Post-Meal High Blood Sugars: How to “Strike the Spike”!
Вставка
- Опубліковано 26 сер 2024
- One of the most frustrating issues for people living with diabetes is dealing with the post-meal blood sugar spike. Drs. E + P offer nutritional strategies, medication options, insulin timing advice and CGM tips they personally use to strike the post-meal spike.
For more info on Afrezza and how to use it:
afrezza.com
For more info on Fiasp:
www.mynovoinsu...
For more info on Lyumjev:
www.lyumjev.com/
We've got tons of other great resources on how to live a long and healthy life with diabetes:
Website: tcoyd.org
Blog: tcoyd.org/blog/
Instagram: / tcoyd
Facebook: / tcoyd
Twitter: / tcoyd
Stay connected!
Sign up for our free monthly e-newsletter here:
bit.ly/3xdqUJ6
T1D Facebook group: / 52436. .
T2D Facebook group: / 38014. .
Facebook group for family and friends of people living with diabetes: / 37586. .
Please consider helping TCOYD continue to improve the lives of those living with diabetes by supporting our educational programs: tcoyd.org/donate
The information contained in or provided through TCOYD content is for purposes of general consumer education only, and though it is professional medical advice, always consult your doctor for medical diagnosis and treatment. The use of this information is your full responsibility with the understanding and agreement that TCOYD is not liable for claim, loss, or damage occurring as a result of its use.
![Lp. Сердце Вселенной #1 НАЧАЛО ПУТЕШЕСТВИЯ [Новый сезон] • Майнкрафт](http://i.ytimg.com/vi/380Q7gLWGvk/mqdefault.jpg)
Two comments:
1. If you show a spike almost daily at the same time after a meal (and you know your basals are good), you might adjust your carb/insulin ratio. Carefully!
2. Some of us react to insulin more slowly than most people. I find it generally works well to take my bolus ~half an hour before a meal, unless I'm trending down or am low already.
--Keith
T1 for 61 years; last A1c 6.2 (but I do have a slight late-morning spike issue I'm working on :-)
With regard to your first comment…yes that’s true, though it is tough to be that consistent. Agree on #2, and congrats on 61 years and awesome A1c!
Thanks, guys! I can only wish my A1c was a 6.7...I will keep trying and watching your videos is a good start. Type 1 for 27 years
Thanks Forest, glad to have you as part of the TCOYD community. Hope to see you at our next virtual conference on June 18th!
Great tip!!! Dr suggested I start 15 minutes prior to each meal to help with that spike. I am a type 1 on an insulin pump.
That's a good place to start.
Great video !! Another day of learning
Glad you enjoyed it!
Thank you! Great information! So practical. Ready to put into practice...
Lyumjev and a cgm have helped me so much. I love that insulin. Sometimes, it makes me feel almost normal.
That's great - we are "almost normal" over here too. :)
Good video thanks. Having cancer along with diabetes and the cancer drugs constantly throwing my sugars high and low it’s quite the challenge to maintain normal ranges. Ugh.
That's a whole other challenge for sure. Hang in there.
If it doesn't 'fill you up' dont add rice back, add more protein foods. Protein is the macronutrient most responsible for satiety.
I like the tip to set my CGM alert at 150. I have it set at 200 but I'm going to change it to 150. Makes sense to me! Thanks
Hope it works well for you, Forest!
This was very helpful! Thank you! I spike particularly after dinner. My fasting BS is higher than at HS?!
Timing is so important! Some extra nuances I might add, is that it's important to know where bg is trending and what the current levels are. So for my son, if he is 80-95 range and trending down a bit, if I wait longer than 10 minutes (on NovoLog), he is definitely going to go hypoglycemic while he is eating. However, if he is >130 and trending up a bit, I definitely give it at least 15 minutes or when I see it start coming down. Also, sometimes he crashes down right before dinner. I try to even him out but not overcorrect with carbs before bolusing as much as I can. Or he might be a bit high so I'll do a correction 45 minutes before a meal.
