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PatriciaJ

Spikes

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PatriciaJ

What exactly do people mean by "spikes"? Anyone's blood sugar would rise after eating something. So does spike mean any number over 140 @ 1-2-3-4 hours?

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jwags

Lots of things cause spikes. I will spike from 94 to 140-160 if I don't eat breakfast right away. IF I eat breakfast I will spike from 94-160-170 that first hour but will be under 140 by the second hour.

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Fraser

For me I concidered a rise of 30 from before eating to anytime after a spike so before dinner I usually 90 so keep the rise to under

120.

 

Example today. Out of bed 103 one hour after breakfast 119. To me that would

Be acceptable.

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meyery2k

In these posts, a spike would be defined as an unacceptable rise in glucose.  Yes, after you eat, some increase is expected.  Through testing, you will discover how this works with specific types and quantities of foods.

 

My own personal "goals".  I don't like to go over 120 ever.  Through testing over the year and using the data from A1Cs, I estimate my basal glucose rate to be 85.  This is somewhat of a number I just came up with because it is easy to remember and my random testing is somewhere in that area.  My A1c is below 5 so that would also support this number.

 

So, in my definition, a spike would be anything that causes a 35 point rise when testing 2 hours after eating.  Rice and bread are guaranteed to do this so I stay away from them. 

 

I use the 35 point marker vs. the end result as my guide.  For example, this morning I tested at 73.  If I ate toast and went to 119, it could be argued that I stayed under 120 and didn't spike but my OCD won't allow this.  This would be a 46 point spike which I don't want to do AND I know it would be avoided by not eating toast.  Lower fasting numbers in the morning are good but I wouldn't necessarily use them as a "free" pass.

 

Keep up with the questions! ~ Mike

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Kit

There are actually two common uses for the term spike.

 

The most common is a large jump in BG levels.

The second is the highest point after a meal.

 

I personally prefer to never go above 120.  By 4 hours I expect to be well back under 100 (preferably in the 80s).

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samuraiguy

A medical spike is defined as blood glucose rising over 160 mg/dl or 80 points over premeal levels whichever is lower, i.e. If your premeal was 75 mg/dl and you rise to 155 mg/dl it is still a spike despite being lower than 160 mg/dl.

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PatriciaJ

Thanx for all your replies, but I'm still not clear on what exactly qualifies as a "spike". 

What is the number to consider as the maximum limit after a meal?

How do you identify the food item that contributed to a high number? 

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Kit

A general guideline for an A1C of under 6.0.

 

Under 100 fasting or before meals.

Under 140 at 1 hour

Under 120 at 2 hours

 

 

However, normal non diabetic is an A1C range between 4.0 and 5.6.  My personal hoals are to get as close to non diabetic numbers as possible.  So my personal goals

 

Before meals and fasting:  Under 100

Under 120 at 1 hour

Under 100 at 2 hours (and remain there until the next meal).

 

I don't always manage those goals, but I hit them most of the time.  This has given me an A1C of 5.1/5.2 for the last 2.5 years.

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PatriciaJ

Hi Kit, Thank you for your reply. It seems easy to understand better about what the guidelines are for pre and post meals as I wondered about the desirable maximum after meals. I'm not sure what personal goals would be appropriate in my case. I'm not on any medications.. My doctor told me to control my pre-diabetes with diet and lots of exercise. 

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Fraser

Ok then take my goals and guidelines, which are pretty much the same as Kits. I control my T2 with diet and exercise only.

As to identifying food items that make you spike you test before and after you eat.

I am not sure there is anymore information out there for you

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Kit

Hi Kit, Thank you for your reply. It seems easy to understand better about what the guidelines are for pre and post meals as I wondered about the desirable maximum after meals. I'm not sure what personal goals would be appropriate in my case. I'm not on any medications.. My doctor told me to control my pre-diabetes with diet and lots of exercise. 

 

That's where monitoring comes in.  Testing yourself before (your baseline) and after meals gives you a pretty good idea of how you are doing with your diet and exercise goals.  Once you have your targets, its then a case of seeing how those lifestyle changes affect your nubers and get you into the range you desire.

