A big drop?

[Jean]

As one who is relatively new to 'testing', I'll welcome some comment from experienced practitioners.

1 hour after evening meal - I'm 9.1.

An hour later - and I'm 6.7.

In your experience, fellow-correspondents, is a drop of 2.4 exceptional - about the average - or what?

I'll be grateful if you'll share your own testing 'ups' and 'downs' with me, thus giving me some idea of how your 'graphs' go.

 

[aymes]

That sound ok to me, and where you'd want your levels to be back to two hours after eating.

Are you on insulin, tablet or diet only!

 

[Steff]

yea thats sound fine as aymes says ? im lucky if i get a drop at all x

 

[Northerner]

That is excellent Jean! The ideal is to have it at less than 8.5 mmol/l two hours after eating, so you're nicely within that🙂

 

[C*5_Dodger]

As one who is relatively new to 'testing', I'll welcome some comment from experienced practitioners.

1 hour after evening meal - I'm 9.1.

An hour later - and I'm 6.7.

In your experience, fellow-correspondents, is a drop of 2.4 exceptional - about the average - or what?

I'll be grateful if you'll share your own testing 'ups' and 'downs' with me, thus giving me some idea of how your 'graphs' go.

Dear Jean, Those figures seem to be heading in the right direction - have you or your diabetes team set some targets - you can get the standard ones from DUK

Regards Dodger

 

[VBH]

I don't think your drop is particularly unusual for T2s in general. The carbs in the meal shoot your BG up to a peak at around an hour after which your second-phase insulin response kicks in and it starts to drop.

Carbs are processed fairly quick so by the 2 hour mark, they're mostly gone and whats left keeps your BG at a lower level.

I try to aim for as low a spike as possible - within reason. So I don't like to go over 8 at any time. I suggest you have a read of this:
http://www.diabetes-support.org.uk/joomla/jennifers-advice

That includes the targets I aim for. Bear in mind of course that it depends to some extent on how high your BG was before the meal. So the next time you have that meal, a couple of small tweaks might be enough to make it an 8 next time you have it. So reducing the amount of starchy carbs in the meal overall, or changing the type of carbs, or changing the combination of food e.g. more fat to slow the carbs

Personally I consider the 1 hour reading to be more important than the 2 hour. After all its high BG that causes problems, so if it never gets excessively high it should be less of a problem.

Hope thats of some use.

 

[Caroline Wilson]

Sounds pretty good, you are getting it right, so keep up the good work.

 

[rossi_mac]

Personally I consider the 1 hour reading to be more important than the 2 hour. After all its high BG that causes problems, so if it never gets excessively high it should be less of a problem.

Hope thats of some use.

I never thought of doing that VBH, it sure would be interesting to see how high my spikes are. Is it gauranteed that all carbs are "processed" 1hr after the feast?

Cheers,

Oh and Jean, looking good keep it up, and feel free to ask any questions no matter how silly you think they are, some of the peeps on here are extremely helpful!

 

[Jean]

I thank you all most warmly for your observations - but please, everyone, don't think I'm wanting to close the discussion down - do chip in!

I'm on the lowest dose of metformin.

As for a 'diabetes team' - well, that's something I've never been offered.

I have followed up your website link, VBH - and find it very useful.

Is there general agreement that the 1 hour reading after meals is more important than the 2 hour's after?

 

[VBH]

I never thought of doing that VBH, it sure would be interesting to see how high my spikes are. Is it gauranteed that all carbs are "processed" 1hr after the feast?

Ah not guaranteed in the slightest. But its usually most of the carbs for most meals. It depends on the GI of the components of the meal, the amount of fat, time of day etc. Higher GI carbs will be processed faster and be in and out of the system. It takes the pancreas a while to catch up as well of course so the BG takes some time to come down again.

Then theres the notorious Pizza Effect, which can cause a spike 4 hours after the meal. Pasta can cause similar problems with unexpectedly late spikes but it seems to be a bit more random.

