Can’t figure out blood sugar reactions

[Amyfaith]

Hi all,
Fairly new here, but got myself a glucose monitor (finger prick, not CGM) and am doing some experimenting. Mostly my results are pretty consistent - but now and again a food/combination that by all rights should do nothing out of the ordinary sends my glucose readings a bit on the higher side. I know these aren’t remotely *high* readings but I was wondering if anyone could help out. (Equally, if these are all really good readings, especially early on, please do tell me not to be so hard on myself.)

Typical morning, fasting reading: 5.4-6.2. Trends lower if I’ve had a snack before bed.

Typical breakfast - 1x oatabix, 100g 5% Greek yogurt, 20g linseed, 25g walnuts - usually 6.8-7 at 2 hrs. (About 35 carbs)

Typical lunch: 2x medium ww bread, chicken, mayo, cheese, huge handful of leaves, half an avocado (about 40 carbs) - usually 7ish. But if I leave out the leaves, goes upwards of 8. If I leave out the avocado, often doesn’t crack 7, which seems *wrong*.

Almost all dinners, regardless of make-up: 7.5 max two hours after, usual sub-7. Exceptions have been having some potato (no more than 30g of carbs worth - 8.8) or pasta (30g of carbs - 8.9) - total carbs were maybe 40. Most dinners have no more than 35g carbs, and most don’t crack a 7 on the glucometer. Notably, with both ‘high’ readings, I was back sub-7 in an hour (so 3 hours after eating).

It’s the lunch that confuses the heck out of me - I can have the same exact thing and get wildly different readings on different days. I know glucose readings can be affected by loads of stuff, but this is just reading backwards. (I am keen not to go much below 130 total carbs a day for lots of reasons, as I tend to have fine reactions most of the time and sustainability over the next 30-40 years is going to be an issue - plus a sandwich/etc is a bit of convenience I can’t let go of.) Unless I’m missing my peaks, exercise seems to do basically nothing unless I’m out for a 3 hour walk, which isn’t feasible on the daily.

I’m also aware I might be holding myself to too stringent of guidelines - as I’m doing this testing off my own bat, I’m aiming for sub 8 most of the time, and preferably sub 7.5. I know the advised levels are 8.5 from the NHS (weirdly 10 from the ADA??), but seems best to stay low and as close to ‘normal’ as possible. Stress seems to have a significant effect on my readings, so I don’t know if that’s making everything go weird randomly or what.

Any help much appreciated!

 

[Leadinglights]

Hi all,
Fairly new here, but got myself a glucose monitor (finger prick, not CGM) and am doing some experimenting. Mostly my results are pretty consistent - but now and again a food/combination that by all rights should do nothing out of the ordinary sends my glucose readings a bit on the higher side. I know these aren’t remotely *high* readings but I was wondering if anyone could help out. (Equally, if these are all really good readings, especially early on, please do tell me not to be so hard on myself.)

Typical morning, fasting reading: 5.4-6.2. Trends lower if I’ve had a snack before bed.

Typical breakfast - 1x oatabix, 100g 5% Greek yogurt, 20g linseed, 25g walnuts - usually 6.8-7 at 2 hrs. (About 35 carbs)

Typical lunch: 2x medium ww bread, chicken, mayo, cheese, huge handful of leaves, half an avocado (about 40 carbs) - usually 7ish. But if I leave out the leaves, goes upwards of 8. If I leave out the avocado, often doesn’t crack 7, which seems *wrong*.

Almost all dinners, regardless of make-up: 7.5 max two hours after, usual sub-7. Exceptions have been having some potato (no more than 30g of carbs worth - 8.8) or pasta (30g of carbs - 8.9) - total carbs were maybe 40. Most dinners have no more than 35g carbs, and most don’t crack a 7 on the glucometer. Notably, with both ‘high’ readings, I was back sub-7 in an hour (so 3 hours after eating).

It’s the lunch that confuses the heck out of me - I can have the same exact thing and get wildly different readings on different days. I know glucose readings can be affected by loads of stuff, but this is just reading backwards. (I am keen not to go much below 130 total carbs a day for lots of reasons, as I tend to have fine reactions most of the time and sustainability over the next 30-40 years is going to be an issue - plus a sandwich/etc is a bit of convenience I can’t let go of.) Unless I’m missing my peaks, exercise seems to do basically nothing unless I’m out for a 3 hour walk, which isn’t feasible on the daily.

