• Guest - w'd love to know what you think about the forum! Take the 2025 Survey »

Post meal spikes

Glad you enjoyed the post:happy:, I went with the spike of 14 because of either the portion size required to eat 250g of carbs in one sitting or simply the quality of carbohydrate that would allow you to eat that much in one meal.

That kind of meal plan obviously isn't for everyone and is a very bodybuilding/macro-counting oriented approach to minimising average blood sugar while maximising carbs consumed. The most efficient balance for a low Hba1c would be to eat low carb with all carbs in one meal ie: the best case scenario.

I feel the margin of error would be impossilbe to calculate without the statistical data of a few thousand type 1 diabetics and seeing as most don't eat like this and have a largely varying diet of different kinds of carbs/fibre and eating habits the error could be greater than 50%. A better way to look at it would be that the above calculated average blood sugars are the absolute minimums(best) blood sugars you can achieve with your particular kind of meal plan where the lax in your own discipline or other unforseeable complications account for any higher average levels.

I know from my own experience of eating only 70-100g of carbs a day, about 30-50g each at breakfast and dinner (2 meals) with only meat, cheese and leafygreens at lunch my fasting blood sugar was around 5 and post meal was usually at 6-8(avg 7) at 2 hours so mathematically: ((4x7)+(20x5))/24 = 5.33mmol/dL which translates to a theoretical Hba1c of 5.0% and my actual Hba1c was 5.1%!!! thats an error of only 2% (I did have the odd hypo and the odd hyper)
So I imagine with very consistent control you could easily see an error of only 10%

So I'm going to try replicate my last Hba1c with 1 meal of high carbs; allowing for a higher spike of 9 which conveniently gives the same result :woot:


But like I said this kind of thing isn't for everyone, I know there are those who struggle to keep their levels below even 8 or 9 due to other complications. I imagine that this fasting approach could help those who are stuck at Hba1c's of 6 or 7 who need that extra little change to join the 5% club. Or for bodybuilders and athletes who need the high carb count but don't want to damage their bodies just to achieve it.

EDIT: formatting

Your HBA1c is great - mine is normally good and I have been diabetic for over 25 years now and I am a woman whose had children, and my daily routine can vary mainly as a result of having had children :). I only eat about 140g carbs a day at 3 meals (I've always counted carbs and more by chance have ended up on a lower number of carbs). I don't regularly exercise, though I am fairly active and I wonder whether that is also what helps to keep you really stable - it is something I want to try experimenting with and am starting to try just a little bit of cardiovascular - just 15mins of jogging 3 times a week so that I can fit it in and see the results. I also wonder whether you weight can come into it too (just thinking out loud here!) and the length you've had diabetes. I know that I find that when my sugar is in 4s or 5s it takes very little to knock it into hypo, and a quick response to a hypo can save any liver dumps if I can stop it going too low then it doesn't seem to cause me too many problems (and is also what you want to do anyway).

Are you going to do your big carb meal in the middle of the day?

I just find that in theory I fit you less than 9 mmol spike but I know my HBA1c will not be anywhere that low - it will be more a 20% difference - so around 6. I have had HBA1cs in the 5s only when I was pregnant and I got to their target but I found it was just too many hypos and I was having to eat lots of wholegrain stuff to avoid post meal peaks and almost eating my food slowly over a period of time just to stop the peaks (I remember saying at the time - to be able to drip feed food with the insulin would be the ideal, but it is hard to do in practise!)…this is just me and my experiences and we are all different and it was a while ago.

I like the maths and it makes sense, part of it reminds me of the olden days of diabetic care where I went through a whole patch of being told my blood sugar should be between these levels and it is so straightforward, and it felt like some doctors believed you just do maths like that and your blood sugar should just float along at the same level (it felt like they had read a text book)….but the reality is that it doesn't just float at 5, but even if it doesn't just float at 5 you can do a lot to keep it within the ball park and still achieve good HBA1cs but it takes lots of work :)
 
Hi Njieberridge, the diet that I've been following for the past few months and for the next couple of weeks until I start a high carb diet has been generally low carb high fat, high protein 20%C 40%F 40%P.

