What do you call a ‘spike’?

[itd]

Hi, I have T2 and started taking BG readings recently after it was clear I wasn’t managing as well as I thought I was. I’ve been eating low carb (in fact carb-paranoid) for the last couple of months and not really getting the results I was expecting.

My pre-meal never seems to go much below 7 mmol/L and then 2hrs after eating goes up to 8.4 or 8.5 or so. Is that a ‘spike’? Am I supposed to keep numbers below 8.5 on average, or at any time I take a reading? How do I get the pre-meal down further if I already avoid almost all carbs?

 

[Rachox]

Hi itd and welcome to the forum!
First let me post a link to our useful info:
https://www.diabetes.co.uk/forum/threads/basic-information-for-newly-diagnosed-diabetics.17088/
Here’s some info on blood sugar levels too:
https://www.diabetes.co.uk/diabetes_care/blood-sugar-level-ranges.html
Can you just let us know a little more information about yourself too if you are happy to do so. Can you let us know if you are on any diabetic medication and then also can you give us a run down of a typical days diet, what did you eat yesterday for example? We can help you check if there are any hidden carbs in your diet.

 

[itd]

Ok, I’m on 2 x 500mg Metformin twice a day. Yesterday I have bacon & egg with a slice of black pudding (~9g carb). Baked aubergine stuffed with lamb mince & topped with a cheese / yogurt / egg combo at lunch then a chicken & cauliflower curry made with coconut cream and stir fried greens on the side for dinner. Had some cheese later in the evening (no crackers).

 

[itd]

Snacked on small handful of nuts during the afternoon at some point too

 

[Goonergal]

Hi @itd and welcome

It sounds like your post meal rises are within, or at least close to the 2mmol rise that is commonly recommended as the maximum rise that we should be looking for after a meal.

What was your HbA1c at diagnosis? You mention that you’ve been low carbing for a couple of months. Depending on where you started, pre-meal levels around 7 may be an improvement. Looking back at my own numbers (I was diagnosed with an HbA1c of 108), it took a few months of low carb before Imwas consistently under 7 before meals.

 

[itd]

Long story.

I was first diagnosed in February 2018 with a HbA1c of something like 108, I can’t remember exactly but was obviously ridiculously high! Immediately dropped all sugar and high GI carbs and drastically reduced stuff like bread and potatoes. At my annual test in August the same year, I’d dropped to 47. Very happy, thought I was doing all the right stuff and got on with my life.

Following year (August again) it’s back up to 72. I’d got complacent and decided I needed to get a bit more serious. Found this site in the meantime and got onto low carb in mid November. Struggled a bit before that as I’d been on a guided holiday with little control over food options during the day.

 

[itd]

Note that even with HbA1c at 108 the Practice diabetes nurse said there was no need for BG testing. What’s that all about?

 

[Rachox]

Note that even with HbA1c at 108 the Practice diabetes nurse said there was no need for BG testing. What’s that all about?

That’s because there’s no budget to fund testing kit for type 2s! Call me a cynic but I think that’s why.

 

[Lotties]

Note that even with HbA1c at 108 the Practice diabetes nurse said there was no need for BG testing. What’s that all about?

To avoid the discussion on who pays for testing supplies, probably.

 

[itd]

So, a rise of 2 is about where I need to be and a pre-meal BG of below 7 will likely come in time, is that the verdict?

 

[Goonergal]

So, a rise of 2 is about where I need to be and a pre-meal BG of below 7 will likely come in time, is that the verdict?

A rise of 2 is the maximum - overtime you’ll likely be able to reduce that. Pre-meal levels should also come down. In addition to low carbing you could also try eating in a narrow window by skipping a meal - that will accelerate the lowering of your blood glucose levels.

 

[itd]

Not sure I’d be able to manage skipping breakfast - I already struggle with what to eat at lunch whereas breakfast is relatively easy and I don’t seem to have any problem with monotony at that time of day!

 

[LooperCat]

A spike is a sharp rise of several mmol, very quickly. What you describe is a gentle rise.

 

[HSSS]

Not sure I’d be able to manage skipping breakfast - I already struggle with what to eat at lunch whereas breakfast is relatively easy and I don’t seem to have any problem with monotony at that time of day!

It not unusual for me to skip lunch, especially if I’m away from home. As you say it can be trickier than breakfast. Whilst one long prolonged fast each day may be the ideal two longish fasts are better than none! Improvement may be more achievable than perfection for now.

 

[Robbity]

That’s because there’s no budget to fund testing kit for type 2s! Call me a cynic but I think that’s why.

That's more or less what my GP has told me - he wasn't allowed to give me prescriptions for strips as that's what our practice manager had ruled.
(But GP's quite happy for me to carry on testing if I so wish!)

 

[itd]

I wonder what the cost to the NHS is for the mass of people failing to control BG because they’re not testing. I guess there’s a subset who would receive a kit but not use it but it seems obvious to me that providing the means to control BG between annual check ups would surely save on expensive outcomes later.

 

[HSSS]

I wonder what the cost to the NHS is for the mass of people failing to control BG because they’re not testing. I guess there’s a subset who would receive a kit but not use it but it seems obvious to me that providing the means to control BG between annual check ups would surely save on expensive outcomes later.

I don’t think many would disagree on the principle. But along with the test kit they must also be taught how to use it to get useful information and then be prepared to do something with that information.

In the past it was used, imo, incorrectly for type 2. A single morning test or only before meals etc is merely a commentary with limited use. The testing before AND after meals is where the massive benefits are to be found in educating the effect of foods on individuals.

 

[itd]

they must also be taught how to use it to get useful information and then be prepared to do something with that information.

Absolutely agree - I’m sure I would have benefited from that help. There is so much contradictory information out there, not least from people who should know more about the subject. Only seeing the BG readings spike or not has given me sufficient accurate information to manage it. All I get from the medical profession is the ‘company line’ and finger wagging, demanding that I better control my condition.