What do you think of this glucose profile?

[PJMartin]

Can anyone comment on what the following daily glucose profiles say about control of my type 2 diabetes? I have always been diet controlled and recently followed the 800 calories for 8 weeks Newcastle University diet to lose 30lbs to get back to about 10.5 stone. I now have a LibreView 2 sensor for 2 weeks and am back on what should be my maintenance diet of 2000 calories a day, and am tweaking the menu. Just not sure how to interpret what it is showing me. Any thoughts welcome. (GP not in the loop due to the difficulty of getting appointments at the moment).

 

[Antje77]

Can anyone comment on what the following daily glucose profiles say about control of my type 2

Looks pretty good to me. What was your latest hba1c?

A: at a guess, you had a late night snack with carbs/drink containing carbs like beer one night (tuesday 28) but not the other nights.
B and C: You had one day of an early breakfast, but usually you have your breakfast between 8:30 and 10. At a guess you're having traditional breakfast foods like toast, oats, weetabix or fruits, as your daily graphs show a quick rise but dropping quickly too, very nice.
Have you experimented with low carb breakfasts like bacon and eggs or greek yoghurt or such to see how this affects your graph?
D: Lunch. Smaller spike, either because of your choice of foods or because you're body deals more efficiently with the carbs in the afternoon.
Perhaps you've had the occasional afternoon snack (fruit? Small bag of crisps?) between C and E as well.
E and F: Evening meal. Either you vary the timing of your meal, or perhaps you munch on something after dinner or drink a beer or such.

Of course I'm only guessing here, for all I know you're eating completely different things!

Can anyone comment on what the following daily glucose profiles say about control of my type 2 diabetes?

How do you feel about those numbers?
For some, this would be a brilliant graph, something they can only dream of, others would see points where they can improve. Both are equally valid.

 

[PJMartin]

Thanks for your replies...some good guesses there about my diet! My most recent HbA1c was 42 before weight loss, and the estimate by the app from the above curves is 40.

I can see that my meal spikes go up just beyond 10, but the lunch that is low carb (vegetables, meat, fish, yoghurt) stays low. Is there any drawback to switching all my carb calories over to protein, which presumably would help with the spikes? Healthy diet advice seems to have a proportion of whole grain carbs, but I could get the same calories from meat or fish to spike the glucose less.

 

[bulkbiker]

Healthy diet advice seems to have a proportion of whole grain carbs

"Healthy diet advice" is unfortunately not healthy for many of the general population and could be considered pretty deleterious for most with T2 diabetes.

It would definitely be better for you to reduce the spikes by not eating the carbs.

We need no dietary carbs whatsoever so as a T2 with effective "carbohydrate intolerance" it's often been found that reducing them to a minimum is beneficial.

 

[LionChild]

Can anyone comment on what the following daily glucose profiles say about control of my type 2 diabetes? I have always been diet controlled and recently followed the 800 calories for 8 weeks Newcastle University diet to lose 30lbs to get back to about 10.5 stone. I now have a LibreView 2 sensor for 2 weeks and am back on what should be my maintenance diet of 2000 calories a day, and am tweaking the menu. Just not sure how to interpret what it is showing me. Any thoughts welcome. (GP not in the loop due to the difficulty of getting appointments at the moment).
View attachment 51392

I would not be happy with so many Peaks at around 10. I am on low carb diet and rarely get above 9. If you really mean business, give up all those carbs which are responsible for the highs?

 

[Antje77]

Is there any drawback to switching all my carb calories over to protein

Nope, not unless you have kidney problems
I think you might like to read this if you're interested in reducing the spikes: https://www.diabetes.co.uk/forum/blog-entry/the-nutritional-thingy.2330/
However, it's good to keep in mind the numbers you are seeing at the moment wouldn't be likely to give you a (pre)diabetes diagnosis!

the estimate by the app from the above curves is 40.

Don't hang on too much on the estimate, it can be way off.

 

[KK123]

I would not be happy with so many Peaks at around 10. I am on low carb diet and rarely get above 9. If you really mean business, give up all those carbs which are responsible for the highs?

But you use insulin too don't you?, hence it's not just your low carbing keeping you below 9?, entirely diiferent situation to the poster.

 

[Ronancastled]

Healthy diet advice seems to have a proportion of whole grain carbs

Your healthy advice would probably guarantee you complications in the future.
Carbs are carbs, whole grain doesn't matter to your liver.
Every time you see your graph go up, that's carbs, doesn't matter what the source.
You control those rises then you control T2.