I’m also aware I might be holding myself to too stringent of guidelines - as I’m doing this testing off my own bat, I’m aiming for sub 8 most of the time, and preferably sub 7.5. I know the advised levels are 8.5 from the NHS (weirdly 10 from the ADA??), but seems best to stay low and as close to ‘normal’ as possible. Stress seems to have a significant effect on my readings, so I don’t know if that’s making everything go weird randomly or what.

Any help much appreciated!

You are doing very well with what you are eating, the aim is 4-7 fasting and before meals and no more than 8-8.5 mmol/l 2 hours post meal. Unless you are testing before you eat as well then you will not know if you go higher whether it was higher before. If you get anything really unusual then it is wise to retest.
Bread is high carb so you may want to try just 1 slice.
Some more meal ideas in this link for a low carb approach. https://lowcarbfreshwell.com/

 

[Amyfaith]

Apologies, I’m testing before eating as well - consistently into the mid-to-upper 5s, with an odd low 6 if I’ve eaten more recently/ not been as active.

I got a funny post lunch result today, and did retest but it remained highish (dropped from 8.5-> 8.1), but again, I’ve had exactly the same meal with far lower results previously. I know I have less data overall for lunch (there’s just no good way to test during working hours for me), so maybe the higher numbers are ‘normal’ for that combo and I just need to rethink sandwiches. I’ll have a play while we’re out of term time. Single slices, as you suggest, cut in half may be a solution. It’s just so weird that what I pair it with makes an impact as well - wouldn’t have thought I’d have more of a response to avocado than I would to just bread and lettuce leaves given that’s extra fat and fibre.

Am I right in thinking carb source is potentially a culprit? My overall carb (and overall macro) intake per meal tends to be pretty consistent. I sort of expected potato and pasta to be an issue, but didn’t expect whole meal bread to cause as much as a problem.

 

[Leadinglights]

Apologies, I’m testing before eating as well - consistently into the mid-to-upper 5s, with an odd low 6 if I’ve eaten more recently/ not been as active.

I got a funny post lunch result today, and did retest but it remained highish (dropped from 8.5-> 8.1), but again, I’ve had exactly the same meal with far lower results previously. I know I have less data overall for lunch (there’s just no good way to test during working hours for me), so maybe the higher numbers are ‘normal’ for that combo and I just need to rethink sandwiches. I’ll have a play while we’re out of term time. Single slices, as you suggest, cut in half may be a solution. It’s just so weird that what I pair it with makes an impact as well - wouldn’t have thought I’d have more of a response to avocado than I would to just bread and lettuce leaves given that’s extra fat and fibre.

Am I right in thinking carb source is potentially a culprit? My overall carb (and overall macro) intake per meal tends to be pretty consistent. I sort of expected potato and pasta to be an issue, but didn’t expect whole meal bread to cause as much as a problem.

Avocado is pretty low carb only about 3 per whole fruit. So it is more likely the bread which is the culprit as 2 slices could be as much as 30g plus of carb depending on your bread, carbs per slice will be on the bag, unless unsliced where controlling the size of your slice is more tricky unless you weight it. Lettuce leaves are again pretty low carb and very little fibre.
It is interesting that people can be different how they tolerate the same amount of carb depending on whether it is bread, rice, pasta, potatoes. Diabetes is unpredictable so don't get too hung up on individual readings but look for trends.
Once you have tested a meal a couple of time you don't really need to test those meals again.
The book or app Carbs and Cals is a good resource for giving the carb values of a whole range of foods and sample meals and portion sizes. I found it was my bible when first diagnosed.

 

[grovesy]

I do not always get the same results with the same meals.

 

[Docb]

In my humble opinion you will not be able to do what you are trying to do.

The first and major point is that hand held meters only give you a rough estimate of your blood glucose and my rule of thumb is that if you round your meter reading to the nearest whole number then there is a reasonable probability that your blood glucose is somewhere in the range of that number +/- 1. If you are considering two readings then the ranges should not overlap for the readings be considered "different". So, a reading of 6.4 is best treated as blood glucose of somewhere between 5 and 7. Another reading might be different if the minimum value in its range is 8 or greater or the maximum value in its range is 4 or less.

Do this with your readings and you might get a different perspective. Things might not be as wildly different as they seem to be at first sight.

The second point is that carb levels are also a bit of a guess, especially on food packaging labels. Same on unpackaged goods. Look at any standard list and you will find a carb value for the humble spud....but it does not differentiate between varieties, time in storage and method of cooking to name but three things that will affect the carb level.