What my breakfast consists of is usually some sort of combination of eggs(or egg whites) with a barley wrap, plums and blue/black/strawberries sometimes figs (though I haven't checked the effect of figs on their own yet). If I have a cereal it'll all-bran original which doesn't spike too high on its own (roughly 8/9) with almond milk. If I have more than 30-40 carbs in my breakfast then I'll bump up fat and protein as well and generally eat the fat and protein foods before the carbs like a mix of greek yoghurt and nuts for example or cottage cheese.

Not much to say about lunch just a lean protein and fats so chicken, fish any kind of red meat(kangaroo has been a recent addition; very very low fat content and consequently much lower cal than other red meats.) maybe nuts and cheese(I love trying new kinds of cheddar) and of course green vegetables(can't miss out on micronutrients).

Dinner will always be some kind of legume, I'm the most familar with lentils so thats the way to go for me, however I have taken note that Sydney University's Glycemic index has cited a spanish study which gave cooked chick peas a glycemic index of 10. I don't usually take anything that involves the GI at face value but with a value that low it seem worth trying out at the least.
http://www.glycemicindex.com/foodSearch.php?num=1410&ak=detail

With regards to your insulin management are you waiting at least 3 to 4 hours to see if your bs levels out? Because thats really the only way to know if you've got the right amount. It sucks to wait out a bad level but for me at least it was the only way to be sure. I've found to be certain of my levels I need to eliminate all variables so; have only that food at the same time of the day for a couple of days until you get it right and it will be your benchmark when your sensitivity changes later you can refer back to it and adjust your benchmark accordingly if that makes sense. I know its extremely tedious to do but its working for me at least for now.

I feel that I should reiterate that eating carbs mostly by themselves regardless of the type will give you a decent spike and I've found fats and protien to be awesome at lessening that peak when eaten in conjuction with your carbs(which is why lentils are so awesome!)
 
I guess I am more cardiovascularly fit than most that may help me a bit. I am a student at the moment and I don't let a lot of things get to me I'm at a point in my life where I'm less stressed and I have somewhat less responsibilities I only have work and studies(and not children!) to worry about.

There are many things that occur on a metabolic level when you're stressed or exercising that will play havoc with blood sugar in normal people perhaps much more (or even less) in diabetics(seeing as we have no hormonal insulin level changes other than those we give ourselves). I played a lot of soccer in school before I was diagnosed and I'm thankful to my younger self that I was in good shape and so now I need only worry about maintenance(and gaining muscle). My workouts also have their place firmly in my day and have become routine so I can account for them when managing my levels. I try to be in the 5's when I start a workout and if I'm any lower or at the low 5's then I'll have a jellybean or two just in case (hypo during a lift is no fun). I probably do hypo more often than most diabetics about 1-2 times a week but I know what my resting heart rate is and if i feel a little funny I'll measure it and if its slightly elevated I know to take a blood test.

It really is my background insulin I've been so focused on managing though and which is why I'm very interested in doing a one carb meal day so I need only worry about my levemir dosage. I'm planning on doing the meal in the morning so I can have the energy at the start of the day which is typically when I do most of my activities and when my insulin sensitivity is at its highest.

I don't know what your typical meal looks like but I'd give having something fatty a go along with your carbs like a yoghurt, salmon or cheese might be your alternative to eating over slowly over a period of time, unless of course you already do that.

I wouldn't put much weight in the maths it was a very crude way of quantifying the effects of my one meal plan thats all :happy:
 
A student…and you don't fill yourself on pizza and kebabs :D I do think that when you are serious about sport and exercise from a young age you pay a lot more attention to what you eat as you can see the effects in your performance whereas if you aren't so active you can get a way with not noticing it so much so it sounds like you got trained in some great eating habits :) 1-2 a week for hypos is fantastic…when I was at my lowest HBA1c it would be more like that a day which was just not fun. It's funny as I would go into any exercise and want to be over 8 so would eat to counter it and as I exercise the peak dips - sometimes if I notice that I am starting to rise I can stop it and make it drop with just 15mins of cardio type stuff. The routine is definitely something that helps - it makes it all easier to manage and easier to see the patterns.

