What counts as a spike?

[Goldmum]

Hi everyone,
I'm a few months into my T1 diagnosis now and have just finished a FEFI course (flexible eating, flexible insulin). It was great and I'm feeling really good as adjusting my fast acting doses to what I eat and have a half unit pen. I've had hardly any hypos since the start of the course and I'm generally running in the high 5s/low 6s. Before the course I was running lower (4s/5s) but with hypos almost every day.
I'm now looking more closely at what I eat though and I'm wondering what everyone would consider a spike in their BG to be. For example, tonight I had soup and sandwich (seeded bread) plus fruit - total about 45 carbs - pre meal BG was 5.7, 1 hour later it's 8.7. If after another hour, it's back in the 5s/6s, is that ok or should I be looking to keep rise lower even after 1 hour? Or should I inject 15-20 minutes before meal to prevent this rise? Any thoughts/views would be great. Thanks.

 

[ButtterflyLady]

I can't answer your question as I'm T2 not T1 but that FEFI course sounds great. It would be good if it was available to all insulin users... maybe it will be eventually. There seem to be long waiting times in some cases for DAFNE and DESMOND courses. Glad you are doing better

 

[Goldmum]

Thanks #CatLadyNZ - it was really useful as covered all aspects of diabetes including travel, alcohol, eating out in restaurants (all my favourite things ) as well as carb ratios etc. I got lucky getting onto this one as there was a space available at short notice. It should definitely be something offered to all diabetics.

 

[Jestred]

Hi Goldmom, Ive been living with T1 for 3 months now and have just started carb counting i have spikes that head me to the 12's an hour after eating. and thats with my BG around the 5-6 before the meal. I actually brought a new testing kit just so i can monitor my BG in 30 mins slots as my DSN's said its not worth testing until 2hrs after. but i have found i can limit the spike to 8-9ish at the moment if i take it 20-30 mins before the meal. if anyone has ways to get it lower it would be helpfull.
For me my Bg seems to resume to normal around 2.5 hours after taking my insulin

 

[Squire Fulwood]

I am a T2 (disclaimer) but we get spikes too. I have never seen a definition of a spike but I regard them as a blood sugar level higher than I would wish but of a limited duration.

 

[cz_dave]

Hi everyone,
I'm a few months into my T1 diagnosis now and have just finished a FEFI course (flexible eating, flexible insulin). It was great and I'm feeling really good as adjusting my fast acting doses to what I eat and have a half unit pen. I've had hardly any hypos since the start of the course and I'm generally running in the high 5s/low 6s. Before the course I was running lower (4s/5s) but with hypos almost every day.
I'm now looking more closely at what I eat though and I'm wondering what everyone would consider a spike in their BG to be. For example, tonight I had soup and sandwich (seeded bread) plus fruit - total about 45 carbs - pre meal BG was 5.7, 1 hour later it's 8.7. If after another hour, it's back in the 5s/6s, is that ok or should I be looking to keep rise lower even after 1 hour? Or should I inject 15-20 minutes before meal to prevent this rise? Any thoughts/views would be great. Thanks.

I had a very similar question and here is the discussion. In retrospect, my thinking is that if you define a spike as going over what's normal, that is over approx. 7.2, then it is extremely hard, perhaps impossible not to have spikes as a T1 diabetic when eating a "normal" diet. What's achievable, is bring down your BS to around 5 or 6 mmol two hours after eating. Perhaps a bit easier with a pump...

 

[tim2000s]

@Goldmum 8.7 is pretty reasonable as a spike after an hour. Various different people suggest many numbers here, including a max of 7.8 as a spike, however, even non-diabetics will post meal spike up to more than that. The main difference is that they will recover much more quickly as the way the body administers insulin is very different.

You can aim for slightly lower, but it sounds as though you are on the correct track!

 

[Wurst]

I aim at 'flat lining' i.e. keeping below 5.5 mmol at all times so a spike to me is over 5.6 mmol . I read an article claiming that repeatedly spiking over 7.8 mmol i.e. every meal , every day could lead to complications. I'll try and find the article again and post the link, this method is also recommended in the Bernstein Diabetes solution. Whether it is true or not I prefer not to gamble with my health hence the 'flat lining' approach.