The final point is that the human body is a compact but complicated chemical plant and there are loads of things going on that affect blood glucose levels. Food intake is the big one but there are lots other things.

The hand held meters are amazing bits of kit but interpretation of the data they produce needs a bit of care and attention. A bit of statistical knowledge and a few years of experiment design helps, but if you don't have that then you need bigger differences in readings than you might expect in order to make sense of what is going on.

 

[Amyfaith]

Avocado is pretty low carb only about 3 per whole fruit. So it is more likely the bread which is the culprit as 2 slices could be as much as 30g plus of carb depending on your bread, carbs per slice will be on the bag, unless unsliced where controlling the size of your slice is more tricky unless you weight it. Lettuce leaves are again pretty low carb and very little fibre.
It is interesting that people can be different how they tolerate the same amount of carb depending on whether it is bread, rice, pasta, potatoes. Diabetes is unpredictable so don't get too hung up on individual readings but look for trends.
Once you have tested a meal a couple of time you don't really need to test those meals again.
The book or app Carbs and Cals is a good resource for giving the carb values of a whole range of foods and sample meals and portion sizes. I found it was my bible when first diagnosed.

The bolded bit is super helpful, thanks. The biochem behind it must be more than just carbs do x - so I’ll adjust my expectations accordingly.
And I’ll give the app a go. I’ve been using MyFitnessPal just as I have it already (pre diagnosis, I used it periodically to check in on general macro and nutrient levels), but it’s such a mix of US and UK totals that it can get a little confusing, which might also be part of why I’m seeing what I am.

 

[Amyfaith]

I do not always get the same results with the same meals.

Good to know! How do you manage what you eat, then, out of curiosity?

 

[Amyfaith]

In my humble opinion you will not be able to do what you are trying to do.

The first and major point is that hand held meters only give you a rough estimate of your blood glucose and my rule of thumb is that if you round your meter reading to the nearest whole number then there is a reasonable probability that your blood glucose is somewhere in the range of that number +/- 1. If you are considering two readings then the ranges should not overlap for the readings be considered "different". So, a reading of 6.4 is best treated as blood glucose of somewhere between 5 and 7. Another reading might be different if the minimum value in its range is 8 or greater or the maximum value in its range is 4 or less.

Do this with your readings and you might get a different perspective. Things might not be as wildly different as they seem to be at first sight.

The second point is that carb levels are also a bit of a guess, especially on food packaging labels. Same on unpackaged goods. Look at any standard list and you will find a carb value for the humble spud....but it does not differentiate between varieties, time in storage and method of cooking to name but three things that will affect the carb level.

The final point is that the human body is a compact but complicated chemical plant and there are loads of things going on that affect blood glucose levels. Food intake is the big one but there are lots other things.

The hand held meters are amazing bits of kit but interpretation of the data they produce needs a bit of care and attention. A bit of statistical knowledge and a few years of experiment design helps, but if you don't have that then you need bigger differences in readings than you might expect in order to make sense of what is going on.

This is helpful, thanks. For the above, obviously it’s a limited data set as yet, but it was all more or less within that rough +/-1 range, but then some would be randomly +2 outside it with roughly the same meal (obviously individual items will vary - everything from exact harvesting process of wheat to variety to whatever will impact exact nutrient profiles). And, for a newbie, seeing ‘good’ numbers which become considerably less good out of nowhere is a little disconcerting, I think, which is why I got concerned and confused. I’ve seen stats mentioned that meters can be out by 15% in general and totally off a fairly small percentage of the time, so I’ll need to remind myself this occasionally. But having a rough rule of thumb for how much individual meals impact me is useful, at least for now while I’m trying to get my head around the whole thing. I suspect for someone on insulin it would be a bigger issue but for me just trying to get a sense of things and where I sit normally, I can handle a general estimate and will try not to get too super concerned unless I’m seeing something like a 9 off the back of an ounce of cheese…

 

[Leadinglights]

This is helpful, thanks. For the above, obviously it’s a limited data set as yet, but it was all more or less within that rough +/-1 range, but then some would be randomly +2 outside it with roughly the same meal (obviously individual items will vary - everything from exact harvesting process of wheat to variety to whatever will impact exact nutrient profiles). And, for a newbie, seeing ‘good’ numbers which become considerably less good out of nowhere is a little disconcerting, I think, which is why I got concerned and confused. I’ve seen stats mentioned that meters can be out by 15% in general and totally off a fairly small percentage of the time, so I’ll need to remind myself this occasionally. But having a rough rule of thumb for how much individual meals impact me is useful, at least for now while I’m trying to get my head around the whole thing. I suspect for someone on insulin it would be a bigger issue but for me just trying to get a sense of things and where I sit normally, I can handle a general estimate and will try not to get too super concerned unless I’m seeing something like a 9 off the back of an ounce of cheese…

That is a surprise for cheese as it is pretty low carb.