Eating with the kids and family I aim to cook a nice balanced sort of meal - it is probably lighter on the fat side of things; family fare like spaghetti bolognase or pasta with chicken, spinach,sun dried tomatoes and pesto (the kids have a plainer version), roast dinners or some meat, potato and veg combo - all cooked from scratch I gave up on sauces as they are just full of sugar and homemade is just as easy and nicer :). lunches is a cheese sandwich with some salad (not my 5 a day humungous portion of salad - just some cucumber and some leaves in a sandwich) ,and brekkie is porridge with a tsp of sugar…proper porridge - might have some fruit if I notice my sugar level dropping a bit, With injecting earlier I'm not really finding peaks to be too large. So what are some of you higher fat foods (even pudding like if that is indeed possible) that you find not so peaky? I could look at yoghurts again - quite like fromage frais!
 
I'd say my go to fat foods would be cheeses(brie,cheddar), salmon, yoghurt(greek which has more protein), avocados and peanut butter. Apparently nutella has some decent results for slowing digestion but I haven't tried that myself though I must say I doubt it, nuts are also very fatty. I'd just be sure to avoid trans fats, hydrogenated and partially hydrogentated oils.
 
Hi Omar 101, just been reading your reply,a bit complicated for me with all the maths, and not being a bodybuilder, and being a female, I would like to know what foods you are eating, I am on low carbs, I try to keep them below 50-70, I give myself 1 unit of Novarapid to 10 carbs, but it doesn't seem to keep my BS down, so I am now experimenting with 1 unit of NR to 5 carbs, see if that makes a difference, like you, I love lentils, in fact any type of beans, but, I would be interested to know what your diet consists of, as your levels are excellent
Oooo thanks for all those replies, I think I might try the inject 15 mins before and see what happens. I test 1 hour after- on advice by DSN as trying to conceive so important to track when it is highest and lower it! Eat about 100g of carbs a day and use carbs and cals ap so can predict the amount in a meal.
Omar101, wow lots of info there, may take me a while to digest it all!!! (no pun intended) my cholesterol is also slightly raised, so Im trying to lower it with diet and exercise, tried eating porridge for b.fast with whole oats, but got huge spikes from that so back to multi grain bread. Its amazing who different people are and what they can tolerate.

Thanks everyone
hi, I was advised not to inect 10 or 15 mins before meals as food takes 10 mins to digest so if I inject same time as eating the food digestion and the insulin meet about same time,
 
Ooo ve


Interesting and lots to look into. I looked at GI to help with the post meal spikes probably about 10 years ago, but I think I read stuff about low GI to mean that you should eat more wholegrain food and I took that as more unprocessed whole grain food (so not ground down grains)…so I have a granary bread, one of the really seedy sorts and that seems to stop me peaking so high after food. Like you, for me proper porridge (not ready brek) is the one that works best for me in the morning producing the least highs afterwards (depends on whether there is a morning phenomenon going on in there or not - this morning - without the old morning bounce in the rise in my sugar was about 1.5mmol - I have cgm so can see it all). I also find pasta seems fairly stable afterwards for me. Beans, lentils and pulses - makes sense that they burn slower too. The Canadian article didn't say that GI was a waste of time for diabetics (it was more positive than that), just for non-diabetics and when companies label their foods as it can be misguiding. Try bulgar wheat for your post meals…that is the only food that I need to inject as I eat it or I go hypo after! - but I know we are all different and our bodies can behave differently (wish I liked lentils!). Your control is amazing and I do think that diet is a big area that gets missed out in teaching us lot to manage our diabetes - they show you how to count carbs and give insulin but it is way more complicated than that - so do keep writing as I am interested, I want to look at fat and proteins and how they effect blood sugar too - but not really done much digging on that yet.

Completely with everyone on trying to inject earlier - I inject between 15 and 20mins before I eat which does help to stop big peaks and is probably the easiest thing you can try to do.
hi, that's interesting as I was advised not to inject before but at same time as eating ,as food takes 10 to 15 mins to digest so the insulin and digestion mix at same time now im confused.
 
hi, that's interesting as I was advised not to inject before but at same time as eating ,as food takes 10 to 15 mins to digest so the insulin and digestion mix at same time now im confused.

