a more efficient way as @Wurst suggests, hopefully sustainable. I have noticed that legumes work really well for me. The spike is very gradual and very mild. It is not exactly in line with LCHF I suppose but it certainly works better for my digestive system than eating a lot of fatty meat :)

    Anyone eats a lof of legumes here?
     
  18. pinewood

    pinewood Type 1 · Well-Known Member

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    I use the FreeStyle Libre. I eat the same diet as before diagnosis and this includes, on occasion, high carb meals. I currently manage to (generally) restrict my peaks when eating medium to high carb meals to 8 mmol and I am comfortable at that level given that (a) it quickly comes back down; and (b) it doesn't happen all the time and is only on occasion. Usually I have porridge for breakfast and peak at 6mmol, a low carb lunch (e.g. salad) and don't have any peak at all and then an evening meal that can range from anything from 20g to 100g+ of carbs depending on my mood. My last HbA1C was 5.7% but I think it's come down a little since then. I have found that advance injecting of bolus and regular exercise are two tools that have been invaluable in helping maintain good control.
     
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  19. leedoak

    leedoak · Active Member

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    I was just taught 4 to 7 before meal 7 to 10 after meals was fine. This was all in the the last 3 months?
     
  20. urbanracer

    urbanracer Type 1 · Moderator
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    Ha @leedoak

    Info from this website....................

    upload_2015-7-7_17-24-39.png
    A lot of people on the forum strive for (and achieve) non-diabetic levels.
     
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