Sugar Spikes

[craigieboy2001]

Hi all,

I'm newly diagnosed with type 2 diabetes. I think I'm at the low end of of 'seriousness' at the moment so I've told the doctor I want to try and control it with diet first instead of Metformin. I can't quite get my head around sugar spikes at the moment though. So I have some questions if someone would be kind enough to answer them for me please My doctor is useless with explaining stuff (and that's putting it kindly!) and I haven't had a proper review with a diabetic nurse yet.

1. I know that before meals my ideal mmol/l should be between 4 to 7 and two hours after should be below 8.5 mmol/l. But what about in between? For example, if I do a finger prick half hour after eating 'healthy' I notice my levels may have risen a couple of mmol's but if I eat a slice of cake or chocolate bar it may rise by as much as 5 to 6 mmol's. Does this matter as long as my levels go back down into the target range after the two hours or is there a maximum level my mmol should be between eating and the 2 hours after

2. After doing finger pricks for a few weeks I have noticed that my mmol hovers between 5-7 when I wake up and also when I take a finger prick before meals. It usually sits between 6-7 two hours after meals. Would this be classed as controlled diabetes? My HBA1C is 46

3. Am I allowed to have snacks between meals as long as it's under my calorie and carb intake for the day and am I ever allowed to indulge in a chocolate bar or a dessert / cake without taking medication or will this just spike me too high?

4 . I've read that daily ideal carb intake should be between 130-143g per day. I know they need to be 'good carbs' but is this amount ok if I'm not taking medication?

many thanks in advance!

Craig

 

[Jasmin2000]

Hi all,

I'm newly diagnosed with type 2 diabetes. I think I'm at the low end of of 'seriousness' at the moment so I've told the doctor I want to try and control it with diet first instead of Metformin. I can't quite get my head around sugar spikes at the moment though. So I have some questions if someone would be kind enough to answer them for me please My doctor is useless with explaining stuff (and that's putting it kindly!) and I haven't had a proper review with a diabetic nurse yet.

1. I know that before meals my ideal mmol/l should be between 4 to 7 and two hours after should be below 8.5 mmol/l. But what about in between? For example, if I do a finger prick half hour after eating 'healthy' I notice my levels may have risen a couple of mmol's but if I eat a slice of cake or chocolate bar it may rise by as much as 5 to 6 mmol's. Does this matter as long as my levels go back down into the target range after the two hours or is there a maximum level my mmol should be between eating and the 2 hours after

2. After doing finger pricks for a few weeks I have noticed that my mmol hovers between 5-7 when I wake up and also when I take a finger prick before meals. It usually sits between 6-7 two hours after meals. Would this be classed as controlled diabetes? My HBA1C is 46

3. Am I allowed to have snacks between meals as long as it's under my calorie and carb intake for the day and am I ever allowed to indulge in a chocolate bar or a dessert / cake without taking medication or will this just spike me too high?

4 . I've read that daily ideal carb intake should be between 130-143g per day. I know they need to be 'good carbs' but is this amount ok if I'm not taking medication?

many thanks in advance!

Craig

Hi @craigieboy2001 - I can only address question 1 with this BG timeline from a non-diabetic (not me, I'm T1). Non-diabetics get a decent BG spike too and that's what we try to mimic with insulin and for T2 also diet. If you are getting back in target range even after chocolate cake then I guess you are still making insulin. However, beware of the spikes of 5-6 mmol/L that take longer to bring down as they will expose your organs to high glucose levels and stress your pancreas, leading to beta-cell death and full on T1 eventually.

 

[craigieboy2001]

Hi @craigieboy2001 - I can only address question 1 with this BG timeline from a non-diabetic (not me, I'm T1). Non-diabetics get a decent BG spike too and that's what we try to mimic with insulin and for T2 also diet. If you are getting back in target range even after chocolate cake then I guess you are still making insulin. However, beware of the spikes of 5-6 mmol/L that take longer to bring down as they will expose your organs to high glucose levels and stress your pancreas, leading to beta-cell death and full on T1 eventually.

