Spikes

[bearlady]

i have tried this morning to take on the advice given with regard to preventing spikes, i.e. take novarapid 20-30 mins before eating and checking after 2 hours. Wake up reading was 7.9 at 9.00 am. Had a bowl of porridge made with 40gm of oats and 200 ml semi skimmed milk at 9.30 am The packet of porridge said there was approx 22 carbs and 5 carbs on the milk carton. I took 5 units of insulin to take account of my sugars being 7.9. I checked after 2 hours and my reading was 9.7 so looks like porridge has spiked me. I have now at 1.30 pm taken my reading before lunch (I have been quite active this morning) and it is 5.8. Are these numbers ok as I am really get worked up as I don't want to do any more damage to my eyesight?

 

[eggyg]

That’s absolutely fine. A raise of less than two isn’t a spike. A “ normal” person would possibly have a higher rise. I can’t eat porridge, it spikes me to 16 or so from 6/7! So I would say it’s a good result for you.

 

[bearlady]

I will keep my eye on things as I go along. Just trying to get to grips with things as it was not until I saw the consultant last week after 18 months of diagnosis that he said to check 2 hours after eating to see if any adjustments needed to be made. Been left a bit in the dark to get on with things whilst covid struck.

 

[rebrascora]

I would agree, that you managed that really well and that rise is nothing to be concerned about.
If it helps you to get a better perspective on it, those of us who use Libre sensors try to keep our levels between 4-10 75% of the time or more and only 3% below 4, which means that whilst not ideal, realistically, going above 10 for 22% of the time is not bad control but obviously the more time you spend in that 4-10 range the better.

 

[bearlady]

I would agree, that you managed that really well and that rise is nothing to be concerned about.
If it helps you to get a better perspective on it, those of us who use Libre sensors try to keep our levels between 4-10 75% of the time or more and only 3% below 4, which means that whilst not ideal, realistically, going above 10 for 22% of the time is not bad control but obviously the more time you spend in that 4-10 range the better.

 

[bearlady]

I generally stay within 5-10 80% of the time and my average over 30 days is 7.4-7.6 so it is just that when it does go over 10 I get really anxious as I think I am doing damage. I think the highest I have been after diagnosis is 15 and I was stressed out. I am trying to control everything being low carb, I did have half a banana and porridge one day and it shot up to 13 so I think it is a bit of trial and error. I was talking to a retired diabetes nurse of 25 years ealrly in diagnosis at hospital and he said anything under 10 and you are doing good so what you have said really makes sense. I think I need to calm down and stop stressing and carry on as I was.

 

[SB2015]

. I think I need to calm down and stop stressing and carry on as I was.

That is easier said than done.
it took me eight years to change my target range for measuring TIR to 4 - 10, (from 4 - 7) for exactly the same reason. anything below 10 is great and you are doing brilliantly if you already getting 80% TIR. Find a big gold star (made from chocolate and just bolus for it). You deserve it.

It is the pre-bolusing that had the biggest impact on my spikes. Also I now just have a tiny tiny bit of banana if OH has one. They are glucose bombs for me. As you say trial and improvement.

 

[bearlady]

That is easier said than done.
it took me eight years to change my target range for measuring TIR to 4 - 10, (from 4 - 7) for exactly the same reason. anything below 10 is great and you are doing brilliantly if you already getting 80% TIR. Find a big gold star (made from chocolate and just bolus for it). You deserve it.

It is the pre-bolusing that had the biggest impact on my spikes. Also I now just have a tiny tiny bit of banana if OH has one. They are glucose bombs for me. As you say trial and improvement.

No chocolate gold star for me | am afraid I am lactose intolerant, double whammy!!!

 

[Bruce Stephens]

No chocolate gold star for me | am afraid I am lactose intolerant

I feel sure somebody, somewhere, sells dark chocolate gold stars.

 

[helli]

@bearlady be nice to yourself.
Personally, I hate the term "controlling diabetes". There are so many things that can affect our levels that there will be times when it does go high and it's not always due to what we eat. It could be stress, it could be illness, it could be the weather, it could be some medication (or vaccination), your pen/insulin may be faulty (it is very very rare but it can happen).
Try not to stress when you go over 8. You will not lose your eyesight or have to have your toes amputated because of an hour or two over the range you have set yourself.
It is very important not to let diabetes take over your life - mental health is as important as physical health and mental health problems are higher with people with diabetes than the average population.

Diabetes burnout is a real thing.

Sorry, I probably ramble a bit there. I just want to highlight the need for balance - manage all of yourself not just your diabetes.

 

[pm133]

I generally stay within 5-10 80% of the time and my average over 30 days is 7.4-7.6 so it is just that when it does go over 10 I get really anxious as I think I am doing damage. I think the highest I have been after diagnosis is 15 and I was stressed out. I am trying to control everything being low carb, I did have half a banana and porridge one day and it shot up to 13 so I think it is a bit of trial and error. I was talking to a retired diabetes nurse of 25 years ealrly in diagnosis at hospital and he said anything under 10 and you are doing good so what you have said really makes sense. I think I need to calm down and stop stressing and carry on as I was.

The DSNs mean well but it would definitely help if they told us more about spikes and what constituted a problem.
It's one thing to say keep within 3 mmol/L rise after meals and under 10 if possible but a bit more re-assurance that even a temporary 13 is not a disaster wouldn't go amiss.
It's not the 80% we need re-assuring about, it's the 20%.

Personally, I try to stay as close to 90% time in range 3.9-10 but won't get upset at dropping to 85% (I'm at 86% right now). In addition, I happily tolerate short peaks to 13 lasting an hour or two after dinner even with pre-bolussing without giving it a second thought. I'm not going to be running a serious risk of losing limbs or my eyesight from that and I'm needlessly worrying myself if I do obsess over it. For me, life is simply too short to waste obsessing over trying to get more accurate than that - that is how you risk developing an eating disorder and have absolutely no desire to go down that path.

BUT, each person has to decide on their own journey and their own exposure to risk of complications.

 

[Ali11782]

The DSNs mean well but it would definitely help if they told us more about spikes and what constituted a problem.
It's one thing to say keep within 3 mmol/L rise after meals and under 10 if possible but a bit more re-assurance that even a temporary 13 is not a disaster wouldn't go amiss.
It's not the 80% we need re-assuring about, it's the 20%.

Personally, I try to stay as close to 90% time in range 3.9-10 but won't get upset at dropping to 85% (I'm at 86% right now). In addition, I happily tolerate short peaks to 13 lasting an hour or two after dinner even with pre-bolussing without giving it a second thought. I'm not going to be running a serious risk of losing limbs or my eyesight from that and I'm needlessly worrying myself if I do obsess over it. For me, life is simply too short to waste obsessing over trying to get more accurate than that - that is how you risk developing an eating disorder and have absolutely no desire to go down that path.

BUT, each person has to decide on their own journey and their own exposure to risk of complications.

Very well written.