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What is your acceptable spike limit?

S

SwissT2

Member
Messages
18
Type of diabetes
Type 2
Treatment type
Tablets (oral)
On this very site the NICE guidelines for recommended blood sugar targets are given. Type 2 diabetics should apparently aim for 8.5 or below 1.5 hours after a meal, and for Type 1 it is below 9. Presumably these are the values on the tail-end of the spike, the spike itself can be higher. The American Diabetes association recommends a target of 10.0 for diabetics.

https://www.diabetes.co.uk/diabetes_care/blood-sugar-level-ranges.html
https://www.diabetes.org/healthy-li...testing-and-control/checking-your-blood-sugar

From some of the the comments I've read on these forums those limits would seem to be a bit generous, I'd be interested to know what limits others use and why? What level of spike would be unacceptable to you?
 
I think an occasional spike to 10 is acceptable considering even non diabetics do that sometimes.
To me a spike means a rapid rise and fall with a short duration. A hump which is at a high level for a long time and has a large area under the curve is much worse.
 
I believe the recommendation for Type 1 is to be between 4 and 10 for 70% of the time with 4% of the time less than 4.
I have seen Libre graphs for people without diabetes who spike higher than 9 so am happy to have my upper range just 1 above that.
 
I believe the highest should be circa 6.5. It has been proven that damage can occur at 7.8, so why go above that knowingly.

My personal limit is under 6.0 for spikes, usually 5.7, with an increase of circa 1.7 mmol/L (many state 2).

It is an educated choice as to how much risk one wants to take.
 
Mbaker said:
I believe the highest should be circa 6.5. It has been proven that damage can occur at 7.8, so why go above that knowingly.
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Though if you're using insulin it can be a much different ball game, for instance I cant possibly stay under 6.5 all the time, heck I think I've only managed 2 days in last year where I haven't gone above 10 (and I was dead proud of myself on those days where I was actually 100% in range (4-10) )
 
Do you mean that at no time after eating your BG goes over 6.0? If so, I doubt most of the healthy population keep to that.
 
This is bad news, I am happy to spike to 18 if I bring it down quite fast, I don’t like 20’s maybe my expectations needs amending? Must try harder it seems
 
That’s pretty tight limits but if you can achieve that that’s good but as @Mr_Pot has said, it is unlikely most of the population can achieve that.

@SwissT2 personally speaking I don’t have a CGM so am sure I spike higher after eating but I tend to try and get as close as I can to the non-diabetic levels that are in the link you provide. But as long as I can keep to the T2 aim in the general long term then that’s fine too. But I don’t worry too much if I err a little over now and again. The stress of trying too hard isn’t helpful to me personally. We all are different and some people with the best will in the world, due to many combinations of factors will be a higher. Over the recommended T2 levels I personally would be uncomfortable with in myself now

I’m a T2, this aim is for me, I know there are very good reasons T1s and those on insulin have a different range
 
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I mean this with full respect, but there are many Type 1's who are doing just that, but I accept in your case it is what it is.
 
I try to keep below 8 most of the time, but I don't mind going into the 10's on the occasional special situation.
There is no spike which would be unacceptable to me. If my body acts ridiculous and I try my best, how can I not accept whatever happens?
I can hardly file a complaint to inform my diabetes I think it's doing unacceptable things.

I also try very hard not to beat myself up when I do spike, it's no use.
I do however try to understand what it was that made me spike so I can do something different next time.
 
I try to stay within 2 points 2 hours after eating. I am juggling several medical conditions, so just do the best I can. It's a balancing act for me.

I no longer stress about it, as stress raises blood sugar levels.
 
Mr_Pot said:
Do you mean that at no time after eating your BG goes over 6.0? If so, I doubt most of the healthy population keep to that.
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That's right. I have measured with Libre's and 6 different blood glucose monitors obsessively. It is of course food choices that allow this; last time I measured my lean muscle mass was at 70%, so I am getting the benefit of GLUT4 independent glucose uptake and in addition I walk after meals (but find 5.7's on the times when I haven't). I would add that the healthy population, I believe to be less than say 15% of the adult population (based on : https://www.sciencedaily.com/releases/2018/11/181128115045.htm. And that I would say is an optimistic number as average fasting insulin is at 8 - I think the Kraft curves on the healthy would make interesting viewing.
 
