Why? Blood sugar spiking

[Namaste]

Good afternoon,

I am struggling again. I'm not sure that what is happening is normal - I would be grateful if someone could help.

Attached is my sugars from today. I've had very few carbs and no sugary food. It seems that my sugars are spiking about 2-3 hours after I've eaten (and overnight, about 5-6 hours after food). I've been for a walk, but I can't work out what is sending them up. I'm tired and grumpy.

I switched from alogliptin to sitagliptin a couple of weeks ago and at first all was fine, but my sugars have crept up and not staying stable which makes me wonder if the sitagliptin is not working in the way that it should? I do have a review in a fortnight with a nurse so will keep a track, but it's very frustrating. I'm trying very hard to get my HBA1C down again, particularly as I am due surgery and they - rightly - won't do it while my sugar control is not good.

Any help, much appreciated.

Jane

 

[NotWorriedAtAll]

I have found that things other than diet and meds and exercise can have major impacts on blood sugar.
In my case sleep disruption and stress and anxiety.

I can eat, drink and exercise exactly the same on different days and my blood sugars will differ significantly if I do not get the same amount of sleep or if my sleep is not as peaceful or if I have a stressful situation or I am anxious about things.

Last year when I was worrying about my endometrial cancer diagnosis before my hysterectomy I was keeping meticulous records of blood sugars, ketone levels and what I was eating drinking and how much sleep I was getting and I was taking my blood pressure too. So I noticed that it was consistent for me over about six months that broken/poor sleep meant I had worse blood sugar levels irrespective of what I ate - I was doing 1 - 3 hours exercise each day and if I had had poor sleep and was feeling stressed then my blood sugars would rise after exercise instead of reducing. I had to combat that by exercising in ten minute intervals to help reduce my cortisol response to exercise as my anxiety/lack of sleep had already raised my cortisol levels.

I also found that I needed to do breathing/meditation exercises every day - sometimes multiple times a day to reduce my anxiety levels and bring my blood pressure down and when I did that my blood sugar levels improved.

I found soothing meditation style audiobooks on audible aimed at children were most effective for me as full on meditation doesn't suit my personality and I prefer visualising stories and having some breathing exercises inside those stories works better for me - a bit like hiding vegetables in stew I suppose.

Hope this is helpful.

 

[helli]

Have you checked your unexpected readings with a finger prick meter as recommended by Abbott (albeit in the small print)?

 

[JITR]

Maybe the other medications you mention in your profile are a factor. One for your doctors?

 

[Leadinglights]

Good afternoon,

I am struggling again. I'm not sure that what is happening is normal - I would be grateful if someone could help.

Attached is my sugars from today. I've had very few carbs and no sugary food. It seems that my sugars are spiking about 2-3 hours after I've eaten (and overnight, about 5-6 hours after food). I've been for a walk, but I can't work out what is sending them up. I'm tired and grumpy.

I switched from alogliptin to sitagliptin a couple of weeks ago and at first all was fine, but my sugars have crept up and not staying stable which makes me wonder if the sitagliptin is not working in the way that it should? I do have a review in a fortnight with a nurse so will keep a track, but it's very frustrating. I'm trying very hard to get my HBA1C down again, particularly as I am due surgery and they - rightly - won't do it while my sugar control is not good.

Any help, much appreciated.

Jane

Maybe keeping a food diary with an estimate of the carbs in your meals and you will have something to show at your appointment and your nurse/GP may then be able to judge if the medication is working.

 

[everydayupsanddowns]

Sorry to hear what a feustrating time you are having @Namaste

Do you think you may have reduced your carbohydrate intake too far and that your body might be dumping glucose as a response, and/or converting more proteins and fats in the absence of carbs.

What would you estimate your total daily carbohydrate intake to have been for the past few days?

I’ve seen a couple of threads recently where people have been similarly flummoxed and suggestions of very low carb intake associating with insulin resistance have been mentioned.

Slightly counterintuitive, but maybe modestly increasing slow acting carbs might help?

 

[Namaste]

Good morning, thank you for all the replies and support.

I have checked with a finger prick test and these read higher than the CGM :-(

I'm wondering if I'm not eating enough carbs. I estimate I've had 100g carbs a day at the moment, so will try upping this and monitoring. Liver dump of glucose seems likely.

The other meds are a pain but necessary for me to function, alas. They do have effects on sugars I know, particularly the mirtazapine, and I'm on maximum dosages but non-negotiable that I need to be on them.

I am trying to relax and I do love an audio book. Not sure if I'm feeling stressed, certainly a bit low, but not as anxious as I often do.

Will keep a track of carbs etc ready to show the nurse/GP.

THanks again for the help.

Jane

 

[everydayupsanddowns]

I'm wondering if I'm not eating enough carbs. I estimate I've had 100g carbs a day at the moment, so will try upping this and monitoring. Liver dump of glucose seems likely.

I think the tipping point was suggested to be less than 20-30g per meal where the liver might get a bit twitchy? And it looks like you might be above that.

 

[harbottle]

I’ve seen a couple of threads recently where people have been similarly flummoxed and suggestions of very low carb intake associating with insulin resistance have been mentioned.

Slightly counterintuitive, but maybe modestly increasing slow acting carbs might help?