But if you want a good example, have a jacket potato. They're a bit of a notorious example having a GI higher than sugar (up to 158). Test at 1 hour then at 2. Notice the drop. That's the carbs being "finished off" and the second phase insulin response kicking in.

I don't have my archived logs here at the moment but when I tried it in the early days I think I hit about 13mmol/l after an hour and down to about 8 after 2 hours. In the early days I took a good look at the effects of occasional meals testing every 15 mins from 45 mins onwards to see what happened.

By having slower carbs, the "processing" takes place over a longer period so although you still have a BG peak, its lower. So by adjusting the speed and quantity of carbs and what you have them with (fat and oils in particular), you can keep the peak for a particular meal down to a reasonable level.

But things like the GI are only a rough guide and what works for one person may be slightly different for another since we all react slightly differently. Since insulin resistance varies through the day, the time of day makes a difference as well. So that's why I tend to think in terms of the effects of a meal as a whole, although it does give you an idea of what individual foods and what quantities are likely to work for you.

 

[sofaraway]

That looks pretty good to me and would be perfectly acceptable to me.
What were you before the meal?

 

[VBH]

I'm on the lowest dose of metformin.

I've seen various references to the effect that the "lowest effective dose" of met is 1500mg/day. But I'm also fairly sure thats misleading. If you are getting by ok on 500mg/day of met then thats fine. Whatever works for you!

As for a 'diabetes team' - well, that's something I've never been offered.

For T2s this can amount to whichever nurse happens to be on that day and a chat with the doc once a year 😉 Oh and an occasional chat with a dietician, possibly a podiatrist and an annual eye scan.

Is there general agreement that the 1 hour reading after meals is more important than the 2 hour's after?

No. Its a little divisive partly because all the official sources (NHS, DUK, ADA etc) all talk about testing at 2 hours (if at all). There doesnt seem to be an awful lot of justification for this, but its been a standard for years.

On the other hand, testing at one hour to find the peak BG immediately makes sense. After all, damage is known to be caused by high BG, so why not examine the point when you have the highest BG and try to learn from your meter in order to do something about it?

Mind you, thats for T2. T1 is slightly different in respect of testing times.

 

[rossi_mac]

Ah not guaranteed in the slightest. But its usually most of the carbs for most meals. It depends on the GI of the components of the meal, the amount of fat, time of day etc. Higher GI carbs will be processed faster and be in and out of the system. It takes the pancreas a while to catch up as well of course so the BG takes some time to come down again.

Then theres the notorious Pizza Effect, which can cause a spike 4 hours after the meal. Pasta can cause similar problems with unexpectedly late spikes but it seems to be a bit more random.

But if you want a good example, have a jacket potato. They're a bit of a notorious example having a GI higher than sugar (up to 158). Test at 1 hour then at 2. Notice the drop. That's the carbs being "finished off" and the second phase insulin response kicking in.

I don't have my archived logs here at the moment but when I tried it in the early days I think I hit about 13mmol/l after an hour and down to about 8 after 2 hours. In the early days I took a good look at the effects of occasional meals testing every 15 mins from 45 mins onwards to see what happened.

By having slower carbs, the "processing" takes place over a longer period so although you still have a BG peak, its lower. So by adjusting the speed and quantity of carbs and what you have them with (fat and oils in particular), you can keep the peak for a particular meal down to a reasonable level.

But things like the GI are only a rough guide and what works for one person may be slightly different for another since we all react slightly differently. Since insulin resistance varies through the day, the time of day makes a difference as well. So that's why I tend to think in terms of the effects of a meal as a whole, although it does give you an idea of what individual foods and what quantities are likely to work for you.

Sounds like you did a lot of reasearch, probably not a bad idea, you certainly seem to have a full understanding of all the parts of the puzzle. I'm doing okay at the mo and would like to understand more, but I'm cautious that I may get over loaded, I may go looking for a DAFNE or similar course next year. But not sure, as I'm moving not sure what the new area will be like re health care!! Bit nervous to be honest as it's pretty darn good where I am now!