If one takes the kitchen sink approach to lowering glucose and selects to not have the "risers" it can all come together, individual body permitting. As an animal based Ketovore technically with the stars aligning (by this I mean pancreas is working, insulin resistance in on the floor, with lean muscle mass and minimised visceral fat) there is no reason for post 2 mmol/L spikes (and long spikes).

I've taken so many data-points I only test once in a while now (within the last 2 weeks to random 4.6's between 1st meal and last). A compilation of my multi-year tests is here
https://www.diabetes.co.uk/forum/threads/my-progress-cgm-food-exercise-results.183005/ I think of note is that I was relatively flat in 2017, but lower and flatter in June / July of this year.
 
And back to what 'limits' we all use and why. Further questions or elaborations on @Mbaker 's choices would take the thread off topic, as it's about different approaches.
Of course you can always take it to a new thread or PM.
 
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Hi Rokaab, I absolutely agree with you. I think it's easy for those not on insulin (or equivalent glucose lowering medication) to imply that if 'other' type 1s can stay below 6.5 why can't you, etc. When I was first diagnosed I made every effort to stay below 7 and managed it on paper by going very low carb and by the use of insulin. That meant that I gave myself no buffer between being in the 6s and hypo land. I'd be sailing along in the 6s and then wham, suddenly in the 2s and 3s between meals and during the night. I'd lower my basal insulin to try and stop the lows especially as it was making me unsafe at work, but then, independent of any food, I'd go up into the 8s or 9s. In practice people not on insulin may think it's easy to simply take more insulin thus you'd be lower all the time and whilst that may be correct, it means you have to also accept the risk of having hypos which are devastating, dangerous and massively reduce your confidence and make you fearful of going out. How I wish that I could manage it all with food. If there is one thing that makes me furious it's when people who do not have the same challenges tell us about 'others' doing this, that and the other. In the end I decided that if I go above this magical 7.8, so what? In the meantime I know I'm doing a good enough job and am still minimising any so called damage at that level. The damage from constant hypos is far more potent than damage from being in the 7s for short periods of time. Still, to be fair I care nothing for whether a person not on insulin accepts things or not.
 
Acceptable spikes?
It is what it is.

I try to maintain my numbers within range, but week by week variation plays havoc with that.
Some weeks I run high.
Some weeks I run low.
Some weeks I run normal.

Given that exercise can spike me to above 12 without eating anything I have no set limits.
I just try and keep the spikes as low and infrequent as possible.

Calculating what is a spike is sometimes hard when your BG drops in to the 4s.
Is 6.5 a spike?
 
If by Spike it refers to the highest point reached between first bite and the two hour test then I have no idea what mine is, but I normally (at breakfast) begin at 5.3 to 5.5 and two hours later will be anything between 5.7 and 6.1. If it was over 6.5 I would be unhappy with myself.
 
I'm a type 2 and on 1000mg of metformin a day. My diet is fastidiously low carb.

It's some time since I measured my actual rise after eating but last year a typical meal would elevate my BS level by about 1.5 points. For me, though, low carb gives a very fast return to pre-meal levels so I'm back where I started within about 60 to 90 minutes, which nowadays is mostly in the low 4's. This probably means my spikes usually stay below 7mmol/L.

This is what I can achieve so this is what I now regard as my acceptable limit. I consider myself very fortunate that my body has responded so well to weight loss and the low carb diet. I know there are many others who have to fight very hard for BS control.
 
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Fenn said:
This is bad news, I am happy to spike to 18 if I bring it down quite fast, I don’t like 20’s maybe my expectations needs amending? Must try harder it seems
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It's realistic to spike like this if you eat normally and inject insulin as a type 1.
 
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