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Type 1s: Acceptable spike

samantha13

Well-Known Member
Messages
392
What does every one consider an acceptable 1 and 2 hour post meal spike? Since having the freestyle libre I'm shocked at how I spike after certain foods.

For example I was 7.5 before breakfast had 30g carbs
1 hour post 10.9
2 hours post 13.9
4 hours post 7.9
So although I came back after 4 hours is this spike worth it?
 
It depends where I start @samantha13 and what I'm planning to do,after I eat eg exercise. In general, I like to keep my spikes below 8 in normal circumstances.

Do you advance bolus? That can stop spikes a lot. It's an amazing tool and one that's often under-used.
 
Never over 5.5 mmol , before/ during/after meals i.e. at all times.
 
Ah, well my money's on that being the issue then, so easily improved

Start with the meal that gives you a big spike (for me that's breakfast) and move your bolus 5 mins more in advance each day or two so you can find the 'sweet spot' for that meal bolus. On Humalog, I had to bolus 30 mins in advance for breakfast, but you may be different.

This is an example of my results without pre-bolusing:

Before brek - 5.2
90-120 mins after - 11.0

With pre-bolusing:

Before Brek - 5.1
90-120 mins after - 6.2
 
Wurst said:
Never over 5.5 mmol , before/ during/after meals i.e. at all times.
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I aim for non-diabetic levels, so below 7.8. Ideally, I like to be below 7.2 and am generally in the 5s or 6s post-meal.
 
Wurst said:
Never over 5.5 mmol , before/ during/after meals i.e. at all times.
Click to expand...

Wow!! That is seriously good.
Is this with pump and low carb diet?
 
samantha13 said:
Thanks so much @azure that's brilliant. I'll try that tomo morn
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You'll be absolutely delighted with the results I myself stumbled across a thread a while back, in which @azure had recommended this "alien" concept of pre-bolusing before meals. At the time, I genuinely didn't know this was a technique for BG management...

After further reading on here and in "Think Like A Pancreas", I've never looked back. I'm on MDI, so it does take a wee bit extra planning to get it right - but the general concept still applies and it really makes the difference from 15's and 16's to 7's and 8's. You can imagine what the overall effect on your HbA1c will be, and it's really quite incredible!

Pre-bolusing combined with the data from the Libre system opens doors which were once well locked or entirely invisible
 
We aim for below 7 mmol at all times, and always prebolus. We tend to watch the CGM and wait until she's on a downwards trend before eating.
 
Wurst said:
No chance :-0 MDI and lots of exercise.
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Gosh that's a very tight margin you have for yourself: over 4 to avoid hypos and never over 5.5. Do you take it over 5.5 to exercise or do you hypo when exercising?

Only 1.5mmol/l to move in is probably less movement than non diabetics would see in their levels.
 

I do all my exercise mainly in the morning so never hypo due to DP , although need to inject to avoid going too high dependent on what I'm doing.

5.5 is my target which I stay under most of the time ! I'm still subject to bizarre random readings which typifies diabetes management., This morning I woke up at 6.7 mmol, cycled 14 km in -8 degrees and was still at 6.7 mmol. Must be Monday syndrome :-(
 

A1c has been in upper 4 % for years which is slightly lower than 32 mmol. Half units really help but if you're prone to hypo's I wouldn't try really tight control. My last hypo was in October. Tight control really goes out the window when I don't exercise
 
Sounds like you have everything just the way you'd like it! Congratulations to you.
 
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