Spikes

A lot of us try to keep our BS as low as possible by avoiding carbs. I try to stay under 6 at all times. Short term spikes,whilst not as bad as long term ones, are still thought to be bad for overall health and may lead to future complications. Your nurse is probably used to people who don't adjust their diet to prevent spikes or rely on mess so won't be so aware of what most of us are trying to do here.

dan1jess2 said:

Please can someone answer a question for me, my latest Hb1ac is 45 so pre-diabetes doing ok but I am still eating bread pasta carbs etc but in small amounts measuring them and testing etc, 2 hrs after eating them my numbers are under 8 so ok according to my diabetic nurse however my numbers do spike after an hour to over 8 is this ok? She said everyone's spikes after that time and as long as it goes down after 2 hrs it's ok and your body is dealing with it but I am reading differently on this forum????

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The general idea is to keep the spikes as small as possible. Just how high do they get when you say over 8mmol/l?

Providing that you're spikes aren't much above 8mmol/l, and getting back under 8mmol/l within 1.5 - 2 hours then I wouldn't worry too much.

Are you aware of GI scales, wholemeal alternatives, combining fat with carbs to minimise spikes, etc?

Good work with the HbA1c

Spikes are what cause the damage to eyes and other body parts, so it is best to have as little variation in levels as possible.
Whilst the NHS recommends a target of less than 8.5 at at least 90 minutes post meal the thinking is that this is too generous. I hate to see a 7 at any time.

Why not do some 1 hour tests and see what is happening? Follow this up with a 90 minute test. I find my peaks are around 90 minutes and by 2 hours I am well on the way down. You could also follow the 2 hour test up with another one half an hour later.

Once you can see when you have the highest readings - if that is what you are seeking to know, then you can test at that point after eating rather than doing multiples.
I was keeping my spikes to a minimum with low carb and just testing after 2 hours as I was not getting a lot of difference between before and after eating for some weeks, but the numbers were all drifting downwards. Then they all dropped, so now after eating I usually see just over 7, but before eating well under 6, even though I am not being as strict as when first diagnosed.
The best thing is that I really feel great, even though my mind is all over the place - very bad experience with Metformin and statins before Christmas - both of which I have now stopped taking.

Much depends on what you have eaten and the combination of foods. Fast release carbs like pasta, spuds, rice, cereals, fruit and bread will spike higher and faster. If you add a lot of fats to that meal, the rise will be lower but longer - a more gentle curve if you can imagine it on a graph. The peak is generally within the first 2 hours. Some foods can peak later (pizza is a good example of this). Some of the protein you eat in excess of what your body requires will also turn to glucose and cause a rise, but this can take a lot longer, 12 to 24 hours sometimes. None of it is an exact science.

Your best bet is to give up the pasta etc.

Through the experiment stage of testing you will get a lot of results which may have you confused, it is about how you achieve those results and what your objective is.
If you want to reduce your blood glucose levels and be in control then the first achievement is your spike after eating. This can be done by testing every fifteen minutes after eating a meal, that has some quick acting carbs.
The next is to see if those carbs give you higher readings after two hours, if they do, then the size of the amounts of carbs need to be reduced or replaced.
The need to keep a food diary and record everything will help you in the future to see how you are coping with some foods.
The next step is to see how you are coping with a low carb, higher fat diet and try to see if adjusting your plate size and with introduction of more exercise is helping in reducing your fasting readings and lowering your blood glucose levels, getting your protein, fats, and carb ratio balanced to how it helps you to be in control. Testing all the time and recording. To see trends in your readings, to see if you are getting the insulin resistance down and becoming healthier.
It's trial and error and discovering what foods you cannot tolerate, it's about getting the balance right and keeping your blood glucose levels down and around normal levels. The more often you keep them there your body likes it, it hates being high and fluctuating all over the place, your body wants to be near normal levels. You are healthier there!
Control is key, getting there is a journey that may be long and frustrating.
Your favourite foods may not get near your mouth again.
Temptation is something that you will have to fight!

Hope this helps.

The two hour testing is just that - a test at two hours - it might not be giving you the information which could be the most useful about just how high your glucose levels are going. You might find that different types of foods give you spikes at different times after the meal, and you'll need to adjust for that - if you know that pasta - for instance - gives you a highest reading at 90 minutes you can check at 90 minutes if you change the type of pasta, reduce the serving size etc. to see the exact alteration in blood glucose.

dan1jess2 said:

Thanks for your comments and help, the spikes can go as high as 12 especially in the morning which I know is bad cus I feel it! It then comes crashing down which also makes me feel rubbish. The most confusing for me is at what point do I work towards under 8 after 1 hr, 90mins or 2hrs??? My fingers are sore from all the testing...

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The good news for you is that you'll be entirely able to reduce your BG spikes through better selection of foods and portion sizes. Brown instead of white and smaller quantities of carbs on your plate, more or less.

