Confused

[ChrissieMM]

Hi
I have been diagnosed as a Type 2 diabetic for 3.5 years. I started myself on a low carb diet (under 130g a day), lost 17kg and hover at the non-diabetic/pre diabetic HbA1c level.
However I am still confused about spikes. Online advice I have seen seems to say you must avoid these at all cost as spikes cause immediate damage. The diabetic dietician I met said that everybody spikes if they eat, say, a Mars bar. The important thing is for your blood sugar come down quickly and stay there, and not to spike too often.
Can anyone help my confusion?

 

[Leadinglights]

My understanding is that even though blood glucose levels are at the prediabetic level or below your body still has problems coping with high carb foods which a Mars bar would definitely be and people are able to maintain their levels by still paying close attention to their carb intake. The occasional 'treat' probably does no harm but should be regarded as that reserved for high days and holidays.

 

[rebrascora]

None diabetic people spike too as the nurse was trying to convey. They very seldom spike above 10 though and as the nurse says their levels come back down again pretty quickly as the insulin they produce in response to a carb rich food like Mars Bar gets to work. As a Type 2 diabetic, your insulin response may be more sluggish and so the spike will be higher and longer than a non diabetic person before that insulin kicks in and insulin resistance may hamper it's activity. Higher spikes are best avoided and the increased time when that glucose is in the blood stream means that it is more likely to become attached to the blood cells increasing your HbA1c and therefore risk of complications.

That is my understanding of it anyway.

 

[Docb]

Hi @ChrissieMM and welcome to the forum.

Agree with what the others have said, but I would add that "a spike" in blood glucose is a term used with gay abandon, often without any thought about what it means. There is no common definition. As a consequence, things that some would describe as a spike, others would describe as being perfectly normal.

The way I look at it is that between me and the DN we have decided to set a target of keeping my blood glucose between 5 and 10. On top of that I know that if it averages around 6, my HbA1c will be decently sub diabetic. How it varies through the day, how fast it goes up and comes down really does not matter provided I keep within my targets.

So,when I get up I expect a reading of 5. Eat my breakfast and my BG shoots up to 8 or 9 within an hour but is back down to around 5 or 6 after a couple of hours. Some might describe that as a spike, but to me its entirely normal. If I added a Mars Bar to my breakfast (heaven forbid) I would expect my BG to shoot up to low teens. Some might call that a spike but me, I just call it a bad idea and write memo to self not to add a Mars Bar to my breakfast.

I'm perfectly happy with this approach to monitoring what is going on with blood glucose variation because when I started blood glucose monitoring I swiftly came to the conclusion that it is far from an exact science. It's a very powerful tool when it comes to adjusting diet to get overall levels down but over analysing the results can get in the way of that goal if you do not take care.

Usual disclaimer..... remarks apply to non insulin dependent T2 's only, T1 and blood glucose monitoring is a very different ball game.

 

[Inka]

I’d go with the diabetic dietician @ChrissieMM People without diabetes ‘spike’ - ie their blood sugar goes up after eating, sometimes as high as 10. Up and down blood sugars are normal. The trick is to try to keep the ups and downs within a normal range and to limit the length of time spent at higher levels.

 

[helli]

With the advent of "relatively" cheap CGM/Flash GM (continuous glucose monitoring/flash glucose monitoring), there are some people without diabetes who have been wearing them and publishing their graphs on the internet. Here are some student's graphs:

https://imgur.com/a/wLiNa

If you convert the units, you see that he spikes pretty close to 10mmol/l

 

[ChrissieMM]

That is all very helpfu! Thank you. I was getting a bit worried as well as confused. What led me to join this forum was disillusionment with another forum I was on and the 7 day low carb menu Diabetes UK published. This seemed very do-able but included items such as porridge which I had been led to believe was a complete no-no. However when I have eaten low GI items like this, my BGlevels HAVE gone up but ‘only’ to high 8s and a couple of hours later to my usual base line of about 6. (My last 4 HA1BC have been 45, 41, 48 (long holiday in France) and 39. So hopefully, based on my figures and your information I shouldn’t be at too much risk of complication.)
PS I haven’t had a Mars bar for years, more concerned about spikes after bread, potatoes, porridge ☺️ Seems mine aren’t too bad, which is exactly what Iwanted too know. Thanks.

 

[everydayupsanddowns]

That is all very helpfu! Thank you. I was getting a bit worried as well as confused. What led me to join this forum was disillusionment with another forum I was on and the 7 day low carb menu Diabetes UK published. This seemed very do-able but included items such as porridge which I had been led to believe was a complete no-no. However when I have eaten low GI items like this, my BGlevels HAVE gone up but ‘only’ to high 8s and a couple of hours later to my usual base line of about 6. (My last 4 HA1BC have been 45, 41, 48 (long holiday in France) and 39. So hopefully, based on my figures and your information I shouldn’t be at too much risk of complication.)
PS I haven’t had a Mars bar for years, more concerned about spikes after bread, potatoes, porridge ☺️ Seems mine aren’t too bad, which is exactly what Iwanted too know. Thanks.

Sound like you have found a system that works really well for you @ChrissieMM

And your A1c results are excellent, and should certainly reduce your chances of developing complications in the future. 🙂