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meyery2k

Patricia - I believe many of us figured out our goals based upon seeing what others have done and then seeing if they could achieve those goals using medicine, diet, exercise, insulin, etc...

 

Unfortunately, diabetes only covers a clinical description of too much glucose in the blood.  There are many, many reasons for this.  Diabetes and pre-diabetes is very much a condition that is managed via putting an idea into practice and then observing the results of said practice.

 

In general you have been told that lowering your carbohydrate intake will likely result in lower glucose in your blood.  The most hardcore way to get on top of this would be to eliminate all the starches and sugars and concentrate on your carbs only coming from non root vegetables.  This will help you figure out a baseline.  Once that is established, you can then try some things and see what the affect is.  If the effects are within the targets you have set for yourself, then there is nothing wrong with that.

 

In time, and via testing, I have found I can eat potatoes, beans, and berries in reasonable quantity.  Initially, potatoes would be something I would avoid.  I have also found that bread and rice will spike me so I avoid those.

 

I actually used Kit's and Fraser's target to help develop my own and I think that might be as good a starting place as any.

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scribner

Patricia1 - Diabetes is a condition that varies widely from one individual to another. So rather than rely on the experience and advice of others, it may be better to first test yourself.

        Since you aren't apparently taking medication, try testing your blood sugar every two hours on a day you eat normally, then again on a day you eat nothing and drink only water. Try to keep your activity level similar both days.

        Then you will see first-hand how your body reacts to what you eat as well as the natural ebb and flow of your blood glucose. Then, with that information, you can more easily figure out what is best for you.

        Relying on the advice and assumptions of well-meaning strangers - or even medical professionals - can be a risky proposition.

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PatriciaJ

Sorry, I'm still not crystal clear on what spiking means. From what you all wrote, I guess baseline is the number just prior to eating a meal. But exactly how does one set an individual goal or target to a specific number?  I won't ask anymore questions about spiking, but will read and reread what you all wrote hoping to understand, lol.

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meyery2k

Patricia - The best answer I can give would be to determine how tightly you want to control your diabetes and then try to follow the recommendations given to see if you can achieve your target.  You would then make adjustments based upon your findings. 

 

I have found that really managing diabetes depends more upon how I want to do it vs. following others.  I certainly have taken advice from people here but have adapted it to follow a plan that usually results in the numbers I like to see and be something I can realistically do for the rest of my life.

 

Diabetes is definitely a long vision game.  If I concentrated on the day to day small details, I would go nuts.  Especially the fasting readings.  I used to get upset when I would be in the 90's for no discernible reason.  I now accept that this is how it sometimes works.  I am then happy to be under 100 and my A1C supports that I am doing the right things over the long haul.

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PatriciaJ

@meyery

Is 35 points above the fasting number (after a meal) a good rule of thumb? 

I guess knowing how to set an idividual "target goal" is my concern.

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meyery2k

For me, personally....

 

I know through testing that I usually run around 80-90 throughout the day so I arbitrarily call my basal rate 85.  No scientific basis for this except my own observation.  My A1C would support this number.  I have no idea what my true basal is but I think this figure is "good enough"

 

Early on I set a goal of not going over 120 when testing 2 hours after eating.  Again, no scientific reason behind this.  I saw other posts where other people set that as a goal.  My reasoning is that if 140 is considered a toxic level then I would want to stay below that with a bit of a safety margin. 

 

Through testing, again, I found I could do this in a way that I could live with in the long term.  I have developed a way of eating that I enjoy and an exercise regimen that allows me to meet my goals.

 

Once in a while, I do go over 140 if I celebrate or take a day off from diabetes.  Most recently, Thanksgiving, when I had a turkey dinner with all the trimmings.  The next day, back to my daily living.

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Kit

@meyery

Is 35 points above the fasting number (after a meal) a good rule of thumb? 

I guess knowing how to set an idividual "target goal" is my concern.

