Blood Sugar Numbers

[Stoobey]

Hello All,

Shortly after diagnosis I was fortunate enough to have a work colleague I could confide with, they had been diagnosed as type 2, fifteen years earlier, when they were a similar age to I am now. One thing they said to me, which stood out, was when testing blood sugar levels, they had been advised to test 3-4 hours after eating, as numbers were too high after two hours.

This is when I realised how diabetes effects everyone differently, what may be good for one person, could be bad for another, but it also left me a little baffled about blood sugar testing. Reading up, I see some people test an hour after food, 90 minutes, two hours, three hours, everyone is different. I also see a rise of 2.0 is considered a spike, but have also read some people say it's only a spike if it goes out of the safe range, while others have individual spike levels.

I fully understand carbs and the low carb diet, also the the glycemic index and the impact this has on us. Does anyone know a good resource where I can educate myself more on the science side of the numbers, what they all mean?

Why is 2.0 a spike? Is that much worse than 1.9, 1.8 etc... What would the ideal range be, Would testing a 5.5 before food and a 7.5 after be equally as bad as a 4.0 and a 6.0? If I tested one hour after food and spiked a 2.5, then at two hours after food I was at 1.4, would that be concerning? (These numbers have all been made up)

I apologise if these are stupid questions and I sound a tad neurotic asking, it's difficult when it's all unique to us all.

Thanks

 

[Felinia]

I had my 3 monthly review with my DSN last week and she said the 3 monthly HbA1c was the best measure of how people do over the past 3 months. Although I had been concerned that my daily blood glucose monitoring was almost always over the Diabetes UK recommended levels, she said that my HbA1c showed that I was actually under most of the time, I just wasn't measuring during those periods. Which substantiates the varying results and conclusions you have drawn about blood glucose and monitoring. I use the monitoring now to work out what foods affect me adversely, and what don't, using more than a 2 increase in 2 hours as a guide. So potatoes and apples are off the menu, but surprisingly a small amount of wholemeal bread is not. I got a very good book "Can I Eat That?: A nutritional guide through the dietary maze for type 2 diabetics" by Jenefer Roberts which was written in plain simple language. I don't know that it would answer your specific questions but I suspect that what is OK for some, is not for others.

 

[Bruce Stephens]

One thing they said to me, which stood out, was when testing blood sugar levels, they had been advised to test 3-4 hours after eating, as numbers were too high after two hours.

That seems confused advice. The goal of testing after a meal is to see how high your blood glucose goes after you eat. If it's "too high", the things to try changing don't include when you take the measurement!

 

[Ljc]

Hi. I sure don’t consider a rise of 2.0 a spike. I would be delighted in such a low rise.
if you scroll down to the T2 section on this link it will give you what is considered ideal figures
https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/testing
Of course it really depends on what your pre meal level was , ie if you were 11.0 and two hrs later were 14 .0 then that meal was fine ,it was just that your starting level was too high. .

Before I started to use the Libre ( it’s a different method of testing to a fingerpick) I sometimes tested at one ,two and three hours to find out where my spike was occurring, I did this if it was a fatty meal , as fat tends to slow down the absorption of carbohydrates, we call it the pizza effect.

 

[Ljc]

The trouble I find with the Hb1ac s, that it is an average of our blood glucose over the last 12 or so weeks .
My last one was 42 the two previous one were 38. So you’d think I would h@ve near perfect numbers all the time when my meter tells a different story.
Anaemia can affect the result , too many hypo’s can give you a lower result than you really, the life span of your red blood cells affects it too. . their may be other things that I am unaware of that affect the results.

 

[zoombapup]

I apologise if these are stupid questions and I sound a tad neurotic asking, it's difficult when it's all unique to us all.Thanks

Definitely not stupid. I'd like to know too.

 

[Stoobey]

Thank you for all the responses, I think we can safely say, everyone is different, which makes the number scoring tricky to work out, I have my next three monthly review mid-late December, will be interesting to see what the Hb1ac comes back at.

I keep a spreadsheet with all my scores on it, it's amazing that you can eat the same meal multiple times but get varying blood sugar results from it, for example today I had 1.8 increase two hours after food, which sounds high, but the three previous times I tested came back as 0.7, 0.8 and 0.9. Which does suggest that other factors may have influenced today's results.

