Midday blood sugar spikes

[starf]

Hi all,

I'm a new T1 (diagnosed Dec 2019) and I've managed to fairly quickly gain control of my hba1c (15 to 5.6) via a low-carb diet, exercise and insulin. I am likely not in the honeymoon phase since my last C-peptide was abysmally low.

My doctor has recently put me on Toujeo from Lantus due to overnight hypos, and lately I've been having a different issue with midday blood sugar spikes (they inconsistently happen right before lunch time). I've been on Toujeo for over 1.5 months now so I am not still "adapting" to the insulin.

The spikes are nothing major (usually a rise 5 -> 6.5 mmol within a time span of 30min - 1 hour around noon or 1 o'clock), but I am still unsure what to do about them. My nighttime and fasting bg seems to be okay (usually runs around 4.5 mmol throughout the night) so I feel uneasy changing basal even though it's the first thing that comes to mind.

My regular breakfast is 4 eggs on 1 unit of NovoRapid, and it doesn't seem they are the cause of this. I sometimes also have 4 eggs for dinner - with a serving of vegetables and some cheese - without any delayed blood sugar spikes.
My boluses on low-carb are usually 1-2 IU NovoRapid.

Anyone facing a similar problem? Any advice you could share?

 

[ert]

You're doing so brilliantly well, do you need to improve what you're doing?

Anyway, you could talk to your consultant about checking your background insulin by meal skipping or (more usual) going carb-free.
I'm on a similar regime and face similar issues, but manage them through splitting my doses and following the numbers. I'm also am happy to put on my running shoes anywhere, anytime, if my split dose hasn't done its trick. I set a narrow alarm on my MM so I know when my BS's are heading upwards (to time my second dose. Meals high in protein and fat take a longer time to process.)
Someone on the forum recommended this early on - Sugar Surfing: How to Manage Type 1 Diabetes in a Modern World Book by Stephen W. Ponder.
Good luck.

 

[starf]

You're doing so brilliantly well, do you need to improve what you're doing?

Anyway, you could talk to your consultant about checking your background insulin by meal skipping or (more usual) going carb-free.
I'm on a similar regime and face similar issues, but manage them through splitting my doses and following the numbers. I'm also am happy to put on my running shoes anywhere, anytime, if my split dose hasn't done its trick. I set a narrow alarm on my MM so I know when my BS's are heading upwards (to time my second dose. Meals high in protein and fat take a longer time to process.)
Someone on the forum recommended this early on - Sugar Surfing: How to Manage Type 1 Diabetes in a Modern World Book by Stephen W. Ponder.
Good luck.

Hi ert, thanks a lot for responding!
I guess I'm a bit of a perfectionist, no harm in asking for advice.

My biggest problem is these blood sugar rises are way less predictable than I'd like them to be and I'm fairly confident they are unrelated to what I eat for breakfast. So I'm left wondering if it's just a diabetes thing or if I can fine-tune my basal some way to make things easier to control.

I don't have MM (yet, at least) so I guess I'll talk to my consultant about the best way to approach this and check out the book recommendation, thanks!

 

[KK123]

Hi ert, thanks a lot for responding!
I guess I'm a bit of a perfectionist, no harm in asking for advice.

My biggest problem is these blood sugar rises are way less predictable than I'd like them to be and I'm fairly confident they are unrelated to what I eat for breakfast. So I'm left wondering if it's just a diabetes thing or if I can fine-tune my basal some way to make things easier to control.

I don't have MM (yet, at least) so I guess I'll talk to my consultant about the best way to approach this and check out the book recommendation, thanks!

Hi there, are you saying your 'spikes' go from a reading of 5 up to '6.5' or they are rising by 5 or 6 whole points? If it's the former then they are not spikes in my opinion, they are a perfectly normal rise in glucose levels over the course of a day (for anyone, diabetic or not). Even without food, levels can go up and down the whole day through because there are so many factors involved, exercise, running up the stairs, stress levels, getting on the bus, sitting on the sofa, shouting at the kids and a million other reasons. I know there are some type 1s on a low carb diet who strive to keep their numbers in the 4s but I'm afraid our bodies may do otherwise despite our best intentions. I found at the start that I was always adjusting things, whether insulin, exercise or food to try and keep at some constant level and I soon realised that yes, you may get one thing 'perfect' but the balance is that something else won't be to your liking. An example was where my levels were great most of the time but around 4pm EVERY day no matter what, my levels would drop into the low 3s. I adjusted bolus & basal and a load of other things but it still happened, so now I accept that I have to eat 15 carbs of something to combat that, a small (tasty) sacrifice but it stopped me becoming obsessive about the numbers. For me, as long as I am in a reasonable range, ie not high or low and can go about my life as normal as possible I'm happy. Don't forget what you eat is only half the problem, your body is using it's basal as well and that can drip out whenever it feels like it thus scuppering your intentions. x