Morning spikes / Afternoon lows

[Smiffy1967]

Hi all having a few problems with the old Diabetes which some of you may be able to help with

After 15yrs of bimbling along quite nicely I'm having real problems with spikes after meals especially in the mornings

I've traditionally had weetabix, shredded wheat, toast or porridge and hasn't caused a problem but now I get really bad spikes after. From BG of 6-7 I have had spikes 2hrs after a meal of upto 16 :shock: so have cut down on carbs but still spiking. I even tried a low carb shake of 2g and still got a spike of 11 from 7

I have tried delaying eating after injecting but can only delay by 20 mins as I arrive at the office at 8:10 & officially start at 8:30 Injecting before this would mean doing it on the train. This helped slightly. My readings after 4hrs before food is back to normal. I mentioned this to my dietician and she suggested giving more insulin to combat the spike or change my carb ratio but when I reiterated the levels were back down before the next meal and I would hypo she didn't give anymore suggestions.

That's problem No.1 the second is in the afternoon my levels plummet dramatically. The spike is still present but not so great. I have changed my carb ratio, had snacks, apples, crackers etc but still struggle to not go hypo by 17:00.

I have checked my basal by fasting and am sure it is correct

For info I'm on Levemir and Novorapid

I have booked an emergency appointment with a diabetic nurse tomorrow but any suggestions would be gratefully received

As an aside I read on the forum that somebody was testing an hour after meals...with the spikes I'm getting I would be scared :shock:

 

[GlazedDoughnuts]

Have you gained weight since being diagnosed? I ask as you could of bought on a resistance to Insulin.

 

[Smiffy1967]

After the initial weight loss before diagnosis I've stayed more or less the same weight +/- 1/2 stone.

The insulin resistance had crossed my mind as well, not sure why it would occur after 15 years but is a possibility.

I saw the GP Diabetic Nurse today and she was baffled and referred me to the DSN at the hospital. I had an appointment in Dec but they are going to bring it forward

 

[Smiffy1967]

Forgot to mention my levels rise from waking to getting to work by up to 3mmol even though I virtually power walk uphill for 10mins

 

[diabetes51]

If you were developing insulin resistance, surely it would affect all your BS readings.

I have the same problem, spikes in the morning and lows at night, so I changed my insulin/gCHO ratio for the different meals. I took 2iu/10gCHO in the morning, when many people have numerous hormones racing about. Getting up. planning the day etc can increase adrenaline, but as we settle into the day the amount reduces. Lunchtime I was taking 1.5iu/10gCHO and in the evening 1gCHO - when I am obviously more relaxed!

One thing I have always found, in over 52 years of integrating diabetes into my life, is that when when I eat cereals and bread I need more insulin, no matter what time of day I eat it. But eat new potatoes, my favourite, and the amount of insulin I need goes down. Even if I have 20gCHO fried new potatoes for breakfaxt, I need less insulin than if I have 20gCHO toast. I have experimented and it works each time - potatoes = insulin down or hypo. Have you tried leaving things out such as the bread, to see if you spike more with certain foods? After all not all of us digest food in exactly the same way and at the same speed. Even a change in the acidity of the stomach e.g. when stressed, can affect a digestive enzyme called gastric amylase, that works on less complex carbohydrates that are contained in processed foods such as bread and breakfast cereals.

I have recently started a DAFNE course where they believe I should take the same amount of insulin per gCHO, no matter what I eat, so I am doing as I am asked to and they can view the results tomorrow. But my BS is once again spiking in the morning and dropping in the evening. It is going to be interesting discussing the results with others, including a nurse and dietician. I will let you know what we decide if it would be helpful to you.

 

[marybadlady]

Please do let us know how your discussion with the DAFNE lot goes diabetes51. I'm having trouble with this and have changed loads of things one at a time to try and isolate what's happening but no joy. This is total speculation but I am toying with a theory re carbs at the moment. I have had to recognise that while I don't have wildly violent reactions to carbs containing glutens, I do tend to get bloated and uncomfortable and have trouble sleeping. Wonder if glutens causing some inflammation somewhere which could contribute to BG highs and need for more insulin than gCHO would suggest. Just a thought.

 

[Smiffy1967]

Thank you diabetes51 for your reply and advice. I have taken the advice about the new potatoe and will be checking them out Definitely in agreement with you on different carbs having different effects, I will keep testing to cut out the 'bad' carbs

Like I said I haven't noticed any adverse reactions to bread or cereals but am actively cutting them down / out wherever I can due to the affect on my BG

Your views on the DAFNE course would be much appreciated.

I do have different carb ratios for different times of the day which are working for a 3-4 hour reading but not for the dreaded 2hr spike if I take more insulin / adjust the carb ratio I'm then low or hypo before my next meal so in a bit of a catch 22 situation .

The hospital are aware and are bringing my appointment with the DSN forward so hoping they can help

 

[Smiffy1967]

I did wonder if coffe may be causing some resistance as I drink coffe in the mornings and afternoon it's tea..terribly British..but not noticed any noticeable change