I see on your graph that you do spike from what I'm guessing is a nice health 45-60g of carbs per meal.
Good news is that you do seem to come down which shows a good 2nd phase insulin response.
Your night time seems smooth & you must have of had something gorgeous midnight of the 27th.

I've a thread on here for posters AGPs so I might nick that if you don't mind.

 

[LionChild]

But you use insulin too don't you?, hence it's not just your low carbing keeping you below 9?, entirely diiferent situation to the poster.

I would think it helps both Type 2s and Type 1s to reduce carbs in order to keep BG lower? Whether you are on insulin or not? This aspect of things we share in common?

 

[KK123]

I would think it helps both Type 2s and Type 1s to reduce carbs in order to keep BG lower? Whether you are on insulin or not? This aspect of things we share in common?

It's still two entirely different concepts, my point was that for you it's not just reducing carbs that is keeping you 'below 9' unless you are saying it is, it's a combination of that and your injected insulin which to some extent you have immediate & direct control of. The poster is diet only so lowering carbs enough to keep their levels lower is a different challenge altogether. Also, even in the absence of any food/carbs, a type 1 (or anyone who isn't producing their own insulin or not enough etc) can still have high levels in between meals, hence why we have our basal insulin, for many lowering the carbs makes no difference whatsoever. It's not a criticism of what you said, just a reminder that it can cause confusion between very different types of diabetes and possibly give people the wrong impression as to how certain things are achieved for one person which may not be something they can do themselves.

 

[LionChild]

It's still two entirely different concepts, my point was that for you it's not just reducing carbs that is keeping you 'below 9', it's a combination of that and your injected insulin which to some extent you have control of. The poster is diet only so lowering carbs enough to keep their levels lower is a different challenge altogether. Also, even in the absence of any food/carbs, a type 1 (or anyone who isn't producing their own insulin or not enough etc) can still have high levels in between meals, hence why we have our basal insulin, for many lowering the carbs makes no difference whatsoever. It's not a criticism of what you said, just a reminder that it can cause confusion between very different types of diabetes and possibly give people the wrong impression as to how certain things are achieved for one person which may not be something they can do themselves.

True, but the poster did not stipulate what exactly the parameters were, and I just responded to the invitation to comment, 'Can anyone comment'? -----which I did.
Of course this might mean a bit of discrimination/thoughtfulness in understanding my response-----as we know the forum is often mixed with type 1 and 2s together.
Anyone can see I am talking from predominantly a type 1 perspective from my profile, i.e. LADA.

 

[KK123]

Anyone can see I am talking from predominantly a type 1 perspective from my profile, i.e. LADA.

I wouldn't bet on that for a newbie and some LADAs aren't on insulin at all.

 

[LionChild]

I wouldn't bet on that for a newbie and some LADAs aren't on insulin at all.

Enjoy your evening KK

 

[Antje77]

A gentle reminder this thread is about what we think about PJMartins glucose trends. Please take your interesting but off topic discussion to PM or a new thread, it's not helpful to the OP.

 

[PJMartin]

Thanks for all the advice. Will be trying lower carb higher protein meals, and smaller meals with added snacks, to level out the profile. However today I experimented with a high carb diet just to see what the glucose level does while my sensor is still running. Surprisingly breakfast of 600 calories worth of porridge was lower and shorter peaking than lunch of 600 calories of oatcakes; but 1600 calories of battered cod and chips from the chip shop for evening meal (months since I had a meal this big) gave multiple peaks, but non exceptionally high. I guess this is the effect of the potato, the fish and the batter cutting in on different and longer timescales also mitigated by the fat content, as it gave a set of different peaks at different times, but all lower than the rather modest lunch.

 

[Antje77]

breakfast of 600 calories worth of porridge was lower and shorter peaking than lunch of 600 calories of oatcakes; but 1600 calories of battered cod and chips from the chip shop for evening meal (months since I had a meal this big) gave multiple peaks, but non exceptionally high.

For the effect on blood glucose you need to count the carbs in your meal, not the calories.
The multiple peaks from the fish and chips are likely due to the fat content. High carb high fat meals are notorious for such a pattern, as the fat makes the carbs act slower and stretch the effect.
For insulin users this means that meals like chips, pizza, pasta often need multiple injections over many hours.

That said, whith your chosen meals today I'm amazed by your results, very nice!

 

[Ronancastled]

I guess this is the effect of the potato, the fish and the batter cutting in on different and longer timescales also mitigated by the fat content, as it gave a set of different peaks at different times, but all lower than the rather modest lunch.
View attachment 51409

It's the fats, they will smooth out your carb intake.
Btw Good use of your remaining time.