Yesterday I had a 2.5 spike for what was a low carb meal, last time I had this identical meal it rose by 0.6

It all just seems so random, I can't complain about any of my numbers, I'm just trying to get a better understanding of them. At one time, when I was unwell, my blood sugar levels actually fell by 1.2 after eating.

 

[TheClockworkDodo]

Lots of things effect your blood sugar as well as what you eat - exercise is the obvious one, but there's also the weather, stress, a hot bath, illness (my levels often drop when I'm ill too), allergens, all sorts of things. Someone posted a list on here once and they'd found about 40 things, other than food, which might make blood sugar go up or down - so it's not really that surprising you can eat the same meal multiple times and get different results each time. But if the results are not wildly different (by wildly I mean blood sugar going from 4 to 5 after a meal one day and from 4 to 15 after the same meal another day) then I don't think it's a problem.

Btw I wouldn't consider a 1.8 increase after food high, I'd consider it miraculously low! I'd be pleased with a 2.5 increase - I wouldn't call that a spike, I'd call that good.

 

[Drummer]

Your colleague seems to have got the wrong end of the stick about testing.
The concept is simple.
Test before and two hours after starting the meal. If you see more than a two whole number increase, consider the carbs you consumed. Adjust down a little - maybe five grams less next time. If your second number is double digits, maybe take the carb content down 10 gm.

I found that once I was seeing 8mmol/l after eating, I was feeling a lot better, so I stayed with what I was eating, but when I tested again, my levels were below 7, and sometimes below 6mmol/l - but I stuck to the same foods and amounts, eating twice a day, and that seems to have sorted everything really well.

 

[zoombapup]

Hmm, I must be doing something strange then, because almost all my meals have been less than 0.9 rise so far. Although to be fair, I haven't had anything with many carbs in to really test what a spike might look like as I want to get off some of the meds. Usually my meals push me back up to my waking number, which is slightly higher because of the dawn effect I guess.

 

[Drummer]

With my intake of carbs being a maximum of 40 gm per day, my post meal readings are sometimes just 0.5 higher than pre.
Even with that, my Hba1c seems set at 42, which I am assuming is down to long years undiagnosed with anything but the need to eat complex carbs at every meal.

 

[everydayupsanddowns]

I certainly wouldn’t consider 2mmol/L rise a spike.

for me my aim is to keep the rise after a meal as gentle as I can, but this is t always possible. I’m also aware that higher BGs can take more dosed insulin to deal with than lower BGs (but I appreciate this may not currently be a concern for you).

I think you can drive yourself batty trying to achieve entirely non-D numbers (certainly as a T1) and I’m yet to see compelling evidence that such efforts, and the impact they would have on my quality of life, are worth it for me.

My post-meal ideal target is 9, but I know that it’s better if I don’t just scrape that if I’m starting at 4.2. So I aim for around 3mmol/L rise if I can manage it, which would mean I top-out 9ish if I am starting mid-range. I don’t stress unduly if I reach 10, but try to perhaps wait a little longer than usual after dosing if I am starting nearer 8-9 (or in double figures) as I have less ‘wiggle room’.

For me a spike would be a rise of 5 or more over less than an hour. And I know that I can get that with exactly the same meal that has given me a rise of 1 or 2 in a different day.

So my strategies are more based around ‘what generally works OK more often than not’ 🙂

 

[SueEK]

Hello and welcome. I think you are doing really well and you obviously have a good understanding of your diabetes. I hope you don’t mind me saying, kindly, that perhaps you are overthinking things a bit. Your levels sound very good and your bg raises after food are what I would be very happy with. Diabetes is a fickle thing and we sometimes have to accept anomalies simply for what they are, sometimes things just don’t make sense but we carry on with our diabetes journey as best we can. Good luck with your next HbA1c test and let us know how you get on. Sue x

 

[trophywench]

Non-D folk will get a rise after a meal, same as we do. The only difference is - normally they don't have the slightest ide about it! ISTR the precise clinical average for non-D is 2.8 ?