- advertisement -

Typical post meal spike w/CGM

Discussion in 'Parents of Children with Type 1' started by Megnyc, Mar 7, 2013.

?

"Typical" Post meal Spike (max bg value on cgm graph)

  1. 100-120

    0 vote(s)
    0.0%
  2. 120-140

    1 vote(s)
    5.6%
  3. 140-160

    4 vote(s)
    22.2%
  4. 160-180

    5 vote(s)
    27.8%
  5. 180-200

    4 vote(s)
    22.2%
  6. 200-250

    5 vote(s)
    27.8%
  7. 250-300

    0 vote(s)
    0.0%
  8. 300+

    1 vote(s)
    5.6%
Multiple votes are allowed.
  1. Megnyc

    Megnyc Approved members

    Joined:
    Nov 8, 2012
    Messages:
    1,373
    Hi all,

    I am looking to get some idea of what a typical post meal spike is for folks using a CGM. Assume for the sake of the poll this is a typical meal you eat with regard to carb count and you bolus as you usually do. I know it will be different for everyone and even individuals based on the meal and timing but I am just curious.

    Thanks! And let me know if you have questions (or have any genius ideas for getting reducing that spike :D)

    Edited: Also, I know this will clearly vary based on starting blood sugar. I would assume this is a meal eaten while blood sugar is between 70 and 130.
     
    Last edited: Mar 7, 2013
  2. cdninct

    cdninct Approved members

    Joined:
    Jul 29, 2011
    Messages:
    888
    I can't really check a box because there is almost no spike with lunch or dinner but there is often a large spike (into the 200s) with breakfast!
     
  3. mysweetwill

    mysweetwill Approved members

    Joined:
    Dec 10, 2011
    Messages:
    249
    Same here, we have a big breakfast spike, but a minimal lunch and dinner spike.
     
  4. TheFormerLantusFiend

    TheFormerLantusFiend Approved members

    Joined:
    Sep 10, 2006
    Messages:
    4,925
    I'm the one who voted 120-140. On my CGM the median spike is extremely small or nonexistant for breakfast, about a 20 mg/dl rise for supper, and usually a fall around lunch time.

    That's not to say that I never have spikes, but in terms of the 50th percentile, over the last nine months (the CGM data I can easily look at) the median rise for meals is 132 for breakfast, 126 for lunch, and 141 for supper.

    My tips? I dunno- break up a meal into two smaller meals if you are seeing a spike. If you have to, bag half your breakfast to eat it later. Over the summer I had a period where I was waking up with a dawn phenomenon at six am, injecting for the dawn phenomenon plus a little bit of breakfast then, going to prayers, and then my bg would be dropping when I injected for breakfast around eight. I stopped having a dawn phenomenon though (I seem to have it for a few months at a time and go months without seeing it).
     
  5. Megnyc

    Megnyc Approved members

    Joined:
    Nov 8, 2012
    Messages:
    1,373
    Thanks for the responses! It is interesting to see the variation. After a meal I usually go up to around 250 from 100 or so and then drop down to 120 within 90 minutes. I usually bolus about 5 minutes before eating using apidra. I would bolus earlier but I generally already have a dip to about 65-70 before going up and wouldn't want that to get any lower.

    The idea about splitting meals is a good one however, personally I don't find the number of carbs to really impact the spike. But I eat a pretty low carb high protein diet to begin with.
     
  6. mmgirls

    mmgirls Approved members

    Joined:
    Nov 28, 2008
    Messages:
    6,030
    so you give a 5minute prebolus dip down to 65-70 then go up to 250ish and are back down to 120 by 1.5hrs? what is your duration on Apidra? how much longer are you droping after 1.5hrs?
     
  7. TheFormerLantusFiend

    TheFormerLantusFiend Approved members

    Joined:
    Sep 10, 2006
    Messages:
    4,925
    I don't split meals to have smaller meals, I split meals so the insulin matches them. I take one shot for two meals, kinda- that way the insulin is kicking in hard enough for the first one.
    I eat a high carb, high protein, low fat diet.
     
  8. Megnyc

    Megnyc Approved members

    Joined:
    Nov 8, 2012
    Messages:
    1,373
    Let me give you today's numbers from my CGM. I was a bit high to start with though and this was a late lunch of 35 carbs. But you can see the initial 30 point drop then rapid rise and fall.

    3:40: 184 Bolus
    4:00: 151
    4:20: 191
    4:40: 258
    5:00: 149
    5:40: 134

    I attached a graph from today. I am only using the pump as a CGM right now and omnipod for insulin so you can't see where I bolused but it was the first peak to the right of the big peak.

    I have by duration set to 2 hours but I think it is actually about 90 minutes. I usually don't drop after 90 minutes.
     
  9. TheLegoRef

    TheLegoRef Approved members

    Joined:
    Nov 13, 2011
    Messages:
    328
    My DS will spike about 75-100 points from an average breakfast, so it's very important to us to keep him under 120 when he takes his first bite, or he will go over 200 at school. Sometimes, we have a very small spike (25-40 points). Last night at dinner he went from testing at 71 to 160's in an hour, I think because of the banana.
     
  10. mmgirls

    mmgirls Approved members

    Joined:
    Nov 28, 2008
    Messages:
    6,030
    well the picture is flipped and I am not familar enough with that CGM graph to be helpful.

    BUT, if your goal is to start a meal at a good bg and not dip to being low and spike I have a suggestion if your ending BG is where you want it to be.

    Combo out your bolus so you get less upfront and more hitting when your bg is spiking. You said you do a lower carb high protein meals so it makes sense that your bg is starting to spike an hour in but your insulin has already peaked; assuming your are right about your duration with Apidra being 90min.

    Or if your BG is great maybe try not prebolus because you are eating lower carb and high protein, might work out well for you.

    Can I ask what you I:C is?
     
  11. Megnyc

    Megnyc Approved members

    Joined:
    Nov 8, 2012
    Messages:
    1,373
    Thanks! I only posted the graph so you could see how brief the spike is. I am only above 200 for maybe 20-30 minutes but that rapid rise and fall 3-4 times a day can't be great for my body.

    Here are insulin to carb ratios:

    Night (10pm-7am): 1/40 carbs
    Morning (7am-11am): 1/24 carbs
    Afternoon (11am-5pm): 1/35 carbs
    Evening (5pm-10pm): 1/30 carbs

    I know they are low but since I am almost always in range within two hours of eating I think they are correct. My target is 100 during the day and 120 at night. CGM range is set for 80-150.

    I have been wondering about bolusing after eating or even in the middle of a meal. I may try this next week when life is a little less hectic. I usually do dual-wave boluses if there is a decent amount of fat in my food and that works really well. For example, I never spike with ice cream or pizza.
     

Share This Page

- advertisement -

  1. This site uses cookies to help personalise content, tailor your experience and to keep you logged in if you register.
    By continuing to use this site, you are consenting to our use of cookies.
    Dismiss Notice