View attachment 68484

thank you so much! This chart is extremely helpful

 

[Melgar]

Hi all,

I'm newly diagnosed with type 2 diabetes. I think I'm at the low end of of 'seriousness' at the moment so I've told the doctor I want to try and control it with diet first instead of Metformin. I can't quite get my head around sugar spikes at the moment though. So I have some questions if someone would be kind enough to answer them for me please My doctor is useless with explaining stuff (and that's putting it kindly!) and I haven't had a proper review with a diabetic nurse yet.

1. I know that before meals my ideal mmol/l should be between 4 to 7 and two hours after should be below 8.5 mmol/l. But what about in between? For example, if I do a finger prick half hour after eating 'healthy' I notice my levels may have risen a couple of mmol's but if I eat a slice of cake or chocolate bar it may rise by as much as 5 to 6 mmol's. Does this matter as long as my levels go back down into the target range after the two hours or is there a maximum level my mmol should be between eating and the 2 hours after

2. After doing finger pricks for a few weeks I have noticed that my mmol hovers between 5-7 when I wake up and also when I take a finger prick before meals. It usually sits between 6-7 two hours after meals. Would this be classed as controlled diabetes? My HBA1C is 46

3. Am I allowed to have snacks between meals as long as it's under my calorie and carb intake for the day and am I ever allowed to indulge in a chocolate bar or a dessert / cake without taking medication or will this just spike me too high?

4 . I've read that daily ideal carb intake should be between 130-143g per day. I know they need to be 'good carbs' but is this amount ok if I'm not taking medication?

many thanks in advance!

Craig

Hi Craig. I personally try and avoid post prandial big rises in blood sugar If I can. I wear a Continuous Glucose Monitor so I see what my sugars are doing at any given moment. I aim for a smooth graph if possible. Everyone’s blood sugar rises after a meal. It’s natural that it does, and this is true for none diabetics and diabetics a like. For me I try and avoid my blood sugars going up Too high. Mine can go up to around 12 mmol/ls. This is better than the 15’s I was getting. I do this by knowing what foods shoot my blood sugars up, mine tend to stay up past the 2 hr mark. Big rises and sharp falls in blood sugar, in my opinion, takes its toll on our system. Ed grammar

 

[JoKalsbeek]

Hi all,

I'm newly diagnosed with type 2 diabetes. I think I'm at the low end of of 'seriousness' at the moment so I've told the doctor I want to try and control it with diet first instead of Metformin. I can't quite get my head around sugar spikes at the moment though. So I have some questions if someone would be kind enough to answer them for me please My doctor is useless with explaining stuff (and that's putting it kindly!) and I haven't had a proper review with a diabetic nurse yet.

1. I know that before meals my ideal mmol/l should be between 4 to 7 and two hours after should be below 8.5 mmol/l. But what about in between? For example, if I do a finger prick half hour after eating 'healthy' I notice my levels may have risen a couple of mmol's but if I eat a slice of cake or chocolate bar it may rise by as much as 5 to 6 mmol's. Does this matter as long as my levels go back down into the target range after the two hours or is there a maximum level my mmol should be between eating and the 2 hours after

2. After doing finger pricks for a few weeks I have noticed that my mmol hovers between 5-7 when I wake up and also when I take a finger prick before meals. It usually sits between 6-7 two hours after meals. Would this be classed as controlled diabetes? My HBA1C is 46

3. Am I allowed to have snacks between meals as long as it's under my calorie and carb intake for the day and am I ever allowed to indulge in a chocolate bar or a dessert / cake without taking medication or will this just spike me too high?

4 . I've read that daily ideal carb intake should be between 130-143g per day. I know they need to be 'good carbs' but is this amount ok if I'm not taking medication?

many thanks in advance!

