Normal Glucose Reading 6 Weeks After Delivery
Good news! The diabetes world no longer revolves around the A1c. Fourth dimension-in-range and glucose variability play a much greater office. We also know more than always nigh the harmful effects of after-meal blood carbohydrate spikes.
What's a Blood Sugar Spike? And Why Do They Happen?
Postprandial spikes are temporary high blood sugars that occur soon after eating. Information technology is normal for the blood sugar to rise a minor corporeality after eating, even in people who practise not have diabetes. Still, if the spike is likewise high, information technology tin bear upon your quality of life today and contribute to serious health bug down the route.
The reason blood saccharide "spikes" is a uncomplicated affair of timing. In a non-diabetic, consumption of carbohydrate results in two important reactions: the immediate release of insulin into the bloodstream, and production of a hormone called amylin which keeps food from reaching the intestines too chop-chop. In well-nigh cases, the later on-meal blood sugar ascension is barely noticeable.
However, in people with diabetes, the situation is like a baseball game histrion with very ho-hum reflexes batting confronting a pitcher who throws 98 mph fastballs: the timing is not skilful. Rapid-acting insulin that is injected (or infused by a pump) at mealtimes takes approximately 15 minutes to offset working, 60-90 minutes to "superlative," and four hours or more to finish working. And don't forget almost the amylin hormone effect. In people with diabetes, amylin is either produced in insufficient amounts or not at all. As a result, food digests even faster than usual. The combination of slower insulin and faster food tin can cause blood sugar to rise absurdly loftier soon after eating. This is followed past a sharp drop once the mealtime insulin finally kicks in.
Why Are Claret Carbohydrate Spikes a Problem?
Fifty-fifty though the spike is temporary, all of those spikes throughout the day can raise your HbA1c. Research has shown that for those with an A1c below 7.5%, postal service-meal readings actually have a greater influence on A1c than fasting blood sugars. In other words, managing pre-meal readings will only go yous so far. If y'all want tight control, you need to pay attention to the after-meal glucose as well.
The long-term effects of postprandial hyperglycemia have been studied extensively. For those with type i diabetes, pregnant mail service-repast rises have been shown to produce before onset of kidney illness and accelerate the progression of existing eye issues (retinopathy). And like a dagger through the heart, post-meal hyperglycemia is an contained risk factor for cardiovascular problems. Recently, post-meal spikes and glucose variability have been associated with macerated brain function and an increased risk of dementia.
But the problems are not limited to long-term health issues. Any fourth dimension claret sugars rising particularly high, even temporarily, our quality of life suffers. Free energy decreases, cognitive (thinking) ability falters, physical/athletic abilities become diminished, and moods get altered. And don't forget: What goes up must come down. The rapid blood sugar decline that usually follows a postal service-meal fasten can cause false hypoglycemic symptoms.
Blood Sugar Measurement & Goals
The verbal timing of blood sugar spikes can vary from person to person and meal to repast. Yet, on boilerplate, the post-repast peaks tend to exist virtually one hr and xv minutes later starting a meal. But the best manner to measure post-meal patterns is by using a continuous glucose monitor (CGM). These systems, available from Medtronic, Dexcom, Abbott and Senseonics, provide glucose readings every couple of minutes and so you won't miss the elevation, whenever it happens to occur.
So exactly how loftier is TOO High? There is no universal answer. The American Diabetes Clan recommends keeping claret saccharide below 180 mg/dl 1-two hours after eating. However, no specific guidelines are provided for blazon-1 vs. type-2 diabetes, insulin users vs. non-insulin users, or children vs. adults.
Based on my experience, I usually recommend the following:
Post-meal readings that are consistently above these levels should be addressed past you and your healthcare squad (see strategies in the sections below).
How to Control a Claret Saccharide Spike
To reduce the spike, a number of strategies can exist used. Some involve medications while others involve our lifestyle choices. Hither are a few medical approaches:
ane. Choose the Right Insulin
The right insulin can make or suspension your ability to control those after-repast spikes. In general, insulin that works quickly and for a short period of time volition work better than those that work slowly over a long period of time.
For example, rapid-acting insulin analogs (Humalog, Novolog or Apidra) will cover the mail service-meal blood saccharide rise much better than regular insulin. Newer ultra-rapid insulins, such as Fiasp, work even faster.
The way insulin is administered can dramatically affect its speed of action. Afrezza is an inhaled insulin that tin be used at mealtimes. Because the dry pulverisation is absorbed through the lungs, its onset and peak are much earlier than injected insulin. For those who don't mind a twinge of pain, injecting insulin into muscle will also make it blot and act much quicker than injecting it into the fat layer below the skin.
Enquiry has as well shown that injected insulin can work much faster when the injection site is warmed by rubbing the site, immersing in warm water, or exercising the muscle most the site. Warming the site causes the blood vessels nearly the skin to dilate, which allows the insulin to blot more quickly. Past the style, smoking causes the blood vessels to constrict, and then quitting smoking might improve your post-meal claret sugar (in addition to helping you and those around you to live longer).