Hi Annette, It really isn't as black and white as that, something like the sugars from jellybeans or candy will enter your blood stream in under 3 minutes, your cheeks can also absorb glucose directly and lower that time significantly(under 1 minute). A rapid acting insulin can start working in 15-30 minutes at best and sometimes only start to have noticable effects after 1-2 hours; thats if you inject it into your abdomen, injecting in other places such as the arm or thigh can delay insulin by an hour.

Also consuming carbs with protein and fats will significantly reduce the rate of carb digestion and consequently glycemic levels in the blood.
This study shows that fat had a significant effect on blood sugar responses and protein had even more of an effect: "subjects consumed 50 g glucose dissolved in 250 mL water plus 0, 5, 10, or 30 g fat and/or 0, 5, 10, or 30 g protein. Each level of fat was tested with each level of protein. Dietary intake was measured using a 3-d food record. Gram per gram, protein reduced glucose responses ∼2 times more than fat"
http://jn.nutrition.org/content/136/10/2506.full

Fibre is also known to affect the speed at which carbs are digested though to less of an effect than fats and protein. Not all carbs are equal; pasta does not digest at the same rate as bread or potatoes etc.

If you were confused before I'm sure you're confused even more now :oops:. In my own experiences I've found (and this may not be same for you) that diabetes nurses/advisors and to some extent doctors will dumb down facts or not disclose all information about carbs and insulin with respect to blood sugar levels to avoid confusing and over-complicating things to new patients so as not to put them off self medicating and to allow them to ease into insulin therapy. However you should eventually start to do your own research and education to truly have 100% control over your average levels to avoid any unnecessary complications in the future.
 
hi, that's interesting as I was advised not to inject before but at same time as eating ,as food takes 10 to 15 mins to digest so the insulin and digestion mix at same time now im confused.

Yes and read all of Omar's post :) The type of carb you eat will effect how quick sugar gets into your system, and since wearing a CGM monitor like many other people wearing one I have realised that my blood sugar starts to rise before my insulin kicks in (if I eat bulgar wheat though - that burns sooooo slowly in me that I would inject and eat or inject afterwards - but for most food I need to inject a little while before I eat). I inject in my arms and thighs (not my stomach) but I will look at my blood sugar level and if I am a bit high then go for my arms as arms are quicker than legs! Then to add to all of that everyones metabolism and biology is slightly different and so for some people novorapid only last 3 hours and for others 5 hours and the peak isn't exactly the same for everyone. With using cgm I know that my novorapid starts to kick in at about 30mins (from my arms) - that is when my blood sugar starts to change - not it reaching it's peak, so for me that waiting 10-15 minutes, and then the 10mins for my stomach to be digesting sounds about right - they tend to coincide and I don't get as big a peak afterwards. It depends whether you have issues with highs after meals and stuff like that, then you might want to consider injecting a little earlier - but talk to your hospital about it.
 
Omar - is there a list of foods anywhere to show those that slow carb digestion and those that are quick (I'd just like a list to look at and compare my experiences/thoughts to)….like a proper glycaemic index of quick to slow burning foods or is it all independent research?
 
Omar - is there a list of foods anywhere to show those that slow carb digestion and those that are quick (I'd just like a list to look at and compare my experiences/thoughts to)….like a proper glycaemic index of quick to slow burning foods or is it all independent research?

Even if you could find such a list it would only apply to the person/people it was compiled for. Which one of the reasons GI values should be treated as a rough guide. It's not uncommon for people to find that there personal GI for a food is radically different from any published value.
Together with there being no "equation" to convert individual food GI's into a meal GI.
Foods can also vary in what's in them. Including in ways which can dramatically affect GI, but would leave ingredients lists unchanged. e.g. "lactose free" milk has a much higher GI than regular milk. But would the label change at all if the recipe for a milk containing product switched to "lactose free"? It would still contain "milk" and around the same amount of "sugars".
 
Even if you could find such a list it would only apply to the person/people it was compiled for. Which one of the reasons GI values should be treated as a rough guide. It's not uncommon for people to find that there personal GI for a food is radically different from any published value.
Together with there being no "equation" to convert individual food GI's into a meal GI.
Foods can also vary in what's in them. Including in ways which can dramatically affect GI, but would leave ingredients lists unchanged. e.g. "lactose free" milk has a much higher GI than regular milk. But would the label change at all if the recipe for a milk containing product switched to "lactose free"? It would still contain "milk" and around the same amount of "sugars".