Exercise is also a factor of which the importance cannot be stressed enough. As a T2 you're almost definitely suffering from an element of insulin resistance which is ultimately why you're having BG spikes in the first place. Exercise, whether that be running or a gentle walk, will improve the performance of your GLUT4 transporters (the means in which glucose enters your muscles). That in turn will stop you spiking so high, so regularly.

GrantGam said:

The good news for you is that you'll be entirely able to reduce your BG spikes through better selection of foods and portion sizes. Brown instead of white and smaller quantities of carbs on your plate, more or less.

Exercise is also a factor of which the importance cannot be stressed enough. As a T2 you're almost definitely suffering from an element of insulin resistance which is ultimately why you're having BG spikes in the first place. Exercise, whether that be running or a gentle walk, will improve the performance of your GLUT4 transporters (the means in which glucose enters your muscles). That in turn will stop you spiking so high, so regularly.

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Not convinced by brown bread over white.. both are high carb foods and therefore best avoided completely for us carb intolerant type 2s .. Onviously it depends on the level of control that the OP desires. My wish is to remain unmedicated for as long as possible so I have drastically reduced my carb consumption to as close to zero as possible.

bulkbiker said:

Not convinced by brown bread over white.. both are high carb foods and therefore best avoided completely for us carb intolerant type 2s .. Onviously it depends on the level of control that the OP desires. My wish is to remain unmedicated for as long as possible so I have drastically reduced my carb consumption to as close to zero as possible.

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That's your view and opinion @bulkbiker. For most of us, eradicating carbohydrates from our diet completely - is simply not an option.

For those who wish to continue to eat carbohydrates, it is sensible to choose foods which are lower on the GI scale. That would mean brown over white, typically.

I do agree that I've personally had a few instances where "wholemeal" alternatives have neither reduced or improved post prandial BG spikes. It's just the way of things, often down to gimmicky marketing and loosely controlled regs by the FDA and associated regulatory bodies.

Overall though, I do find that carbs which are richest in fibre do limit the severity of post prandial spikes. Most people will and do agree

GrantGam said:

That's your view and opinion @bulkbiker. For most of us, eradicating carbohydrates from our diet completely - is simply not an option.

For those who wish to continue to eat carbohydrates, it is sensible to chose goods which are lower on the GI scale. That would mean brown over white, typically.

I do agree that I've personally had a few instances where "wholemeal" alternatives have neither reduced or improved post prandial BG spikes. It's just the way of things, often gimmicky marketing and loosely controlled regs by the FDA and associated regulatory bodies.

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Of course it is an option... as you say "those who wish to continue to eat carbs" it's a choice.. there are much nicer things to eat than bread....

bulkbiker said:

Of course it is an option... as you say "those who wish to continue to eat carbs" it's a choice.. there are much nicer things to eat than bread....

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There are also more carbohydrate biased foodstuffs that aren't bread

GrantGam said:

There are also more carbohydrate biased foodstuffs that aren't bread

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Also best avoided completely...

bulkbiker said:

Also best avoided completely...

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Again your opinion.

Please remember, @bulkbiker that the original purpose of this thread was to discuss "appropriate" post prandial BG spikes, and not to argue the warrant for LCHF or low to zero carb diets.

If you so wish, you could always start another thread outlining the benefits or low carb for T2's?

The best mantra is "eat to your meter". That alone will tell us what our personal carb thresholds are, and it is up to each individual to set their own targets. If those targets are too high there may well be problems down the line and people should be made aware of this..

Personally my target is 4 to 7, and I am within that target 98% of the time so I am happy. Oh! and I eat potatoes.

GrantGam said:

Again your opinion.

Please remember, @bulkbiker that the original purpose of this thread was to discuss "appropriate" post prandial BG spikes, and not to argue the warrant for LCHF or low to zero carb diets.

If you so wish, you could always start another thread outlining the benefits or low carb for T2's?

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Sorry but I am sticking to the thread.. spikes are dangerous and best avoided... to avoid them avoid eating things that cause them. I.e. Carbohydrate.. I don't see why you have a problem with that. There are already a significant number of threads on the benefits of LCHF for type 2's. I am simply helping a fellow Type 2 to avoid dangerous levels.. aren't you?

bulkbiker said:

Sorry but I am sticking to the thread.. spikes are dangerous and best avoided... to avoid them avoid eating things that cause them. I.e. Carbohydrate.. I don't see why you have a problem with that. There are already a significant number of threads on the benefits of LCHF for type 2's. I am simply helping a fellow Type 2 to avoid dangerous levels.. aren't you?

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You're driving a dietary choice which may not be for everyone.

Certainly if the OP chooses to partake in the LCHF lifestyle then excellent, I'm merely stating that diabetics can (and do) consume carbohydrates with respectable A1c's and post prandial BG readings. That may be something which the OP wants to consider before banishing carbs from their diet completely.

I am not helping a fellow T2 as I'm not one. I'm merely advising a T2 as to other options to help minimise post prandial spikes.

Enjoy your evening @bulkbiker.