Craig

Hi @craigieboy2001 ,

Your HbA1c is currently in the prediabetic range, so your control is fair, but not perfect; still a tad higher than you'd like to be, as the prediabetic range can be a place where complications can start occurring over time.Not for everyone, but some get problems sooner than others, that's not an exact science, alas.

To be clear, Type 2 diabetes is usually a matter of making plenty of insulin, but being insensitive to it because there's so much of it, not your betacells dying off. That's Type 1 and a completely different condition, though with certain medication or somesuch, a pancreas can become exhausted and insulin output reduced. Would still not be T1 as that's an autoimmune condition where the body actively attacks and kills your betacells, which just doesn't happen in a straight T2. So "respectfully, T2 doesn't "progress to T1, just to set that record straight.

Question 1: You test before a meal and 2 hours afterwards, aiming for a rise of no more than 2.0 mmol/l in between those measuring points, as that means you could cope with what you put into your body. Even a non-diabetic can spike beyond 10 for instance, but they recover faster than we tend to do. The thing is, try and keep under 8.5 as a general rule, as being above that often, regularly or consistently, can damage organs, which can create problems with the cardio-vascular system, eyesight, liver function, nervous system etc. So you want to be below 8.5, which isn't always feasible, but hey, sometimes you gotta live a little. (A lot of T2's on diet only will step off the wagon for a bit around christmas or a wedding etc. The Big Events, the one-offs where it is worth it.) They're aims, not hard rules, and you decide what is worth a little spike.

Question 2: Like I said, a HbA1c of 46 is classed as prediabetic. Too high, but not high enough to be alarming. Personally I'd prefer my numbers lower, but that's entirely up to you. The morning numbers can be higher for whatever reason, from having to have a wee in the night to a nightmare, the liver dumps glucose and that's basically out of your hands for the most part. Once you're awake and your metabolism is up and running for the day though, you'd like to see things a little lower than a 6 when you've fasted for a few hours between meals. Five'd be nice before starting your next meal...? But again, not a hard and fast rule.

Question 3: No-one here is going to rap your fingers with a ruler if you have a snack. They're generally not a great idea, because when you eat something carby, you demand an insulin response from your pancreas, and you want your body -I assume so anyway- to become more sensitive to its own insulin. So the fewer times a day you trigger an insulin response, the better your sensitivity eventually becomes. So if you do want to snack... Try something low carb, maybe? Hard cheeses, olives, cold cuts, pork scratchings, that sort of thing?

Question 4: Preferable carb intake is kind of useless.... It depends entirely on how insulin resistant/sensitive you are, so that's where eat-to-your-meter comes in... That'll tell you how many carbs are okay with you. I canm have about 40 a day, but tend to hover around 20. Others here are fine on 180 grams of carbs a day. It's entirely personal, so yeah.... Useless numbers if they have nothing to do with your own body and metabolism.

Aaaaand I have to go cook now, but hope this was somewhat useful?

Good luck!
Jo

 

[KennyA]

Hi all,

I'm newly diagnosed with type 2 diabetes. I think I'm at the low end of of 'seriousness' at the moment so I've told the doctor I want to try and control it with diet first instead of Metformin. I can't quite get my head around sugar spikes at the moment though. So I have some questions if someone would be kind enough to answer them for me please My doctor is useless with explaining stuff (and that's putting it kindly!) and I haven't had a proper review with a diabetic nurse yet.

1. I know that before meals my ideal mmol/l should be between 4 to 7 and two hours after should be below 8.5 mmol/l. But what about in between? For example, if I do a finger prick half hour after eating 'healthy' I notice my levels may have risen a couple of mmol's but if I eat a slice of cake or chocolate bar it may rise by as much as 5 to 6 mmol's. Does this matter as long as my levels go back down into the target range after the two hours or is there a maximum level my mmol should be between eating and the 2 hours after

2. After doing finger pricks for a few weeks I have noticed that my mmol hovers between 5-7 when I wake up and also when I take a finger prick before meals. It usually sits between 6-7 two hours after meals. Would this be classed as controlled diabetes? My HBA1C is 46

3. Am I allowed to have snacks between meals as long as it's under my calorie and carb intake for the day and am I ever allowed to indulge in a chocolate bar or a dessert / cake without taking medication or will this just spike me too high?

