Mid morning spike

[Jennyninja]

@Jennyninja
To answer your other points, if your levels are back normal before the next meal, you've got your bolus pretty much spot on so that's great news.
My spike comes from 50g of Bran Flakes with 50g of grapes on top and 100ml of fresh fruit juice so I'm fairly piling in the carbs in that one meal but I don't care. I have decided to spit in the eye of Diabetes and take the delicious hit.

It also sounds like your basal is working too if you are waking up to readings of 5.5 to 9.
You should feel hugely encouraged by all of this. It sounds like you are making brilliant progress.

Thanks pm133. Also for your encouragement.

 

[Jennyninja]

I disagree @pm133 The spike is more likely to be incorrect timing of insulin. As I said above, I eat 45g carbs breakfast (cereal) and have for years. If I bolus 10-15 mins before, I’ll spike up to 11 or more. However, if I eat the same cereal and bolus 30 mins in advance I don’t spike and my 2hr result is in the 6s.

Food is rarely to blame with Type 1 @Jennyninja It’s almost always the insulin - the amount or the timing.

 

[Inka]

And yes, your breakfast is perfectly healthy. Ignore the ‘carbs are evil’ people and the dietary advice that’s largely aimed at Type 2s. Their situation is different.

 

[Jennyninja]

I disagree @pm133 The spike is more likely to be incorrect timing of insulin. As I said above, I eat 45g carbs breakfast (cereal) and have for years. If I bolus 10-15 mins before, I’ll spike up to 11 or more. However, if I eat the same cereal and bolus 30 mins in advance I don’t spike and my 2hr result is in the 6s.

Food is rarely to blame with Type 1 @Jennyninja It’s almost always the insulin - the amount or the timing.

Inka, following your comments earlier I took my insulin 30 minutes pre dinner this evening. I warned my husband ref what I was doing and had my glucose ready. Nothing bad happened so will try similar tomorrow morning. Thanks for your support.

 

[pm133]

I disagree @pm133 The spike is more likely to be incorrect timing of insulin. As I said above, I eat 45g carbs breakfast (cereal) and have for years. If I bolus 10-15 mins before, I’ll spike up to 11 or more. However, if I eat the same cereal and bolus 30 mins in advance I don’t spike and my 2hr result is in the 6s.

Food is rarely to blame with Type 1 @Jennyninja It’s almost always the insulin - the amount or the timing.

Interestingly, I don't seem to be able to prevent my spike regardless of when I take my bolus.
I've tried the usual timescales that you mention and I have tried a few times where I wait to see my levels start to drop before eating (sometimes up to 90 minutes). It doesn't matter whether my pre-meal readings were 4.5 or 7.0 either. I'll always get the same spike.
I've also tried increasing my bolus for that one meal but that just causes a hypo after the spike. For me, it just appears to be the food. I can't think of anything else.

I'm open to any other ideas for experimenting because it really would be nice to get rid of it.

ETA. Oh sorry, hang on. Exercise fixes it. If I exercise during the spike, 15 mins on my bike sorts it.

 

[Inka]

Thanks pm133. It's usually weetabix with some seeds which I thought was pretty healthy, low sugar and high fibre. However I was surprised to see it is higher carb than some other cereals. In fact shredded wheat which I thought was really blameless is even higher carb. I had scrambled eggs on 1 small slice of Vogel linseed bread yesterday but still had a spike. I'm worried if I don't have the right amount of carbs to insulin I'll hypo especially with being a runner. I've read that different carb foods have different effects on different people. I'll continue to experiment !

See, this really worries me. You do not have to avoid carbs or strictly limit them @Jennyninja You honestly don’t. It upsets me when I see new people given this impression. It is not true.

Eat Weetabix, eat Shredded Wheat, eat what you want within reason. Carbs are ok - genuinely.

 

[Jennyninja]

See, this really worries me. You do not have to avoid carbs or strictly limit them @Jennyninja You honestly don’t. It upsets me when I see new people given this impression. It is not true.

Eat Weetabix, eat Shredded Wheat, eat what you want within reason. Carbs are ok - genuinel

 

[Inka]

Interestingly, I don't seem to be able to prevent my spike regardless of when I take my bolus.
I've tried the usual timescales that you mention and I have tried a few times where I wait to see my levels start to drop before eating (sometimes up to 90 minutes). It doesn't matter whether my pre-meal readings were 4.5 or 7.0 either. I'll always get the same spike.
I've also tried increasing my bolus for that one meal but that just causes a hypo after the spike. For me, it just appears to be the food. I can't think of anything else.

I'm open to any other ideas for experimenting because it really would be nice to get rid of it.

Matching insulin to higher GI foods like juice and grapes is harder. Some people use juice to treat a hypo, as you probably know. You could try raising your bolus amount and/or adding some fat to slow down the absorption.

 

[pm133]

Thanks pm133. It's usually weetabix with some seeds which I thought was pretty healthy, low sugar and high fibre. However I was surprised to see it is higher carb than some other cereals. In fact shredded wheat which I thought was really blameless is even higher carb. I had scrambled eggs on 1 small slice of Vogel linseed bread yesterday but still had a spike. I'm worried if I don't have the right amount of carbs to insulin I'll hypo especially with being a runner. I've read that different carb foods have different effects on different people. I'll continue to experiment !

I agree with @Inka that you shouldn't worry too much about carbs themselves other than to continue to experiment to see if you can quash that spike. Maybe waiting a lot longer before eating would help you even if it didn't help me.
I have to say though that if that spike is less than about an hour, it might not be worth worrying about. The problem is if it sticks around for long periods. That was advice from my GP.

