What is a spike?

[HelenMW]

Hi all, I'm really getting my head around the whole thing now and finding that regular testing is helping me so much. Just one question - how much does your blood sugar have to go up 2 hours after eating for it to be considered a spike? Mine tends not to go up much, if at all, but I had a bit of a risky meal for lunch today and the result just before it was 5.8 and 2 hours after was 7.8. I'm not sure if this is too big a gap? I saw on here the other day that someone said it's OK as long as it doesn't go up by more than 3 points but wasn't sure if that meant eg from 6.0 to 6.3 or from 6.0 to 9.0 if you see what I mean? Can anyone advise?

 

[TorqPenderloin]

Think of a basic line graph and imagine what that line would look like if there was suddenly a sharp increase. Now, imagine that line is your blood glucose level.

A spike is nothing more than a sudden increase in your blood glucose levels often brought on by eating carbohydrates. There is no set number to measure a spike and we each define a "spike" differently. Some people are okay with their blood sugar increasing 4 mmol/l after a meal while others want it to increase less than 1mmol/l....we're all different.

The 2-hr rule is a basic measurement of your body's ability to recover from a spike. Optimally, your blood sugar should return to normal within 2-hrs after eating. Unfortunately, that's not always the case for people with diabetes.

Long story short- the spike itself isn't as big of a deal as the ability to recover from that spike within 2 hrs after eating.

 

[HelenMW]

Think of a basic line graph and imagine what that line would look like if there was suddenly a sharp increase. Now, imagine that line is your blood glucose level.

A spike is nothing more than a sudden increase in your blood glucose levels often brought on by eating carbohydrates. There is no set number to measure a spike and we each define a "spike" differently. Some people are okay with their blood sugar increasing 4 mmol/l after a meal while others want it to increase less than 1mmol/l....we're all different.

The 2-hr rule is a basic measurement of your body's ability to recover from a spike. Optimally, your blood sugar should return to normal within 2-hrs after eating. Unfortunately, that's not always the case for people with diabetes.

Long story short- the spike itself isn't as big of a deal as the ability to recover from that spike within 2 hrs after eating.

Thanks, I understand that. Probably best not to risk that meal too often then!

 

[B583]

To pevent spikes in BG after meals, consider splitting insulin dosage: before & after eating meal. However, I'm having big spikes at night, between night & morning BGs, apart from increasing Lantus dose, what else can I do to ensure this doesn't continue?

 

[TorqPenderloin]

Splitting your an insulin dose meant as a meal correction would not be an effective way to avoid a spike. That would be an effective way to avoid an initial low caused by taking too much insulin before a meal. You would effectively be increasing the duration of your bolus insulin which might be helpful for other reasons.

An effective way to avoid a meal spike would be to take your insulin 15-60 minutes before eating so the absorption of insulin hits at the same time the increase in blood glucose would otherwise occur.

As far as avoiding nighttime spikes, it would be important to assess the root cause of these spikes.

Depending on when you take your Lantus, it could be an issue of timing rather than quantity that's causing the nighttime hypers.
It could also be a delayed effect from the food you at that night.

Many possibilities each with a different possible solution.

 

[B583]

Splitting your an insulin dose meant as a meal correction would not be an effective way to avoid a spike. That would be an effective way to avoid an initial low caused by taking too much insulin before a meal. You would effectively be increasing the duration of your bolus insulin which might be helpful for other reasons.

How long is advised to leave timing between splitted dosages, if injecting more than once for a meal?

 

[TorqPenderloin]

How long is advised to leave timing between splitted dosages, if injecting more than once for a meal?

Well, that depends. In some instances it may be inadvisable while in other instances it may make more sense to split your dosages.

A few examples:
If I was going to eat something like pizza, I'd probably split my doses up. Many people with T1 find foods like pizza to be very difficult to manage because it's high in carbs, protein, and fat. As we know, carbs will spike our blood sugar. However, you then have to add the protein into the equation which could possibly be a slower and more gradual spike. THEN, you have to add the high fat content into the equation which could slow the absorption rate of the carbohydrates.

In short, that's a pretty d*** complex equation and one I don't know the exact answer to. Consequently, if I ever eat pizza, I'm giving myself several smaller injections and trying to get "Close" rather than "Exact."

In contrast, if I was going to eat something high in carbs, but fairly low in fat/protein I probably wouldn't split my injections. I would expect a very sharp (and quick) spike that should be combatted with a single dose of insulin. In this case, the chances of the spike being delayed are much lower (in comparison) so I would feel more comfortable trying to solve the equation rather than simply trying to "Get close" as I would when eating pizza.