4 . I've read that daily ideal carb intake should be between 130-143g per day. I know they need to be 'good carbs' but is this amount ok if I'm not taking medication?

many thanks in advance!

Craig

Hi and welcome.

I'll try to do this in order. First, you've probably not been diagnosed with T2 diabetes on an HbA1c of 46mmol/mol. The "automatic" fallback diagnosis level is 48. However you can still have "diabetes" at levels below 48, on the basis of a range of symptoms - I did, and even the fallback diagnosis point recognises that diabetic symptoms and damage happens at lower levels. Do you have symptoms, and has your doctor made a diagnosis on the basis of that?

If you eat any significant quantity of carbs which are digested to glucose your blood glucose levels will rise - that is pretty much inescapable for diabetics and non-diabetics alike. It is normal and to be expected. The issue for those of us who are T2 and insulin resistant (we have lots of insulin, it just doesn't have the effect it should) is that our systems often do not clear tha glucose out of blood quickly enough. Surplus should be put in stores (in muscle, in the liver, or in fat) fairly quickly. With insulin resistance the glucose isn't put away as quickly as it should be and as a consequence some hangs around in the bloodstream. High blood glucose levels over time do damage (eg glucose molecules attach themselves to proteins and stop them functioning properly). So ideally under this low carb model the aim is to restrict the amount of glucose the body has to deal with.

The graph above that @Jasmin2000 posted shows you that working in practice. I'm going to attach another graph showing ups and downs in BG over 24 hours in someone who isn't diabetic. You can probably easily work out when this person ate, and then how quickly BG returned to starting levels. I don't think there's a direct answer to your Q1 - if you can return to baseline then your system can handle the carb load, whatever that was. But - as a T2 with insulin resistance I don't want to stress my system, so I would be a bit cautious about any food that took me from (say) 5.2 to (say) double figures, even if I return to baseline by 2 hours. Pastry does that to me.

Q2. There's no definition of "controlled diabetes". The problem with fingerprick testing and trying to draw conclusions is that the only data you have is from the tests - you don't know what's happening the rest of the time. I would imagine your diabetic nurse would be waiting a year or so and seeing more than a few non-problematic HbA1c results before making that sort of judgement. My practice did not reckon that any HbA1c of 42 or above was "well-controlled", being out of normal range.

Q3. You don't need permission from anyone. It's your choice. Make it and manage the consequences, if any. I have found that "snacks" don't really feature anymore because I'm not ever hungry. I will certainly have things on occasion (eg a sugary dessert) that would not form part of my regular diet but that I can plan for and manage. So I go a bit higher than usual, and tomorrow I'll be back on ~20g/day. Incidentally, I am not bothered about calorie values at all, only carbs.

Q4. You'll find out the answer to that. It might be sufficient for you. For me, I went to 20g a day because that's what I needed - that level worked to get my BG down very quickly and in the nearly five years since I've lost around six stone. I don't think that would have happened to me on 120/130g a day. I am not recommending it, it's just that what works for one won't necessarily work for another.

You see that 130g figure because it's accepted as the "amount of glucose the body absolutely needs" - except that the liver can make glucose, and that many of us become "fat-adapted" - using body fat as fuel and running on ketones instead of glucose as a result.

Just a general note of caution. I'm wary of anything I read, particularly on the internet, that starts handing out firm recommendations. If you read around a bit on this forum you'll see that there is huge variation in what we each do. The point is to find what works for you, not to follow someone else's prescription.

best of luck.