2. Back up Your Bolus
For those taking rapid-interim insulin at mealtimes, the timing of the injection (also chosen a "bolus") tin can take a huge affect on the subsequently-meal spikes. Unless yous suffer from gastroparesis, information technology is all-time to give boluses before eating. How long earlier? It depends. The college your blood saccharide, the earlier the bolus should exist given. With a pre-meal claret sugar that is well above-target, it is best to give the bolus and so wait 30 minutes before eating. Near your target blood sugar? Wait 15 minutes. Below target? Have the bolus and consume right away. Inquiry has shown that only giving mealtime boluses before eating rather than subsequently can reduce the post-meal spike by an average of 45 mg/dl.
3. Bolus for the Basal
In gild to have more than insulin working right afterwards eating and less working several hours later on, a pump user tin can run a substantial temporary basal reduction for 3 hours simply before eating and give a normal bolus equal to the basal insulin that would have been delivered. John Walsh, coauthor of the Pumping Insulin books, calls this a "Super Bolus". For example, if your basal rate in the morning is .half dozen units per hr, you could bolus an extra 1.8 units before breakfast and then set up a temp basal of 10% (90% reduction), for the side by side 3 hours.
4. Choose the Right Medication
Ii classes of injectable hormones, GLP-i receptor agonists and amylin mimetics, have powerful effects on post-repast blood saccharide. Both GLP-1s and Symlin slow gastric emptying and proceed carbohydrates from raising the blood sugar besides chop-chop afterward meals. Symlin, which is a replacement for the amylin hormone (which is lacking in people with diabetes), also helps to diminish appetite and blunt postal service-repast glucagon secretion. GLP-1s blunts appetite and promote the growth of insulin-producing cells in the pancreas of those with type-ii. So both tin can contribute to better post-repast blood carbohydrate control.
For type-2s, the choice of oral medication can likewise impact your after-meal control. Sulfonylureas stimulate the pancreas to secrete extra insulin throughout the solar day, without regard to repast timing. In that location are alternative medications chosen meglitinides which also stimulate the pancreas but do and then in a much faster and shorter mode. When taken at mealtimes, meglitinides produce meliorate after-meal command than sulfonylureas.
Lifestyle Approaches to Stop Blood Sugar Spikes
1. Recollect Lower GI
Glycemic Index (GI) refers to the speed with which food raises the blood sugar level. While all carbohydrates (except for fiber) convert into blood sugar eventually, some do so much faster than others.
Many starchy foods (breads, cereals, potatoes, rice) have a high GI; they digest easily and convert into blood sugar rapidly. Some starchy foods (pasta, beans, peas) take lower GI values. Foods that have dextrose in them tend to have a very high GI. Table sugar (sucrose) and fructose (fruit saccharide) accept moderate GI values, while lactose (milk sugar) is slower to raise blood saccharide. A number of books, such as Dr. Jennie Brand-Miller's Glucose Revolution serial, contain extensive information nearly the glycemic index, along with lists of GI values for hundreds of foods.
As a general dominion, switching to lower-GI foods will help to reduce your subsequently-meal blood sugar spikes.
Below are some examples of ways to substitute typical loftier-GI foods for lower-GI options:
Some other unique food property that affects rate of digestion is acidity. This is why sourdough bread has a much lower GI value than regular bread. Enquiry has shown that calculation acerbity in the class of vinegar (straight or in dressing/additive form) can reduce the ane-60 minutes post-meal blood carbohydrate rise past l% or more.
ii. Separate Your Meal
When having a full repast or big snack, consider saving a portion for one or two hours later. Still give the full mealtime insulin before eating any of the meal; merely don't eat all of the food at one time. For example, if you have a bowl of cereal and juice for breakfast, considering having the cereal at breakfast time, and postpone the juice until mid-morning.
3. Get Moving
Physical activity afterwards eating can reduce post-repast spikes by diverting claret menstruum away from the intestines, resulting in slower absorption of sugars into the bloodstream. Plus, the sugar that does enter the bloodstream is likely to be "consumed" by the working muscles. It doesn't take much activity: Ten or fifteen minutes (or more) of mild activity will ordinarily get the chore done. The central is to avoid sitting for extended periods of time after eating.
4. Prevent Hypoglycemia
Depression blood saccharide is problematic in many means. One of the torso's typical responses to hypoglycemia is accelerated gastric emptying: food digests and raises blood sugar fifty-fifty more quickly than usual. Prevention of hypoglycemia prior to meals and snacks is all the same another constructive strategy for controlling post-meal blood sugars.
Gary Scheiner MS, CDE is Owner and Clinical Manager of Integrated Diabetes Services, a private exercise specializing in intensive insulin therapy. He is author of several books, including Call up Like A Pancreas: A Practical Guide to Managing Diabetes With Insulin, and was named 2014 Diabetes Educator of the Year by the American Clan of Diabetes Educators. Gary has had Type-1 diabetes for 34 years. He and his squad of Certified Diabetes Educators consult with people throughout the world via phone and the internet. He can exist reached at gary@integrateddiabetes.com, or +1 610-642-6055.
Source: https://tcoyd.org/2019/10/strike-the-spike-controlling-blood-sugars-after-eating/
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