Why?????

[Lil Liz E]

OK so I am pretty plain I eat the same things pretty much everyday through the week. Breakfast, snacks and lunch are always the same. I enjoy it though.
Anyway to the point. WHY is it that somedays after eating lunch my BS can go up 4.0/mmol. I mean I am still in range but it just erks me. 50% of the time it goes up that much other days I get OK results after lunch. (2 hrs later)
Lunch always consists of cut up cucumber, green pepers, broccoli (about a 1/4 c of each probably less) and 3 mini pickles. Two slices of low carb bread (12g total with 4 of them being fiber) and I do indulge a little bit with maybe a rice cake or something sweet around 10 carbs.
Weekends I always eat different stuff for lunch and have fine results.
However I have been noticing that if I have a hypo before lunch it tends to (but not always) go higher than I would like.
Today I was 3.0 before lunch. No idea why!! :( and 2 hrs after I was 7.0. What the heck is going on? Could I be getting some sort of liver dump? I don't know what is going on. This has just started happening over the last 3 months or so always good before.
Just frustrated.

[sarahspins]

With a 3 (54mg/dl) it's possible that you had some degree of rebound high... I know that wearing a CGM has shown me that often what I would attribute to being random IR is in reality, often a subtle rebound from a moderate low (in the low 50's) that I wasn't even aware I was having...

[Gordonm]

When you figure that out let everyone know. I have been at this for 35 years now and sometimes it just goes to strange levels for no reason. I have the CGMS on most of the time and I still cannot explain why it does this. I do not low carb at all and for the most part am in very good control with A1Cs in the 6.0 range so I just do the best I can every day and correct when needed.

[Subby]

So you seem to be talking specifically about high BGs after lunch, right?

Options I can see:
- your lunch I:C needs adjusting
- you need to start experimenting with pre-bolusing
-your basal insulin is insufficient at that time, exacerbating bolus issues (I have very extreme aftenoon basal spikes: metformin has been helping a lot)
-you may be picking relatively low spiking foods as far as you know, but maybe you need to reassess the particular foods.

Id do some basal testing, to sort out if there are underlying problems. Try and fix if needs be. Then start to change the parameters of the food/bolus event.

[TommyC1]

Unfortunately there are a few other things besides what you eat and the insulin you take that govern your BS numbers.

Your liver adds glucose into your blood. Sometimes because it thinks you are low, sometimes due to stress or illness and sometimes for no apparent reason.
Exercise can have a major impact on BS, both what you are currently doing and what you have done even as much as several days before.
Pancreas function can be erratic in newer diabetics.

All you can do is try to stay with it and try not to let it make you crazy.

[kgm0612]

I basically eat the same food items every day too and find that no two days are ever the same when it comes to test results! LOL

Karen

[xMenace]

I see a couple of possible things at work here.

You mention hypos before lunch. Rebounds can send you high. Have you basal tested? I have and I still got them too. I had to cut back my morning basals a bit to even em out a bit. I attribute the hypo to my high I:C ratio at breakfast. By the time lunch approaches, my trailing insulin is at a higher dose than needed for my lower I:C at lunch. Any way, cutting my morning basals a smidgen did the trick.

The incretin process plays havoc with me. That's when you consume food and your body releases glucagon. It's Dr. Bernstein's "Chinese Restaurant Effect." I have a big response at lunch, but it seems to vary based on my breakfasts. If I eat a large breakfast, I seem to have a small response at lunch, but if I eat a small one, I have a larger response. If I skip breaky, I need to up my lunch bolus to 2.5 times normal!

[Lil Liz E]

Thanks everyone.
Yes I suppose it is one of the many unfortunate things about diabetes we have to deal with. It is just frustrating as &*^%
I never had a problem after lunch 3 months ago. Weekends I eat different stuff and don't have a problem. Maybe it's work!!! Would this be a good excuse to use??? :) I can't work afternoons anymore they wreak havok on my BS.

[Subby]

Would this be a good excuse to use??? :) I can't work afternoons anymore they wreak havok on my BS.

Well, yeah, I think it is. In fact, I quit a certain job for that very reason. Not that I was particularly attached to it... but I certainly learnt that a stressful IT office scenario dealing with the likes of customers and annoyed clients, (it wasn't a very good IT company) sitting on my bum most of the time, meant was impossible for me to keep good BGs. I might have a little more luck now with the pump and tactics I have leaned... but I doubt I could deal with it very satisfactorily.

[lark 27]

The part that amazes me the most about your post is:
"and I do indulge a little bit with maybe a rice cake or something sweet around 10 carbs."

I can in no way figure out how a rice cake is an indulgence! :) Those things are nasty! Actually good for you at finding an indulgence in what for me would be healthfood!

[Subby]

Heh, that's a funny post Lark.

I have to say rice cakes and similar ricey processed foods are not health foods at all for me, spike me terribly that no insulin will keep up with. And, I think they have a high "official" GI as well! Mind you, 10g is probably not going to do much to me...

[It Ain't Over]

I went through all of the above for years. Found the solution. Don't want to bring in the low carb again, but hey it has eliminated those hi sessions after breakfast, or lunch, or dinner, or in the middle of the night. I hated them and don't miss them now.
Would recommend it to anyone. Just learn to eat a lot less carbs.
By the way, this is my 11th day on the CGMS (same sensor at that) and I am seeing what Sarah and Gordon mentioned, just not those huge jumps. Still the bg's will just go thier own way whenever a whim gets to them.

[Lil Liz E]

I love rice cakes...especially the caramel, chocolate caramel and the apple ones. I can't do the plain...but I know many who agree with you on your dislike for them. :)
I am trying to do my best to low carb but I love them way too much...I have gone from 300+/day to 120-130. I think that's pretty good for me. Not only has lowering my intake lead to much better control (with weekday lunches the only exception) I have been able to lose 45 lbs between low carb and a lot of exercise.
I don't think I could cope with any less carbs.