Rise in BG - what is acceptable

[Countryside_Yoyo_]

As I’ve shelled out for a Libre for 2 weeks I’m trying out different foods from the usual - things I’d like to eat but haven’t for the last few years because although I might catch an initial spike from finger prick testing I wouldn’t get the whole picture. Im prediabetic (hba1c now normal through low carb) but I know from testing the occasional “bad” food I still get a biggish rise in BG from certain things, so I avoid.

Today I tried a slice of the low carb “seedful” bread from Holland and Barrett - a bit pricey but often on offer and if ok I thought it might be good to have now and again. This is the third time I’ve tested it, each with different things on top, first time scrambled egg, the second time avocado and now smoked salmon and cream cheese. Each time I’ve had rises of around 2.4 - 2.6
I’m always confused by what is an acceptable rise - is it ok as long as it’s back down or no more than a rise of 2 by the 2 hour mark? Or does ANY rise of more than 2 indicate I shouldn’t eat that food again (or have a smaller quantity)
If I’d been finger pricking I most likely would have missed the top of the rise.

 

[LittleGreyCat]

Welcome to the "I didn't know that could happen!" club.

Your rises don't sound too bad especially when you are back down within 2 hours.

Most interesting is likely to be what your BG does over night.

 

[sgm14]

I’m always confused by what is an acceptable rise - is it ok as long as it’s back down or no more than a rise of 2 by the 2 hour mark? Or does ANY rise of more than 2 indicate I shouldn’t eat that food again (or have a smaller quantity)

I'm type 2 and I could never get a definite answer to whether there was a spike that was too high. I was told that the important thing was that the blood sugars came done again and didn't stay high for too long, which kinda implies that the figure in between does not matter, but no-one would say that explicitly.

If you look at the libreview website AGP report, you will see that their recommendations for Type 1 or 2 Diabetes is

Spend less than 25% above 10 mmol/L
Spend less than 5% above 13.9 mmol/L

Not sure if it will be different if you are pre-diabetic, but on that basis you don't have to worry.

 

[ianf0ster]

I'm type 2 and I could never get a definite answer to whether there was a spike that was too high. I was told that the important thing was that the blood sugars came done again and didn't stay high for too long, which kinda implies that the figure in between does not matter, but no-one would say that explicitly.

If you look at the libreview website AGP report, you will see that their recommendations for Type 1 or 2 Diabetes is

Spend less than 25% above 10 mmol/L
Spend less than 5% above 13.9 mmol/L

Not sure if it will be different if you are pre-diabetic, but on that basis you don't have to worry.

I think that those AGP report figures are too high - meaning not really aiming for good control (though I'm not a Libre user myself). But this is just my personal view:

I believe that the numbers could/should be different for Type 1's than for Type 2's.
In general Type 1's can accept higher BG readings because they use exogenous Insulin to bring the numbers down fast plus thier most serious concern is that they avoid a Hypo!
Type 2's on the other hand (unless on glucose reducing meds other than Metformin) have no chance of a Hypo and are/ should be purely focussed on keeping BG below about 8.0 or 8.5.

 

[sgm14]

I believe that the numbers could/should be different for Type 1's than for Type 2's.
In general Type 1's can accept higher BG readings because they use exogenous Insulin to bring the numbers down fast plus thier most serious concern is that they avoid a Hypo!
Type 2's on the other hand (unless on glucose reducing meds other than Metformin) have no chance of a Hypo and are/ should be purely focussed on keeping BG below about 8.0 or 8.5.

If you are going to have two ranges, then I think the split should be into insulin users and non-insulin users, not types. I have read several times of Type 1 diabetics who don't need insulin and there are loads of type 2's that do need insulin. Also if you split using types, then what do you do with LADA, MODY, gestational and all the other types.

Also, I don't think it is true that type 2's on metformin have NO chance of having hypos. In fact, if they don't eat it is possible for non-diabetics on no medication to get hypos.

But I would agree that that the AGP targets are not the best you can do. Target is a maybe not the best word to use as some people will interpret that to mean, this is what I should be aiming for, but I think of it more as in this is the minimum that I should be achieving.

 

[HSSS]

In fact, if they don't eat it is possible for non-diabetics on no medication to get hypos.

it’s my understanding that unless on glucose lowering medication (or some much less common other conditions) any drop in bgl is self limiting due to the liver dumping to bring it back up and unlikely to result in any direct harm other than that a bout of dizziness might cause On such meds then the danger is that it will keep on dropping and hit truly dangerous levels regardless of liver dumping.

Also without such meds what might be called a hypo for an insulin user (below 4) is actually a normal and common number for some none diabetics.