Type 1 What is considered a normal spike for after meals

SareN said:

Hi Everyone.

I am a LADA diabetic and am entering my 3rd week on insulin. (Novarapid and levemir) learning new things every day!

When I initially started insulin the nurse simply said carb count and inject all the insulin when you sit down to eat.

I am sticking to between 30 and 50 grams of carbs per meal whilst I get my head around my carb/insulin ratio etc.

I quickly noticed that it isn't just getting the correct dose, its mastering the timing too. Firstly to avoid massive spikes followed by crash and secondly when having slow release carbs, taking all insulin together causes a crash which i have to treat and then a rise later.

Anyway I'm taking notes when I try certain foods and have managed to stop spiking so high after meals like porridge and stop crashing after wholewheat pasta.

However I was wondering what is the aim with regards to spikes? Are we expected to try and stay below a certain number? I know there are targets for 2 hours after a meal but what about the overall spike.

Thanks in advance for any responses.

I have started reading the book "think like a pancreas" which has been very helpful.

Sarah
Xx

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The general aim / rule, is to keep the rise to 2mmol, - measured from before eating to 2hrs after eating.

(If you work out how to do this consistently, then please let me know what your trick is).

urbanracer said:

(If you work out how to do this consistently, then please let me know what your trick is).

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That made me LOL way to hard

@SareN you will get it right one day and then you will eat exactly the same thing a few days later and get it totally wrong. There are so many variations in how your BG is affected not just with eating. The early stages of being diagnosed is soooo difficult. Trying to find what works for you in different situations is hard BUT you will get the hang of it

Hi there, it sounds like you are doing really well and already getting your head around the fact that it ain't a scientific thing, ie, numbers in and numbers out. All I would add to the above is (like me) you may well be in the honeymoon period where your body quite helpfully (it thinks) is still chucking out spurts of insulin. The problem is you are about to eat a meal, you oh so carefully measure out the ingredients and decide how much insulin you will need, you inject 4 units (or whatever) and start to eat. Sometimes your OWN insulin may kick in first if your timing is out (and who the heck can tell exactly when to inject to the exact second like in a normal body), so by the time your injected insulin starts to take effect your body already has some unknown amount swirling about its system! The insulin response in non diabetics switches on and off as and when it needs to thus ensuring the balance is always maintained. The insulin we inject STAYS there basically until it runs out hence if it's the wrong amount and has said hello to our own insulin, down we go. Also we generally only focus on the insulin we take with meals but of course there could be what's left of our own basal and injected basal coming into the mix too. x

SareN said:

Thanks for the comments, i appreciate that diabetes can be very unpredictable and so what works one day won't necessarily work the next. I just want something to aim for so I feel like im doing ok.

I'm managing to keep most spikes below 10 now which compared to 15 on my first day feels like an achievement.

I just wondered if there were any guidelines to aim for. My diabetes nurse just said you will spike after food and not to worry about it yet. High spikes make me feel dreadful so I'm sure it can't be right to not at least try to soften them abit.

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If you choose to eat normally, which is what they encourage us to do as type 1's, ignore the spikes. That's the advice given on DAFNE. As long as your blood sugars arrive back to roughly where they began after 5 hours, then that's what you're aiming for. Injected insulin has a fixed curve and will not match the carbohydrates you eat like a normal person's insulin will, hence the spikes. (You can't take extra insulin to stop the spike, as that will just cause your blood sugars crash as the insulin stacks, and potentially you will hypo, which is dangerous.)

You should ask your diabetes team about your crashing blood sugars. I've experienced that when I had too much background insulin. (My team asked me to eat a carb-free meal to check it, to make sure my blood sugars held a straight line.)

SareN said:

Oh OK thats interesting then, thanks for that.

The reason I'm homing in on the size of the spikes is because I'm going to be trying for a baby soon and i know the targets in pregnancy are very tight. I think its below 7.8 1hr after eating and below 6 after 2 hours. I just wonder how anyone manages these whilst eating a moderate amount of carbs.

I currently don't take extra insulin if I spike, im just playing about with timing, split boluses etc to see if its possible to minimise the spike going so high.

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Ask your diabetes team. They offer comprehensive sessions, which includes a dietician, to all type 1's planning for a future pregnancy at my local hospital's diabetes unit.

The only way I manage not to spike my BS's is to eat LCHF, which I doubt they'd recommend.