 

Ok, the ultimate goal here is no minimize or eliminate the chance of complications due to diabetes.  In my opinion, the best way to do this is to keep your blood glucose levels to non diabetic levels.  Sounds all well and good, right?

 

However, there is currently debate on what non diabetic numbers actually are.  Some people say that a non diabetic person will spike to levels like 180 after a meal with a lot of fast carbs.  Some people claim that they won't and the people we see doing that are already starting to suffer from insulin resistance, etc.

 

Some people say an A1C of under 6 is perfectly fine.  Some people like to keep it within the normal range specified on our labs (4.0 - 5.6).  Some people say that anything under 6.5 is fine as you have already drastically reduced your risk factors.  Some people say that people who aren't dealing with insulin resistance will have an A1C in the 4s (Dr Bernstein).  The ADA recommends an A1C of 7.  (We can cover my opinion of the ADA at another time.)

 

So we can't answer your question because these are YOUR personal goals.  Not mine.  Not Mike's.  Not your doctor or the ADA.  They are strictly your own.  I can give you my personal opinion, but it is just my opinion.

 

I personally have a family chock full of diabetics suffering from various complications.  This is a path I do not want to go down.  So I tend to lean towards a more strict control level.  I see it as better safe than sorry.  I like my eyes and vision.  I like my kidneys.  I do not want to spend 10 hours a night hooked up to a machine.  (My brother is blind and on dialysis.)  I like not having pain and numbness in my feet and legs.  So, we come round again to the ultimate goal.  Minimize or avoid complications due to diabetes.

 

And no, being 35 points above my pre on a 2 hour post is utterly unacceptable in my eyes.  My max acceptable range is 20 and to be honest I am happier if its under 10 and thrilled if its within about 5 points.

 

But then, that's my target.  How did I choose that target?  I witnessed a brother going blind, diagnosed with kidney disease.  Watched his struggles, his additional dietary restrictions, eventually going on dialysis, etc.  I looked at what my family members did or did not do with their treatment.  I read the literature, the different arguments, and made my decision from there.

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PatriciaJ

I'm finding that my pre lunch and dinner numbers are 104 -115. I think it's because I drink a cup or two of decaf coffee with a tablespoon of Hazelnut creamer between meals. The creamer contains 5 grams of carbohydrate sugar per tablespoon. I think the pre meal number would be lower if I only drink water or a sugar free diet soda. I'm going to test that tomorrow. I love the coffee with the creamer, so what else can I do? I don't want to eliminate it all together.. :o I'm at home on the computer quite often and enjoy wetting my whistle between meals!!

 

Should the pre meal number always be close to the fasting number? How can that be achieved if you have a drink or a snack between meals??

 

Sorry for all silly questions. I feel like a kindergartner just learning how to count or spell, lol.

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Kit

For creamer, look into Davinci SF Hazelnut syrup with a little bit of heavy whipping cream.  Torani also has a SF Hazelnut syrup.  Could also replace the heavy whipping cream with half and half or something like almond milk.  But I like the no carb option the HWC gives and I'm always looking for ways to add a little more fat in my diet.  That said, I prefer my coffee and tea plain with nothing in then.  :)

 

Yes, IMO pre meals should be close to my morning fasting (and sometimes even lower depending on dawn phenomena).  I personally rarely snack.  If I have one, its maybe a small piece of cheese or a few nuts in the afternoon and its usually because of a rather large gap between lunch and dinner (7-8 hours).  I find that I'm just not interested in snacks and feel they are more a sign of boredom than actual hunger.

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meyery2k

Patricia, it is good to see you asking questions. It means you take this seriously. Testing will validate your hypothesis.

 

For your coffee you might find heavy whipping cream and sugar free hazelnut syrup will work. Another possibility could be hazelnut flavored coffee with cream and sweetener. I often find a small amount of vanilla extract helps flavor these.

 

While it may be a bit of a search, Torani and Da Vinci make a wide variety of sugar free syrups.

 

Hawaii has a limited variety so I buy flavored coffee and work with that when I need my frou frou coffee.

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