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JellyBaby21

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Type 1
3 weeks post diagnoses and one thing is confusing me. It's probably a stupid question but I was hoping someone could explain.

So after I eat my BG spikes. My DSN says this is normal and not to worry even if it gets to 14/15mmol/L as long as it comes down to 1 or 2 points above where it was before the previous meal before the next meal (hope that makes sense). This can happen even when I eat a very low carb meal or when I eat a carb meal and take novorapid 15 mins before.

So my question is, if it's OK for my BG to spike after eating any meal (carbs or not) then why bother taking novorapid? ‍

Hope this isn't too ridiculous a question.
 
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JellyBaby21 said:
So after I eat my BG spikes. My DSN says this is normal and not to worry even if it gets to 14/15mmol/L as long as it comes down to 1 or 2 points above where it was before the previous meal before the next meal (hope that makes sense). This can happen even when I eat a very low carb meal or when I eat a carb meal and take novorapid 15 mins before.
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It's completely normal, and I think we only notice it because it's so much easier to see it now.

Trying to reduce these spikes still seems worthwhile to me but it's possible to make an argument that so long as you're within the time in range recommendations then that's fine.
 
Bruce Stephens said:
It's completely normal, and I think we only notice it because it's so much easier to see it now.

Trying to reduce these spikes still seems worthwhile to me but it's possible to make an argument that so long as you're within the time in range recommendations then that's fine.
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Yes, I've been noticing it a lot more the last week because I've just got a Libre. I wasn't aware when just finger pricking.

Could you tell me what is the 'time in range' recommendations please? Sorry again for my ignorance!
 
The range is usually set at 3.9-10 and you are aiming to get 70% or more of your time within that range and ideally less than 4% below 3.9. The remainder can be above 10.
 
rebrascora said:
The range is usually set at 3.9-10 and you are aiming to get 70% or more of your time within that range and ideally less than 4% below 3.9. The remainder can be above 10.
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Thank you. The 70% is a relief. I was trying to get a lot higher which is difficult!
 
As regards spiking high and then coming down before your next meal then, whilst probably not ideal it is acceptable, providing your TIR is good. If you didn't inject the NR then your levels simply wouldn't come back down so that is the reason you inject it. I am betting that the times your levels spike even with a low carb meal are on a morning. If so, that is likely your liver contributing to your BG levels. I found that I still needed to inject some bolus insulin even for a low carb or no breakfast at all because my liver would churn out glucose due to Foot on the Floor syndrome. What I find really helps is to inject my bolus insulin before I set foot out of bed on a morning and then give it PLENTY of time to get going before I eat breakfast. For me this is currently about 45mins prebolus time and that prevents my levels spiking much at all and certainly not above 10. I found that spiking up to 15 every morning and then plummeting back down to 5 made me feel pretty rough, so I gradually worked on increasing the prebolus timing for breakfast until I stopped it happening and I feel much better for that and my levels are much more stable.... but you are only 3 weeks into this, so it is very early days yet and your own pancreas could easily chip in with some home grown insulin to upset the apple cart at this stage, so it you can get your levels back down into range by your next meal most of the time then you are doing brilliantly It is really tempting to want to get everything absolutely right from the start but you simply can't, even with years of experience, perfection isn't possible, so just take it one step at a time and maybe experiment a little when you have plenty of time... ie not work days, to see what happens if you add another 5 mins to your prebolus time. I should say that many people would hypo if they waited 45mins between injecting and eating, so you do really need to be cautious about increasing it slowly to find the sweet spot timing for you with NovoRapid and your breakfast choice.... remembering that some foods will digest more quickly than others.
 
