Spikes

[BadgerPaul]

Hi I’ve been type 2 for a long time. I now have a Libra monitor. Which I motivates me. I’m reducing my insulin. Was 74 now 44 and losing weight. I’m reading and asking questions. What I’m puzzled over at the moment is spikes. What is an acceptable spike after a meal ‍‍‍

 

[lessci]

NICE guideline say no more than 2 points from your start, but the lower & shorter you can keep them the better

 

[catinahat]

That's a difficult one to answer @BadgerPaul .
A spike seems to me to be a very individual thing, one person's spike is someone else's Ideal.
Don't forget we all have different metabolisms, weight, activity and severity of T2.
Personally I like to keep my 2hr post meal rise to no more than 2mmol, but I don't take any medication for my T2, I can't go too low , so I can safely cut as many carbs as I need to, to achieve my desired levels.
Someone like yourself , taking insulin , may not feel comfortable with my glucose levels.
What I'm trying to say is an acceptable spike after meal's is whatever is acceptable to you.
Only you can know if any rise is too much for you.

 

[Guilty]

With the Libre you can see 'time in range' which is another good measure of control alongside A1c.

I guess that indicates it's partly about how quickly you come back in to normal range, rather than how high you go.

Though, personally, I don't like to see double digit readings.

Good work on the insulin! You're right - having the Libre can be a great motivator.

 

[BadgerPaul]

Thank you all for your advice.
I’m listening to the Glucose Revolution at the moment. Finding it very helpful and informative. As I’m listening to it I’m finding that I need the hacks and data written. So I’m probably going to buy the book again as a hard back. Have you any recommendations for other books ??
Thanks again

 

[catinahat]

No books , but here's a couple of sites that should be useful.
The first one blood sugar 101, is a huge site with lots of information
https://www.bloodsugar101.com/
https://lowcarbfreshwell.com/

 

[ianf0ster]

That's a difficult one to answer @BadgerPaul .
A spike seems to me to be a very individual thing, one person's spike is someone else's Ideal.
Don't forget we all have different metabolisms, weight, activity and severity of T2.
Personally I like to keep my post meal rise to no more than 2mmol, but I don't take any medication for my T2, I can't go too low , so I can safely cut as many carbs as I need to, to achieve my desired levels.
Someone like yourself , taking insulin , may not feel comfortable with my glucose levels.
What I'm trying to say is an acceptable spike after meal's is whatever is acceptable to you.
Only you can know if any rise is too much for you.

@catinahat , @BadgerPaul Please note that when we Type 2's talk about no more than +2 mmol BG rise after meals, we only mean at 2hrs after the start of that meal.
Our BG goes higher (sometimes much higher) than that somewhere between 30 mins and 60 min after the start of the meal, but unless we wear a CGM like a Libra we don't notice because it's 'too early' to do another finger-prick BG test at that time.

 

[Charliethedog]

Thanks for your reply

 

[KennyA]

@catinahat , @BadgerPaul Please note that when we Type 2's talk about no more than +2 mmol BG rise after meals, we only mean at 2hrs after the start of that meal.
Our BG goes higher (sometimes much higher) than that somewhere between 30 mins and 60 min after the start of the meal, but unless we wear a CGM like a Libra we don't notice because it's 'too early' to do another finger-prick BG test at that time.

Agree. Your BG doesn't go "up" from the pre-meal reading to the +2hr one. It's probably been much higher in the first hour after eating and should now be down, or coming down. You won't see this with fingerprick testing, but a CGM will usually show it.

It's worth having a look on the internet at CGM DG graphs from non-diabetic people. It can be really hard to differentiate them from graphs from T2s, but in general the BG rises are often slightly less, and the return to baseline happens a bit more quickly. Of course with graphs from different people in different situations you're comparing apples with hedgehogs, so it's impossible to be sure.

Personally, I think I might be cutting something out if I was seeing double figures in the first hour, given that my usual baseline is somewhere around 4.7-5.3, but the key thing for me is how quickly my BG gets back to where I started.

 

[catinahat]

@catinahat , @BadgerPaul Please note that when we Type 2's talk about no more than +2 mmol BG rise after meals, we only mean at 2hrs after the start of that meal.
Our BG goes higher (sometimes much higher) than that somewhere between 30 mins and 60 min after the start of the meal, but unless we wear a CGM like a Libra we don't notice because it's 'too early' to do another finger-prick BG test at that time.

Of course you're right I should have made it clear that I was just talking about my level at the 2hr mark. Everyone's blood sugar rises after food depending on the amount of carbs in their meal, even people who don't have diabetes.
I really don't pay too much attention to how high my levels get as long as they are back where I want them with in the 2hrs, that tells me that my body has used any glucose from that meal, I don't need to know how much there was, just that it's gone.
I've edited my post to add in the 2hrs, to avoid any confusion

 

[gogobroom]

In my search for the same answer / validation I came across the following article which I found interesting.

https://tcoyd.org/2019/10/strike-the-spike-controlling-blood-sugars-after-eating/

Weighing more on the "Time in range" rather than the HbA1c solely and thus stating that reducing the post meal spikes is beneficial. As mentioned above and on here a lot the 2 hour marker is generally used but this doesn't take into account any large increases in the first 90 minutes which can be adding to the longer term problems.

I am no expert by any means, have used GCM's over a number of years on and off as a prediabetic, and for sport, and have regularly had initial increases of up to 11, 12 or 13 from a "normal" of around 6.5. This then usually returns back to within 2 of the starting position by the 2 hour mark. I have had this with large amounts of carbs and also very small amounts - as I understand it this is down to a slower reaction.

As mentioned above we are all different and deal with things differently.

Got my "diagnosis" appointment on Thursday so shall be discussing this with my doc.