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Spikes After Eating

Jade-1990

Jade-1990

Member
Messages
14
Type of diabetes
Type 1
Treatment type
Insulin
I’m still fairly new to this, having only been diagnosed at the beginning of the year, but since having the freestyle Libre I’ve noticed that I tend to spike after eating before it comes down again. I’ve started trying to take my insulin at least 20 mins before eating, however I’m still having spikes especially in the morning. I’ve even started taking my insulin first thing in the morning and then eating breakfast last thing before leaving for work which is about 45/50 mins before. Is there a reason it could be mainly in the morning? I’ve really liked having the libre because it’s a lot easier and I like to see what happens in between the testing and stuff but I don’t know whether it’s making me a bit obsessive with it. I’m struggling with it not being as ‘perfect’ as I want I know it takes time and it’ll never be as ‘perfect’ as I want it to be but it’s really bugging me at the moment
 
What you are experiencing in the morning is common.
It is called “dawn phenomenon”.
It happens to most people: as you are waking up, your liver dumps some glucose into your blood to give you the energy to start your day.
For those with a healthy pancreas, they release insulin automatically and don’t see the BG rise.
Unfortunately, we can’t release insulin automatically, so see the rise.

If you search for “dawn phenomenon”, “DP” or “liver dump” you will see lots of threads on the topic. Some have some hints on how to manage or minimise the effect.
 
Think this is quite common Jade. I also have pretty big spikes after eating especially after brekkie. I am on quite a high ratio of insulin to carbs as well especially in morning when it 1 unit insulin to 4 grammes of carbs. And still I can go from a 6.5 to over 10 in about 1.5 hours before falling back again.

Thing is we are all different and need different amounts of insulin. Best thing to do is test regularly and if possible eat foods with low GI rating, carbs that are absorbed slowly

Have a look at the Type 1's R us thread on this forum, you will find plenty of us on there who are not perfect, but we do try. Diabetes is not an exact science, if only it was that simple

Good luck
 
Mel dCP said:
It’s so frustrating, isn’t it? As well as a dawn phenomenon from around 4am, I seem to be quite resistant to insulin and sensitive to carbs in the mornings, so the usual ratios don’t seem to apply.
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Ditto! Made even worse when I swim. I’ve stopped worrying about it.
 
I often feel really rough in the morning because my BG starts to ride from about 4:30 am. It creates a feeling of anxiety so I often wake up about 5 ish. It's that feeling I used to get when I had an exam to take, but now it just happens on a normal day. Really annoying - I like my sleep!!
 
It can sometimes rise up to 15ish, no matter how long before I’ve taken my insulin or what my levels were first thing. I just can’t seem to get it right and yeah I seem to be waking up at 4/5am every morning, I’m constantly tired. It’s just really frustrating.
 
Jade-1990 said:
It can sometimes rise up to 15ish, no matter how long before I’ve taken my insulin or what my levels were first thing. I just can’t seem to get it right and yeah I seem to be waking up at 4/5am every morning, I’m constantly tired. It’s just really frustrating.
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What do you eat for breakfast? As a fellow sufferer of this annoying problem, I found that ditching my usual Shredded Wheat/porridge for a few rasps with yoghurt (10 carbs in total) helped. If I fancy porridge I eat it for tea as I don’t have a problem after about 2pm. I’m always hungry in the morning so it is very annoying. However, it has helped and I have no problem energy wise and don’t eat lunch TIL about 2ish.
 
Do you take split basal dose?

Apart from increasing the time between insulin and eating the only other options would be to further refine your basal, adjust your insulin/carb ratios and eat less carbs....
 
'Feet on the floor effect' makes me spike in the morning from the moment I get out of bed, so I inject for that before getting out of bed. I figured if my liver dumps glucose in my bloodstream I should inject for it just like I do when I put glucose in my bloodstream through food.
I usually don't do obvious carbs in the morning, too hard to inject for, except for a little milk in my coffee. If I want to have breakfast I just make bacon and eggs, eat a piece of cheese and cucumber, or have a bowl of full fat Greek yoghurt (thanks for this idea, all you low-carbing type2's on this forum :) )
The later it gets in the day, the better I can handle carbs and the easier it is to take a correct amount of insulin for them.

Good luck with figuring this whole diabetes thing out!
 