rebrascora said:
As regards spiking high and then coming down before your next meal then, whilst probably not ideal it is acceptable, providing your TIR is good. If you didn't inject the NR then your levels simply wouldn't come back down so that is the reason you inject it. I am betting that the times your levels spike even with a low carb meal are on a morning. If so, that is likely your liver contributing to your BG levels. I found that I still needed to inject some bolus insulin even for a low carb or no breakfast at all because my liver would churn out glucose due to Foot on the Floor syndrome. What I find really helps is to inject my bolus insulin before I set foot out of bed on a morning and then give it PLENTY of time to get going before I eat breakfast. For me this is currently about 45mins prebolus time and that prevents my levels spiking much at all and certainly not above 10. I found that spiking up to 15 every morning and then plummeting back down to 5 made me feel pretty rough, so I gradually worked on increasing the prebolus timing for breakfast until I stopped it happening and I feel much better for that and my levels are much more stable.... but you are only 3 weeks into this, so it is very early days yet and your own pancreas could easily chip in with some home grown insulin to upset the apple cart at this stage, so it you can get your levels back down into range by your next meal most of the time then you are doing brilliantly It is really tempting to want to get everything absolutely right from the start but you simply can't, even with years of experience, perfection isn't possible, so just take it one step at a time and maybe experiment a little when you have plenty of time... ie not work days, to see what happens if you add another 5 mins to your prebolus time. I should say that many people would hypo if they waited 45mins between injecting and eating, so you do really need to be cautious about increasing it slowly to find the sweet spot timing for you with NovoRapid and your breakfast choice.... remembering that some foods will digest more quickly than others.
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Really helpful thank you. Good point about 'foot to floor syndrome'. I tried leaving 45 mins yesterday. I was not quite at hypo by the time I ate. But after eating my levels still spiked so think the insulin kicked in before I'd digested all the porridge?? Tried Novorapid 20mins before breakfast today and it worked better but still went up to 11.0 before I stepped in with 8mins of HITT exercise (always works - but then of course I hypo'd). Will try again tomorrow with the 20mins before and see how far it spikes without exercise intervening. However, much less spike today after low carb (so no novorapid) lunch though because I stopped the breakfast spike (albeit with exercise) (I ate low carb prior to diagnoses anyway).

Started DAFNE so that should help hopefully.

I do feel rough with sudden spikes and come downs. Makes my brain fuzzy/dizzy on and off, pressure and I'm getting brain zaps. Is the yo-yoing doing this do you think?
 
Hope you can find a useful prebolus delay that works well for you @JellyBaby21

Out of interest… have you tried other breakfast choices? I know it’s supposed to be slow release and everything, but my metabolism seemed to treat it pretty much like jam!

I ended up settling on seedy toast (sometimes with rye). I used to love cereals, but in the end the BG chaos just wore me down, and I gave up on them. I’ll still have them as a treat, but every day was just too difficult to reliably dose for I found.
 
Greek yoghurt, seeds and berries with a sprinkle of nutty granola works for me. I too gave up on porridge a couple of years ago because my digestive system gets into party mode on it, even made with best jumbo oats and cream to try to slow it down a bit. It absolutely amazes me that the glucose can start arriving at my finger tip in 20 mins from it going in my mouth. I used to love porridge but now I love my creamy yoghurt and berries and seeds and I don't miss it at all.
The other day I fancied something warm so I microwaved an apple from the garden with a few sultanas and cinnamon and I sprinkled on the mixed seeds and a bit of granola and some cream and it was like having a bowl of fruit crumble for breakfast. Yum and it behaved surprisingly well.
 
everydayupsanddowns said:
Hope you can find a useful prebolus delay that works well for you @JellyBaby21

Out of interest… have you tried other breakfast choices? I know it’s supposed to be slow release and everything, but my metabolism seemed to treat it pretty much like jam!

