Sudden Spike in blood sugar

[mmissanne]

I am Type 1. My regimen is humalog and lantus. My insulin to carb ratio (I/O) is 1 to 10. I am counting carbs for my humalog doses. I have managed to avoided hyper and hypo for 4 weeks consecutively. Yeah!; however, today for breakfast; I ate 1 serving of grits, = (29 carbs) and 1 cup of 2% milk, = (13 carbs), and 4 sausage links = (0 carbs) totaling 42 carbs. My pre-BS was 101 so I took 4 units of humalog to cover. I tested 1 hour after eating and my BS was 222. I usually don't check BS until 2 hours after eating but I was feeling extremly tired so I tested earlier today.

Any logical reasoning to this sudden spike?

[Subby]

Did you check at 2 hours as well? Have you had this exact meal and bolus much before? If so, what results do you normally get?

[mmissanne]

Hi Subby,
I ate at 12 pm pre- BS (101). Checked at 1:15 pm. post (222). Re-checked at 3p (143). I don't usually check 1 hour after a meal; I normally check two hours after but today I felt tired so I checked earlier. Proir to today I haven't seen anything over 160 two hours after a meal within the last 4 weeks.

[Subby]

OK, so this meal may well have been below 160, or close to, at the 2 hour mark. We just can't say.

It's not surprising to get a bigger spike at 1 hour than 2 hour, especially with a moderate-high amount of carbs like this. So the actual trend doesn't seem wrong. The actual numbers obviously are not great and do suggest you could get things much improved.

So first, there's the question if something different or strange went on. Apart from feeling tired this time, there's no evidence that you DON'T normally spike something like this at 1 hour, given this breakfast. I'd take strong note of this, and next time you eat this meal, test at 1 hour and 2 hours to see if the trend is confirmed.

Second, in the event that it's not a random or freak occurrence, you'd do well to do something about such a 1 hour spike and also try and get 2 hour readings down as well. Things to try could be:

- increasing your I:C ratio
- prebolusing 10 or 20 minutes before the meal (carefully)
- changing the food for something else
- decreasing the amount of carbs overall, aiming for a lighter-carb breakfast

good luck.

[jenb]

Mmissanne: Checking after 1 hour is great - that's just about when you hit your peak glucose level after a meal, and it can be shocking if you've eaten a lot of carbs. As you can see, those 42 carbs, even with your Humalog, cause a pretty high spike. You might try reducing the carb load a little by reducing your portion, or eliminating the grits altogether and going with a nice big salad. You can eat a TON of vegetables and have a much lower carb load.

Don't panic over those high numbers an hour after eating - just make the knowledge work for you...it will inform you about changes you need to make in your food choices.

Jen

[foxl]

I gotta ask ... do you regularly eat grits?

Cause they absolutely skyrocketed my BS. I had to throw a box away! I was soooo disappointed!

[mmissanne]

Hi Foxl,
I don't eat grits on a regular;however, I have eating them at least twice with thirty days. During those occasions I did not notice any spikes. The difference is I did not test after 1 hour, instead I've tested after 2 hours. Maybe it spiked during those occasion but because I didn't check at the 1 hour point it is possible that I've missed the spikes. I have to wonder if I am spiking more often without realizing it. I guess my next A1c will reveal that.
Thanks!

[mmissanne]

Thanks for all of your replies. I am going to test 1 hour after my meals today to see if I have been spiking that this on a regular. If so; I will be very disappointed :(

[jenb]

Don't be disappointed. It's just reality. As I said before, you can use the information to change your food choices, or not use it and not be doing all you can to gain control. There is a real payoff for diabetics who make use of the information they garner about their physiological reactions to food. It's a fascinating process (frustrating too, sometimes) and I hope you'll join the cast of characters here who have really "bellied up to the bar" and taken action:D!

Have a great Memorial Day weekend.

Jen