Pretty much this ^^^

The glycemic index should only be used as a rough guide and when different foods are mixed together it doesn't really apply at all.
The University of Sydney conducted some of their own tests and compiled the rest from various studies around the world, that would be the most complete list they should cite their source at the bottom of the page for each food they list.
 
I guess I am more cardiovascularly fit than most that may help me a bit. I am a student at the moment and I don't let a lot of things get to me I'm at a point in my life where I'm less stressed and I have somewhat less responsibilities I only have work and studies(and not children!) to worry about.

There are many things that occur on a metabolic level when you're stressed or exercising that will play havoc with blood sugar in normal people perhaps much more (or even less) in diabetics(seeing as we have no hormonal insulin level changes other than those we give ourselves). I played a lot of soccer in school before I was diagnosed and I'm thankful to my younger self that I was in good shape and so now I need only worry about maintenance(and gaining muscle). My workouts also have their place firmly in my day and have become routine so I can account for them when managing my levels. I try to be in the 5's when I start a workout and if I'm any lower or at the low 5's then I'll have a jellybean or two just in case (hypo during a lift is no fun). I probably do hypo more often than most diabetics about 1-2 times a week but I know what my resting heart rate is and if i feel a little funny I'll measure it and if its slightly elevated I know to take a blood test.

It really is my background insulin I've been so focused on managing though and which is why I'm very interested in doing a one carb meal day so I need only worry about my levemir dosage. I'm planning on doing the meal in the morning so I can have the energy at the start of the day which is typically when I do most of my activities and when my insulin sensitivity is at its highest.

I don't know what your typical meal looks like but I'd give having something fatty a go along with your carbs like a yoghurt, salmon or cheese might be your alternative to eating over slowly over a period of time, unless of course you already do that.

I wouldn't put much weight in the maths it was a very crude way of quantifying the effects of my one meal plan thats all :happy:
Thanks for all that imfo Omar101, I do write down what I eat most days, and also test about 3 hours later, but like you said it does become tedious, also confusing, because for instance, for breakfast one morning I ate 2 hard boiled eggs, when I tested 3 hours later I was shocked to see how high my bs had gone up to, I am begining to wonder if maybe I should look at my Metformin dosage I take 500 for breakfast and 800 for my other 2 meals, now this dose was prescribed over 20 years ago, when I wasn't on Insulin, so maybe, I'm more insulin sensitive, and need a higher dose of Metformin, I know you don't know all the answers, but you seem to know more than my bloody DN, and you have made me think more about what I can do to get More control of my BS , thanks a lot, for your advice, feel today like I'm in contol again, :)
 
Thanks for all that imfo Omar101, I do write down what I eat most days, and also test about 3 hours later, but like you said it does become tedious, also confusing, because for instance, for breakfast one morning I ate 2 hard boiled eggs, when I tested 3 hours later I was shocked to see how high my bs had gone up to, I am begining to wonder if maybe I should look at my Metformin dosage I take 500 for breakfast and 800 for my other 2 meals, now this dose was prescribed over 20 years ago, when I wasn't on Insulin, so maybe, I'm more insulin sensitive, and need a higher dose of Metformin, I know you don't know all the answers, but you seem to know more than my bloody DN, and you have made me think more about what I can do to get More control of my BS , thanks a lot, for your advice, feel today like I'm in contol again, :)

Thank you! :happy: The exact reason I recently joined this forum and wrote these posts was to stimulate some thought in other diabetics, unfortunately I see a lot of people struggling with their levels and many seem a bit too complacent in accepting a lot of outdated or incomplete information and not looking any deeper. There really is quite a depth of complexity in controlling blood sugars and I want to contribute as much as I can to other people's awareness and knowledge.

For now I'll keep experimenting on myself and keep recorded data on my levels/foods and other metabolic factors I can control, noting trends and associations as I go.

I might post something of a megathread here in future with as many concepts & "cause and effect" evidence as I can scrape together though It might be a bit complex and hard to digest and will be more focused toward type 1 diabetics and their glycemic responses(I imagine most if not all could be applicable to type 2's). All in time however:p.
 
Back
Top