I ended up settling on seedy toast (sometimes with rye). I used to love cereals, but in the end the BG chaos just wore me down, and I gave up on them. I’ll still have them as a treat, but every day was just too difficult to reliably dose for I found.
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Have thought about going back to my old high protein egg breakfast. Changed to porridge to add oats into my diet but if I can't find a balance I will go back to eggs I think. Will give it a little longer before I give up. Your description of your metabolism treating it like jam is a brilliant one and may well prove true for me in the end too! 🙂
 
rebrascora said:
Greek yoghurt, seeds and berries with a sprinkle of nutty granola works for me. I too gave up on porridge a couple of years ago because my digestive system gets into party mode on it, even made with best jumbo oats and cream to try to slow it down a bit. It absolutely amazes me that the glucose can start arriving at my finger tip in 20 mins from it going in my mouth. I used to love porridge but now I love my creamy yoghurt and berries and seeds and I don't miss it at all.
The other day I fancied something warm so I microwaved an apple from the garden with a few sultanas and cinnamon and I sprinkled on the mixed seeds and a bit of granola and some cream and it was like having a bowl of fruit crumble for breakfast. Yum and it behaved surprisingly well.
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I have Alpro plant based yoghurt, blueberries and nuts as a dessert in the evening. I'd go back to eggs for breakfast if I can't sort the porridge. Interesting everyone is saying this about porridge though - not just me it seems. I love the sound of the apple mixture - like you say, surprising it behaved well. I might try this one thanks 🙂
 
I find traditional porridge works well for breakfast. I get the steel cut jumbo oats that need proper cooking. I also eat other cereals. I’ve found that some cereals need a slightly higher breakfast ratio than, say, a croissant.
 
I've just found oat bran. Much much higher fibre content than normal oatmeal. Will give this a go in the morning to see if it has less of an affect on my BG.
 
So turns out I can eat oat bran without any spiking problems at all. Clearly don't even need the 2 units of novorapid I was taking with oatmeal. I was at 11.5mmol/L just before breakfast (presumably due to 'foot to floor syndrome') and dropping my basal from 5 to 4 units yesterday evening on the instruction of my DSN (due to upping my morning dose from 9 units to10 units). 1.5 hour after eating the oat bran I'm on 3.8mmol/l (BI) or 4.5mmol/L (BG). Think I need to up my evening basal back to 5 units and take less novorapid tomorrow morning with the oat bran right?
 
If oatbran is anything like the rice bran I sometimes add to my cereal, it’s just the bran part of the grain rather than a cereal, so it wouldn’t have many carbs. You mentioned oatmeal above - if you mean processed/powdered oats, then that might be why your blood sugar spiked up. Porridge is best made with the whole oats.
 
Inka said:
If oatbran is anything like the rice bran I sometimes add to my cereal, it’s just the bran part of the grain rather than a cereal, so it wouldn’t have many carbs. You mentioned oatmeal above - if you mean processed/powdered oats, then that might be why your blood sugar spiked up. Porridge is best made with the whole oats.
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I was eating quite powdery oats in sachets from Aldi. No artificial colours and no added sugar so assumed it would be OK but like you say I think they are too powdery. Might try whole oats (tried getting the pinhead version but not in supermarkets near me) but from what I have read the oat bran is even better (as well over a third of the carbs are fibre).

But based on the readings this morning and the massive spike BEFORE I even ate, I am now wondering if these morning spikes have more to do with 'foot to floor sydrome' as someone previously suggested??

Yesterday I woke at 5.7 and was at 9.0 30 mins later before eating (after 5 units basal the previous evening). 9 units basal at 8am.

Today I woke at 7.3 and was 10.9 before eating (after 4 units basal the previous evening). 10 units basal at 8am.

Suggests 'foot to floor' right?
 
Those instant oat cereals generally cause a bigger spike than proper whole oats. They’re higher GI. Old-fashioned jumbo oats are best. If you look at some of the supermarket ranges, you should find a close equivalent eg the Tesco Finest ones are pretty good. They take 6 or 7 minutes to cook, which is a good general indicator (quick cook oats are usually higher GI).

Yes, that sounds like Foot on the Floor. I get that too. I find if I delay breakfast it’s worse, so I try to prioritise eating as soon after I get up as I can. My breakfast ratio is also higher than my evening meal ratio, and that extra insulin helps squash the FOTF rise.
 
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