The research I've seen onto this was for normal weight people with a low BMI and no diabetes:

Low carbohydrate intake correlates with trends of insulin resistance and metabolic acidosis in healthy lean individuals - PMC

Both obesity and a poor diet are considered major risk factors for triggering insulin resistance syndrome (IRS) and the development of type 2 diabetes mellitus (T2DM). Owing to the impact of low-carbohydrate diets, such as the keto diet and the ...

www.ncbi.nlm.nih.gov

However, low carb diet has also been seen to improve insulin sensitivity:

Effects of a low-carbohydrate diet on insulin-resistant dyslipoproteinemia—a randomized controlled feeding trial - PMC

Carbohydrate restriction shows promise for diabetes, but concerns regarding high saturated fat content of low-carbohydrate diets limit widespread adoption. This preplanned ancillary study aimed to determine how diets varying widely in carbohydrate ...

www.ncbi.nlm.nih.gov

 

[everydayupsanddowns]

The research I've seen onto this was for normal weight people with a low BMI and no diabetes:

Low carbohydrate intake correlates with trends of insulin resistance and metabolic acidosis in healthy lean individuals - PMC

Both obesity and a poor diet are considered major risk factors for triggering insulin resistance syndrome (IRS) and the development of type 2 diabetes mellitus (T2DM). Owing to the impact of low-carbohydrate diets, such as the keto diet and the ...

www.ncbi.nlm.nih.gov

However, low carb diet has also been seen to improve insulin sensitivity:

Effects of a low-carbohydrate diet on insulin-resistant dyslipoproteinemia—a randomized controlled feeding trial - PMC

Carbohydrate restriction shows promise for diabetes, but concerns regarding high saturated fat content of low-carbohydrate diets limit widespread adoption. This preplanned ancillary study aimed to determine how diets varying widely in carbohydrate ...

www.ncbi.nlm.nih.gov

I think @Inka has the sources for low carb’s association with insulin resistance, particularly in the presence of higher fat. But from reading experiences of various forum members over the years it seems to be one of those individual things - and it’s one of the reasons we always stress that there’s no “one size fits all” approach. Low carb works brilliantly for many here - but we have several members for whom it simply doesn’t perform as expected.

 

[JITR]

I switched from alogliptin to sitagliptin a couple of weeks ago and at first all was fine, but my sugars have crept up and not staying stable which makes me wonder if the sitagliptin is not working in the way that it should? I do have a review in a fortnight with a nurse so will keep a track, but it's very frustrating.

I'd ask your DN about switching away from sitagliptin. Vildagliptin may be better for you than sitagliptin according to Dr Google.

One example:
- https://link.springer.com/article/10.2165/11592490-000000000-00000

I'd also ask about other approaches to reducing your BG.

 

[harbottle]

Good afternoon,

I am struggling again. I'm not sure that what is happening is normal - I would be grateful if someone could help.

Attached is my sugars from today. I've had very few carbs and no sugary food. It seems that my sugars are spiking about 2-3 hours after I've eaten (and overnight, about 5-6 hours after food). I've been for a walk, but I can't work out what is sending them up. I'm tired and grumpy.

I switched from alogliptin to sitagliptin a couple of weeks ago and at first all was fine, but my sugars have crept up and not staying stable which makes me wonder if the sitagliptin is not working in the way that it should? I do have a review in a fortnight with a nurse so will keep a track, but it's very frustrating. I'm trying very hard to get my HBA1C down again, particularly as I am due surgery and they - rightly - won't do it while my sugar control is not good.

Any help, much appreciated.

Jane

Is that graph typical? It seems to baseline around 10-11, which is where the body starts to expel glucose in urine.
It looks like you're struggling to cope with the background glucose from the liver.

 

[JITR]

Is that graph typical? It seems to baseline around 10-11, which is where the body starts to expel glucose in urine.
It looks like you're struggling to cope with the background glucose from the liver.

That's a very good point.

I'd also ask about other approaches to reducing your BG.

Such as insulin and/or a medication review?

 

[Drummer]

@Namaste I eat under 40 gm of carbs a day to get normal numbers. I have quite a low tolerance for carbs - and your other medication might be putting a spanner in the works, but increasing intake to over 100gm a day might give little benefit.
When just starting out for remission I discovered that I was more insulin resistant in the morning than evening, so I divide my carbs into unequal amounts for different meals, no more than 10gm in a morning and the rest for the evening meal, though only on days when I have a dessert.
I am coming up to 8 years from diagnosis, so my metabolism has had time to sort itself out by now - you could very well be working on disposing of excess carbs rather than have settled into getting the benefits of low carb eating. Is your waist measurement comparatively large still? I have gone from ( ) to a more ) ( shape

 

[trophywench]

Pain on its own can easily cause blood glucose to increase - so yes - do try and get a medication review!

 

[Mickeyminime]

I was going through the same thing a while back, then i took 30 units of the slow for the day and i think it's had a side effect. Now i'm struggling to keep my levels up according to the sensor. When i lay down, it goes down fast for whatever reason. Because my levels go up and down fast randomly, when it's low, i'm now not taking any quick insulin if i eat anything. It's kinda made me very paranoid and all.

 

[benj84]

Hey all.. T1 since 2012.. I've tested my theory 2 times now spending around 4 months on each regime.. I now take only my rapid, I take 0 units of background and use my insulin like a pump essentially would, I increased my time spent in range by over 20 percent.. hba1c on blood test was 68 now 59 over 3 months.. ccg says its at 67 at the moment which is always out by 8-9.. I'm only spending 9 percent in what we know as Dawn experience and only waking up and injecting obviously stops it.. but is much easier to correct for knowing I have no background to adjust for. During the day if not eating carbs I'd take an injection around every 3-4 hours.. this has lowered my correction dose also over time.. I found my body takes around 4 days to reset.. I know we are all different but from my point of experience, background only makes my control worse.. horses for courses and all that.. peace and love all keep well and happy it all helps..