 

[cz_dave]

For me, it is this constant need to control the spikes that is most annoying and stressful about day-to-day management of diabetes. Trying to match the injected insulin against the carbs by injecting 20 or 30 minutes or right before the meal, depending on the meal, using intuition rather than any objective method. The result for me is little joy from the food I eat and often a mediocre result of controlling the spikes. I am now experimenting with a low carb/high fat diet which obviously eliminates the spikes but for me unfortunately also causes issues with high cholesterol.

 

[Goldmum]

I have high cholesterol so don't think LCHF is an option for me either. Diabetes management seems to be more of an art than a science that's for sure. From the replies here, I guess it's about deciding what approach you want to take - not easy.

 

[cz_dave]

@Goldmum 8.7 is pretty reasonable as a spike after an hour. Various different people suggest many numbers here, including a max of 7.8 as a spike, however, even non-diabetics will post meal spike up to more than that. The main difference is that they will recover much more quickly as the way the body administers insulin is very different.

You can aim for slightly lower, but it sounds as though you are on the correct track!

Good point. But then, I asked my wife to measure her BS an hour after she ate a huge portion of pasta and she had 5.3. Frustrating...

 

[RuthW]

Good point. But then, I asked my wife to measure her BS an hour after she ate a huge portion of pasta and she had 5.3. Frustrating...

I measured a friend of mine's once within an hour of eating and it was 13. I can't say how she is 30 years later, but I saw her regularly for 5 years after that and she had no signs of diabetes.

 

[tim2000s]

The result for me is little joy from the food I eat and often a mediocre result of controlling the spikes. I am now experimenting with a low carb/high fat diet which obviously eliminates the spikes but for me unfortunately also causes issues with high cholesterol.

Are you sure about this? LCHF for many people doesn't result in high cholesterol. The relationship between Cholesterol and CVD or CHD is also not that strong. High levels of Triglycerides show a strong correlation with the two, but high levels of HDL show a negative correlation.

What are your concerns relating to Cholesterol?

 

[C-Mack]

I think what people consider a spike differs and there is a variety of info out there. At 2 hours I try to stay below 10 mmol and ideally won't spike more then 2.5 mmol from what my pre-meal reading was. I am still relatively new though to this and will aim on tightening that up.

 

[cz_dave]

Are you sure about this? LCHF for many people doesn't result in high cholesterol. The relationship between Cholesterol and CVD or CHD is also not that strong. High levels of Triglycerides show a strong correlation with the two, but high levels of HDL show a negative correlation.

What are your concerns relating to Cholesterol?

I have posted about my cholesterol going up after starting LCHF here. Any advice would be appreciated, thanks in advance.

I decided to stay on LCHF but modify my diet in line with Franziska Spritlzer's advice. From what I read, there is a minority that faces adverse lipid developments when going LCHF. It looks like I belong to that minority. I will want to do another lipid test in a couple of months and see whether there is an improvement. I have family history of high cholesterol and CVD, so I would not tend to dismiss high LDL as something that may be just fine when on LCHF.

 

[cz_dave]

I measured a friend of mine's once within an hour of eating and it was 13. I can't say how she is 30 years later, but I saw her regularly for 5 years after that and she had no signs of diabetes.

When doing the OGTT, I spiked to 12 and I was told this was definitely not normal. I remember reading an article summarizing results of a scientific examination. It said that healthy people whose pancreas performs in an optimum way very rarely go over 7.2 at any given time.

 

[RuthW]

Do you know what time frame they refer to? Often they specify two hours after eating.

 

[cz_dave]

Here is an interesting post about what is normal BS for healthy people. It says:

"Most normal people are under 100 mg/dl (5.5 mmol/L) two hours after eating."

 

[RuthW]

Yes, two hours later. The question that never seems to be addressed is what non-diabetics reach within those two hours. It should be lower because they produce both Amylin and insulin, and their insulin works quicker because it enters the portal vein directly (I think), whereas our insulin take a while to get into the blood stream and reach its maximum effectiveness, but I would be interested to see some actual research about actual "normies".

 

[cz_dave]

The article that I quoted displays a charter that answers it I think. On average the spike maxes at 7.2 about 30 mins after a carb-loaded meal.