 

[pm133]

Matching insulin to higher GI foods like juice and grapes is harder. Some people use juice to treat a hypo, as you probably know. You could try raising your bolus amount and/or adding some fat to slow down the absorption.

So raising the bolus would cause a hypo so that won't help. Adding fat is an interesting one. I'm not averse to a wee sausage.

Also, I might try leaving out both the grapes and the juice tomorrow and see what happens. So, bran flakes and a square sausage tomorrow.
I'll try to remember and let you know how it goes.

Thanks for that. 🙂

 

[Jennyninja]

Thanks Inka and pm1333. I really appreciate your interest and support. Your different views just demonstrate to me how individual T1 management is. It certainly is a journey ! By the way Inka I've only eaten Shredded Wheat because as a misdiagnosed T2 I thought it was best/lowest sugar. Now that the currency is carbs I vow never to eat another one of those rectangles of evil again

 

[Inka]

Shredded Wheat are fine! They’re very much NOT evil! That was the point I was making. Eat your Shredded Wheat and enjoy them.

Perhaps I explained badly Carbs are absolutely fine for Type 1s - we have insulin and our situation is very different from Type 2s.

 

[Leadinglights]

I must admit that when I first started looking at the site it was difficult to separate the advice being given to Type 1 or Type 2, in particular when Type 2 people were on insulin or people didn't say what medications they were on as that is something which obviously makes a difference.
All is much clearer now.

 

[PattiEvans]

I'm worried if I don't have the right amount of carbs to insulin I'll hypo especially with being a runner. I've read that different carb foods have different effects on different people. I'll continue to experiment !

Rather than tailoring your carbs to your insulin you need to tailor your insulin to your carbs. Yes, you are right, different carbs affect people different ways. I can eat potatoes with impunity but bread... Eeeek! Also as @Inka so rightly says timing is crucial.

 

[Jennyninja]

Shredded Wheat are fine! They’re very much NOT evil! That was the point I was making. Eat your Shredded Wheat and enjoy them.

Perhaps I explained badly Carbs are absolutely fine for Type 1s - we have insulin and our situation is very different from Type 2s.

Morning Inka, I just wanted to let you know that I took my insulin half an hour before breakfast, had my usual breakfast and half an hour later took my pre run BG - which was 9.2mmol. Much better than the previous 13s and 16s. I realise this could be different tomorrow, but for today am feeling pretty good

 

[Inka]

Oh, excellent news @Jennyninja ! 😎

 

[pm133]

@Jennyninja @Inka

That's great news!
On the other hand, I tried leaving out my fruit juice and grapes this morning and just had my cereal.
2 hours later and I'm sitting with my usual spike.

It's pretty clear that whilst I can eat what I want and my insulin will EVENTUALLY take care of it, injected insulin won't necessarily prevent short-term spikes with every type of carb.
We do indeed, all appear to react differently.

My final experiment will be to add a sausage tomorrow and if this helps, that's great but if I have to add fat to stop spikes then clearly the type of carb matters when it comes to short-term spikes - even for a type 1.

Thanks for the suggestion anyway Inka. If the sausage helps then that's what I'll do from now on.

 

[pm133]

Shredded Wheat are fine! They’re very much NOT evil! That was the point I was making. Eat your Shredded Wheat and enjoy them.

Perhaps I explained badly Carbs are absolutely fine for Type 1s - we have insulin and our situation is very different from Type 2s.

I've been having a wee think about our conversation yesterday and I think I've not made my point clear so I'll try and clarify what I meant.

I am not suggesting carbs are bad or evil or that Type 1s cannot eat what they want as long as they bolus correctly for it. We absolutely can eat what we like.

What I'm saying is that some carbs will cause short term spikes of an hour or so before returning to normal levels soon afterwards. Perhaps some bolus timing will help with that but if anyone has found a cast-iron way for Type 1s to avoid all temporary carb spikes by using nothing more than bolus quantities and timings then I'm all ears.

Hope that clarifies where I was coming from yesterday.

 

[Inka]

@pm133 My comment about some people implying carbs are evil wasn’t aimed at you. I almost clarified that it wasn’t last night, but didn’t. I should have done. Sorry.

Yes, some carbs are definitely harder to handle than others. I’d also add that eating more than a person’s individual tolerance is harder. That is, if I eat more than, say 100g carbs per meal, I have to split my bolus and often do a bolus after eating.

I tend to eat similar amounts of carbs for breakfast and lunch just to remove some of the mental load of Type 1. But gradually we learn what works for us and kind of get an intuition about how a meal is going to go. I do aim to stop spikes but sometimes things beyond my control thwart me eg my predicted routine changes and I’m sitting down rather than out walking as I planned, or my pump site decided to go ‘bad’. On those occasions I correct to deal with any spike. I see that as another strategy rather than a failure.

The hardest thing about Type 1, in my opinion, is the need to be watching and changing things so often. It’s very frustrating. Sometimes I do just leave moderate spikes because I can’t be arsed, and my control is excellent overall.

 

[rebrascora]

Extending the pre bolus time for breakfast for me makes all the difference to preventing that spike. I can now have 35g low GI carbs and barely see a blip on my graph whereas before I would spike up to 15, but I have to wait about 45mins after injecting Fiasp and when I was on NovoRapid it was over an hour. If my waking reading is high, it will take longer than if I am in the 5s or 6s and much less time in the 4s.
For the rest of the day my prebolus timing is about 20 mins but breakfast time needs a whole lot longer for me. When you get Libre you will find it easier to experiment and actually see when the insulin is kicking in and find the best timing for you with your choice of breakfast.