What Happens When Your Blood Sugar Spikes – Self-management of diabetes > Diabetes management > Strike the Spike II: How to control high blood sugar after meals
Several years ago, I wrote an article on diabetes self-management about controlling high blood sugar after meals. It’s called “Strike the Spike” and no article I’ve ever written has received a greater response from readers. To this day, I still receive calls and emails thanking me for the practical answers to this puzzling challenge. I have even been asked to speak on this topic at several major conferences. So when I had a chance to look at the problem again, I jumped at the opportunity.
What Happens When Your Blood Sugar Spikes
A lot has changed in recent years: more than ever we know about the harmful effects of a spike in blood sugar after a meal, but we also have some powerful new tools and techniques. to prevent them. And now that I know how important this topic is to so many people, I will do my best to provide some answers.
Causes Of High Blood Sugar In People Without Diabetes
A postprandial spike, or “postprandial,” is a temporary high blood sugar that occurs shortly after eating. It is normal for blood sugar to rise by a small amount after eating, even in people without diabetes. However, if the gain is too high, it can affect your quality of life today and contribute to serious health problems later.
The reason blood sugar tends to rise after eating in many people with diabetes is a simple matter of timing. In a person without diabetes, eating foods containing carbohydrates causes two important reactions in the pancreas: the immediate release of insulin into the bloodstream and the release of a hormone called amylin. Insulin starts working almost immediately (to move glucose from the blood into cells) and gets its job done within minutes. Amylin prevents food from reaching the small intestine too quickly (where nutrients are absorbed into the bloodstream). As a result, once blood sugar starts to rise, insulin is there to sweep the incoming sugar into the body’s cells. In most cases, the rise in blood sugar after a meal is barely noticeable.
However, in people with diabetes, it’s like hitting a pitcher with very slow reflexes to a pitcher throwing a fast ball at 98 mph: time is up. -90 minutes to “peak” or peak, and four hours or more to get the job done. about three hours. ) Meanwhile, amylin is produced insufficiently or not at all, so the movement of food from the stomach to the intestines is not slowed down as usual. As a result, food is digested even faster than usual The combination of slower insulin and faster food can cause blood sugar levels to spike quite high soon after eating.
Although the postprandial rise in blood glucose is only temporary, several daily increases, day in and day out, can increase glycosylated hemoglobin, or HbA1c levels, and high HbA1c levels have been demonstrated. increases the risk of long-term diabetes complications.
The Relationship Between Low Blood Sugar And High Blood Pressure
Your HbA1c test results reflect your average blood glucose levels at all times of the day (before and after meals) for the past two to three months, with recent weeks affecting results more than weeks before. So, if your average pre-meal blood sugar was 130 mg/dL over a given three-month period and your post-meal average was 240 mg/dL, your HbA1c will probably reflect your level. the overall average is somewhere between those two numbers.
Interestingly, studies have shown that for people with HbA1c below 7.5%, the postprandial glycemic index has a greater effect on HbA1c than the pre-meal reading. In other words, skipping the pre-dinner readings will only get you so far. If you want your HbA1c level to be as close to normal as possible, you should also pay attention to your post-meal reading.
The long-term effects of high blood sugar after meals have been studied extensively. For people with type 1 diabetes, a significant postprandial increase has been shown to cause earlier kidney disease and accelerate the progression of existing retinopathy, a commonly associated eye problem. to diabetes. In people with type 2 diabetes, high blood sugar after meals is a risk factor for cardiovascular problems. More recently, glucose spikes after meals and “variants” have been linked to decreased brain function and increased risk of dementia.
But the problems are not limited to long-term complications. Whenever blood sugar is very high, even temporarily, quality of life is affected. Energy is reduced, brain function is impaired, physical and athletic abilities decrease, and mood changes. An Australian study of young people with type 1 diabetes found that short-term high blood sugar adversely affects thinking ability, coordination as well as emotions and mood. One study of people with type 2 diabetes found that sharp increases in blood sugar slowed mental performance, decreased attention, decreased energy levels, and led to feelings of sadness and stress.
How A Cgm Can Help You Find Your Optimal Diet And Lower Blood Sugar
And don’t forget: what goes up must come down. The rapid drop in blood sugar that usually rises after a meal can cause symptoms of false hypoglycemia. This is called “relative hypoglycemia.” A sharp drop from high blood sugar to normal can trick the brain into thinking there is a crisis and symptoms of low blood sugar are possible.
Also, the effects of postprandial high blood sugar don’t go away immediately once blood sugar returns to normal. Each episode of hyperglycemia can change the way certain genes work, leading to the production of harmful chemicals called free radicals, which cause inflammation and damage to the lining of blood vessels for hours, if I don’t mean days. So it is clear that postprandial spikes are a challenge worthy of attention.
The exact timing of a spike in blood sugar can vary from person to person and from meal to meal. On average, however, the post-meal peak tends to occur about an hour and 15 minutes after the meal begins. So testing your blood sugar (using a fingertip blood sample) about an hour after finishing a meal will provide a good indication of how much of a spike is occurring. Test before and after breakfast, lunch, and dinner several times to determine how much of a spike occurs after each of these meals. Usually, you’ll see a significant spike after breakfast, but check after each meal at least a few times to see what’s going on.
A better way to measure postprandial patterns is to use a continuous blood glucose monitor (CGM). These systems, available from Medtronic, Dexcom, Abbott, and Senseonics, provide blood glucose readings every few minutes, so you won’t miss a peak every time it happens. They also create trend charts that make it easy to see exactly what happens after a meal. See an example below:
Roller Coaster Effect (fluctuating Sugar Levels) In Diabetes
Personal CGM systems can be purchased for long-term or ongoing use. Some specialist diabetes centers offer them on a temporary loan basis just to know what’s going on with your blood sugar at any given time. CGM systems consist of a small disposable sensor wire placed just under the skin, a small transmitter that attaches to the sensor, and a receiver that displays your data. The receiver can be in the form of a handheld device, an insulin pump, a smartphone, or even a smartwatch. Data from all systems can be uploaded to the computer for information analysis purposes.
Whether you use fingers or CGM, when interpreting your numbers, consider readings before your meal. A high or low score before a meal often contributes to a higher score after a meal. For example, a pre-meal blood glucose level of 210 mg/dL followed by 240 mg/dL 1 hour after a meal shows only a 30-point increase, while a subsequent 110 mg/dL increase is 240 mg/dL . 130 points increase. Those lows before meals often affect digestion rates and can trigger a hormonal “rebound” to produce much higher results.
So exactly how much is too high after a meal? There is no general agreement on this matter. The American Diabetes Association recommends keeping blood sugar below 180 mg/dL one to two hours after starting a meal. The European Diabetes Policy Group recommends keeping the peak below 165 mg/dL and the American Society of Clinical Endocrinologists and the International Diabetes Federation recommend keeping it below 140 mg/dL after when eat. However, none of these groups provide specific guidelines for type 1 versus type 2 diabetes, insulin users versus nonusers, or children versus adults.
Based on my experience, I recommend post-meal goals for the following groups. These numbers are usually achievable, resulting in decent HbA1c levels,
Are Blood Sugar Spikes Bad?
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