@becca59 I usually have cereal (cornflakes/weetabix)so fruit and yoghurt is a good thing to try, it just seems to be the last week or so that I’ve woken up high, it is so frustrating. The one night I went to bed slightly higher than normal, I ended up coming down and then staying fine through the night and in the morning so it just doesn’t make sense to me.

@novorapidboi26 yes, I do, well my DSN suggested taking a smaller dose in the evening to top up my morning dose because I had started to be high in the mornings and so she was saying that it was probably running out, so I had been thinking of maybe upping my evening one by a unit or 2.

I think it’s just trial and error with everything so all suggestions are appreciated. Thank you.
 
@Jade-1990 Cornflakes/Weetabix for breakfast? yep that will make you spike, they are notorious for this as they are a slow to digest and so will be later on before you will start to see the effect on the Libre.

I stuff my face with cornflakes, shreddies and some sort of other stuff at breakfast usually bowl over flowing but that is just me. I can inject for that amount of carb and odds on within the next 30mins - hour I will drop.

However I have now found that after, around 4-5hours, then it will spike, so couple of blats of insulin and I can usually catch it. :)

However you are right it is a game of trial and error and the longer you are a diabetic the more you will learn, but beware you are never old enough not to learn something new :)
 
One thought to throw in the mix:
Are you certain you really go as high as 15?
I ask because Libre is less accurate at higher values so it may be worth checking with a finger prick if this happens at a predictable time.
 
Hi @Jade-1990,
Your question resonates with many of us. And I applaud your initiative in trying to delay breakfast after your pre-breakfast Novorapid to see if you could better 'catch' the after meal BSL rise.
My thought is to work out what is happening one step at a time. If you alter several things at once you will not know what is helping and what not. (perhaps before re-considering the above strategy in conjunction with your dsn)
1) Food intake: not all carbs are the same in how quickly and how much they raise BSLs. If you google mendosa.com and 'Glycaemic Values' you will see a range of foods listed according to their GI and GL values. GI (glycaemic index) tells you how much a given amount of a food raises BSL over time compared to pure glucose - the higher the figure the higher the rise.
The GL (glucose load) is about how much carbs per weight (density) of a food. The higher the figure the more dense with carbs is the food. The recommended levels for foods for diabetics tend to be GI < 55 and GL < 10.
So if you look up cornflakes in the table, under C for Cereals in the second list with food /GI/weight/GL: (i quote ranges)
UK cornflakes: GI 81- 93, GL 20 -23, and Weetbix /UK) GI 69-72, GL 13-14
UK cornflakes with milk: GI 65 GL 16
UK oats: GI 58 - 63 GL 18-20 UK oats with milk GI 40-50 GL 9-12 Some cereals have even lower GI and GL.
In discussion with your dsn or dietician a change in breakfast cereal may reduce the after breakfast BSL rise and also milk/yoghurt, due to their fat content, reduce the food going from stomach to intestine and being absorbed = lower bsl rise
2) Carb to insulin ratio after step 1, if BSLs 2 hours say, after breakfast, have improved but not into acceptable range, Carb to insulin ratio might need adjustment for short-acting insulin (Novorapid)bolus before breakfast, Your dsn is your advisor. And this might be where, diet/breakfast is optimised, the further experimenting with your initial straegy of timing of dose vs breakfast can be discussed.
3) Dawn phenomenon: some of us TIDs (but not all) have a BSL rise from 4 am, or later in the morning related to how our bodies prepare for waking up. The hormones involved at this time make insulin less effective and seem to cause the liver to release some stored glucose. Some of us wake early and administer a small dose of short-acting insulin. For you it depends if your Libre-obtained BSLs are in range from say 3 am until before breakfast. If they are also high your DSN will need to advise you on what is best to do. Also, in my case an unrecognised hypo at night can sometimes rebound with a high BSL later and increased insulin resistance (so Libre readings are important to rule that out too). For those on insulin pumps we have the advantage of programming the pump to deliver more insulin to prevent BSLs rising early morning.
4) Stress: Stress can raise my bsl and make my insulin less effective. And at one time I had disturbed sleep , called 'early morning wakening - 3am, 4 am, etc which turned out to be depression. I just ask you to consider this possibility and discuss with your GP.
I think I have written enough ( and do not wish to emulate the length of "War and Peace".
Best Wishes for a successful resolution to your troubles and a challenging and happy journey ! Please let us know how you go.
 
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