 

[helli]

@Amyfaith whilst food is typically the culprit for high or low BG, it is not the only thing which is another reason (in addition to those mentioned by @Docb ) that you will not always get the same results.
For example, I find a stressful work meeting can send my BG rocketing, some find movies (especially thrillers) or watching sports matches or playing sport can affect their BG. And that’s without considering hormones and weather and how well you sleep and illness and injuries and …
The only way of getting the same results every day is to live in a sterile bubble, do the same exercise at the same time, eat the same food at the same time, go to sleep and wake up at the same time … and not get stressed because you are missing out on life.

 

[Amyfaith]

That is a surprise for cheese as it is pretty low carb.

Ha - I meant *if* it did suddenly happen! Thankfully it hasn’t!

 

[Amyfaith]

@Amyfaith whilst food is typically the culprit for high or low BG, it is not the only thing which is another reason (in addition to those mentioned by @Docb ) that you will not always get the same results.
For example, I find a stressful work meeting can send my BG rocketing, some find movies (especially thrillers) or watching sports matches or playing sport can affect their BG. And that’s without considering hormones and weather and how well you sleep and illness and injuries and …
The only way of getting the same results every day is to live in a sterile bubble, do the same exercise at the same time, eat the same food at the same time, go to sleep and wake up at the same time … and not get stressed because you are missing out on life.

Wait… WEATHER?! The rest I knew about and could already see a bit in my own data but weather is a surprise. I’m guessing having a long-standing anxiety disorder on top of diabetes is going to be a recipe for trouble, isn’t it? And working in a dying industry known for overwork is the cherry on top… (Point taken otherwise. To be clear, I’m not expecting identical results with anything but inconsistencies tend to flummox me in general.)

 

[helli]

Wait… WEATHER?!

It is not uncommon for someone with Type 1 to have different summer and winter insulin doses. And some people find barometric pressure can affect their BG.
And sometimes, there is no clear reason which is usually put down to "the wrong colour socks."

 

[Docb]

there is no clear reason which is usually put down to "the wrong colour socks."

In our lab it was put down to the price of fish.

Round here it is best to put it down to a visit from the diabetes fairy.

 

[Amyfaith]

And I’m guessing this applies to type 2s as well? (Totally makes sense; dunno why I’m remotely surprised…)

 

[everydayupsanddowns]

Welcome to the ‘ish’ world of diabetes results @Amyfaith

I’m a bit late to the thread, but one thing that crossed my mind when reading your initial post was the differences between the same lunch where you did or didn’t have a huge handful of leaves.

It may be motivated cognition, or n=1 anomaly, but by observations over the years have led me to factor in how much ‘padding’ there is in a meal, into the likely BG profile afterwards.

Rather than simple addition/subtraction between carb estimates and insulin doses, I feel what I see is more about push/pull momentum/inertia physics. Effectively I’d feel that the leaves padded out the carbs in one lunch meaning that the body had more to work on so the BG push was weaker and more ‘spread out’. While in the lunch without them there was less for the stomach to work with, so the carbs were processed more rapidly, stronger ‘push’, and a higher post-meal result.

 

[Amyfaith]

I had wondered this - sort of a rudimentary food pairing thing? I’m trying to find somewhere that can explain it to me properly (without charging me for the privilege) - I think it would be more sustainable for me long term than medium-low carb, or at least let me enjoy some things on occasion that are currently off limits. Had what the kids call a full on ‘menty-b’ over the weekend about all fun things being bad now, so I’m looking for ways of not doing myself a damage without losing all sense of joy.

 

[Proud to be erratic]

Welcome to the ‘ish’ world of diabetes results @Amyfaith

I’m a bit late to the thread, but one thing that crossed my mind when reading your initial post was the differences between the same lunch where you did or didn’t have a huge handful of leaves.

I have also come to this thread "late" (ie just this morning!). But I now remember reading @Amyfaith's initial postings and how a few weeks ago that bit of dialogue then caught my attention. In the interim my own world has been typically erratic, busy and distracting.