With kids it's difficult as well because you don't know exactly how much they're going to eat after everything, especially when going out for dinner with new foods. For this, I usually do a pre-bolus of carbs I at least KNOW he is going to eat to prevent an early high (usually 1/2 total carb count). Then just keep doing 1 or 2 more chunks of bolus as needed throughout the meal. If we weren't perfect, that's OK because then it's high basal and/or trampoline for highs or sweet candy time for lows :D
Important stuff Jay, thanks! Love "sweet candy time"!
I get spikes when I eat but then my b/g goes down shortly after within 15-30 minutes. The highest being 10 and I'm on Ozempic as I am Type 2 . I like to see a more steady reading without those high spikes. Very frustrating.
I really like your advice about lowering the alert to 150. It is a game changer. But I do have one issue which is that I'll go to 150, take a little more insulin (not too much considering I have IOB) but then I might spike an hour later to 170 or 180 and stay high but not get any alerts! Once it alerts at 150 it wont alert if I keep going high. Normally this wouldnt be a problem because I am constantly checking my numbers but this happened during the night when I woke up the next morning and realized I was high for several hours and got no alert.
Put the repeat high on! Make it an hour or two hours…whatever you like. I personally use my phone, but I also carry my Dexcom reader, because sometimes I like to look at it in meetings or when I’m on my bike. It’s easier because I don’t have to unlock my phone, and the high alert setting on my reader is set at 180, and the high alert on my phone is set at 150.
How do the corrections at 150ish work on mdi? I'm brand new to all this and my endo said to not inject within 2 hours of the last injection. So if I'm spiking up an hour after eating, how does it work? BTW, I love this channel!
Corrections work the same on MDI as they do on pumps. What your endo said is a very cautious thing to say, but the answer is that it really depends on your level of glucose, and your trend arrow. So if your blood sugar is 250 with a trend arrow going straight up one hour after eating, and assuming you bloused, you need more insulin! The higher your blood sugar and the faster it’s rising, the more insulin you need. And btw, you can always keep an eye on it on the way down. Be prepared that if you overdid it that’s fine, but at least you get it down quickly.
This is the BEST
You're the best!!
If you want a headach, contact me : got spikes 2hrs after meal, sometimes 10mn after - So even when I think I did well... I got wrong 2 or 3hrs later (and without pizza or very rich or fatty things, but even with lentils :p) It seems to be more less random.
I really appreciate your approach about pre-bolusing. With insulin like Humalog or Novorapid it seems to work pretty well, but with the next-gen ultra fast acting insulin, we should be able to bolus right in front of the plate (for most of the meal : excluding pizza, bugers, tacos...)
Something that seems to be working as well is to inject a fraction of your total dose 10 to 20mn before the meal, and then the rest of it in front of your plate to create a synergy.
Fiasp is not allowed yet to be used in a close-loop system (t:slim + dexcom) in France...
Great video as usual, please keep doing it I think more and more people should behave just like you do with diabetes : making it fun and turn it to a challenge !
💪💪💪
Thanks! Any suggestions for another challenge??
You can probably do extended bolus
@@TCOYDtv Watching you guys on a giant trampoline together would be highly entertaining. XD
@@jasonnov118 Ha! Great idea!
@@leahsaks I did, and the problem is : if I do 50% right at the lunch and 50% during 1hrs (for example) I’ll be too high the fist hour as there’s not enough insulin kicking - still trying to figure out, but I think a good approach is to adapt depending of the meal and the index of the food
What about Symlin? It definitely reduces the spike (maybe too much, eh?)
We do mention Symlin in our written article on the same topic here, under "Choose the Right Medication":
tcoyd.org/2019/10/strike-the-spike-controlling-blood-sugars-after-eating/
carb 30g per meal is too much.
Why is low-carb automatically atkins? Aren't you throwing out the baby with the bath water? Would you be doing a disservice to those diabetics you claim to help?
It's not. If you go back and listen to what Dr. Edelman says, he suggests people consider substituting higher carb foods they like with lower carb options when possible, as one way to combat post-meal blood sugar spikes.