So now I can't help spotting your reference to a huge handful of leaves (and I realise this was just an illustrative comment).

It may be motivated cognition, or n=1 anomaly, but by observations over the years have led me to factor in how much ‘padding’ there is in a meal, into the likely BG profile afterwards.

Your comment about 'padding', @everydayupsanddowns, is introduced by Jessie Inchauspé in her book 'The Glucose Revolution' in a rather different manner, but as a specific theme and embraced in the first 2 of her recommendatios;

"Hack 1: eat foods in the right order"

"Hack 2: add a green starter to all your meals"

I am still only about 2/3 through the book. I started reading it with a fair degree of scepticism just after Xmas. I was having yet another struggle to sustain any consistency with my own BG management and felt there was nothing to lose in looking at what she had to say. But those 2 principles from Inchauspé add to your "padding" remark (or vice versa).

The book, Glucose Revolution, is proposing ways of flattening glucose spikes and thus making significant health improvements - not just in our world of D. This flattening of spikes is, at a first and superficial glance, less important to those of who are insulin dependent; we have a means to do this anyway and it just [as we all know and of course understand] needs that simple knack of getting the timing right [along with checking the barometer, wearing the correct socks , etc, etc]. But for a T2, smoothing and ideally flattening to eliminate the spikes makes a huge difference in how they can successfully manage their BG even when their natural high insulin resistance is not helping.

Rather than simple addition/subtraction between carb estimates and insulin doses, I feel what I see is more about push/pull momentum/inertia physics. Effectively I’d feel that the leaves padded out the carbs in one lunch meaning that the body had more to work on so the BG push was weaker and more ‘spread out’. While in the lunch without them there was less for the stomach to work with, so the carbs were processed more rapidly, stronger ‘push’, and a higher post-meal result.

Yes. I completely agree. The addtion/subtraction "maths" is way too simplistic; the starting numbers are just estimates in the first place and there are so many other factors that can make those guestimates pretty wrong in practice. I'm not knocking the initial maths, it is needed to get onto some sort of start point, but it's pretty basic. The dynamic of physics (in its wider sense) embraces the 40+ factors that we now have had revealed - qualitatively, but not quantitatively.

Inchauspé proposes (with a certain amount more metabolic explanation): eat a high fibre starter to line one's colon and at the very least delay the conversion of carbs into glucose, but also perhaps get some of those carbs to pass through without full digestion.

I have since early January been having a bowl of mixed salad and veg, pre-assembled from whatever is in the fridge or handy from our local supermarket - before each main meal. Administratively it's not convenient: the rest of my family aren't doing the same (and there is a certain underlying tension because of my weird eating habit!). I also spend an hour every 4 or 5 days chopping and generally prepping my salad box, usefully preserved with lower carb oil and vinegar dressings; included vinegar from pickled veggies. But I can confirm that I am seeing a difference on my BG graphs. A timing issue for prebolus remains (and this is still work in progress, including some split boluses) along with finding suitable starters when eating out (often something from the side dishes menu options - and getting that delivered for me before anything else!). My carb/insulin ratios are altered a bit - but this is not really any different from making a judgement (guess) about my activity/exercise factor (both from yesterday as well as today).

CGM makes this juggling "doable" and the prebolus or split bolus timing more visible. Having a reliable CGM has become so fundamental for my BG management. This is still much more "Art rather than Science", which as an Engineer I find frustrating, but the "logic" component remains intriguing.

I had wondered this - sort of a rudimentary food pairing thing? I’m trying to find somewhere that can explain it to me properly (without charging me for the privilege) - I think it would be more sustainable for me long term than medium-low carb, or at least let me enjoy some things on occasion that are currently off limits. Had what the kids call a full on ‘menty-b’ over the weekend about all fun things being bad now, so I’m looking for ways of not doing myself a damage without losing all sense of joy.

I have a kindle version of Helen Inchauspé's book: Glucose Revolution: The life-changing power of balancing your blood sugar. £1 speculation ?!

 

[Amyfaith]

I’ll have a look - in general, the ‘glucose goddess’ is broadly considered a charlatan, so I’m reticent to throw her any money, even if only a quid (I put her in the same category as Tim Spector, who I also distrust). It may well be this bit is more or less correct, but she’s a biochemist, not a nutritionist or endocrinologist, so I’d be personally wary of her work.