Frustrated by high blood glucose levels after meals? Want to get your glucose levels under better control? Read on…
It is normal for the level of glucose to rise after you have something to eat, even in people who don’t have diabetes, but the rise tends to be small. If you are reading this I am sure I don’t need to tell you that having diabetes means your blood sugar can shoot up after meals and having a high blood glucose level can have a big impact on how you feel today. It can also contribute to your risk of long term health problems in the years to come. The trick to feeling your best, and staying health in the future, is to recognise and try to stop the spike.
It is all a matter of timing. In a person who doesn’t have diabetes, as soon as they eat, their gut and pancreas release hormones to slow the movement of food through their gut, so the glucose is absorbed more slowly, and any glucose that moves into the blood stream is quickly packed away into the different cells of the body to be used as energy later. If you have Type 2 diabetes your body still makes these hormones, just not enough. In Type 1 diabetes, you don’t make ANY insulin so you are relying on this insulin you inject to pack the sugar way. Stopping the spike can be about WHEN you take the insulin rather than HOW MUCH insulin you take.
A bolus or injection of rapid acting insulin takes around 15 minutes before it starts to work and between 60 to 90 minutes to peak. If you take your mealtime insulin just before you eat the chances are you don’t have enough insulin available when the level of glucose in the blood starts to build up. Once the insulin finally kicks in it needs to drag your glucose down from a much higher level and that can be hard to do.
The exact timing of the post meal rise can vary from person to person but the blood glucose level tends to reach its peak at 1 to 1½ hours after eating. Taking your mealtime bolus or rapid acting insulin injection half an hour before you eat can better ‘match’ the insulin to the blood glucose rise, although it is important to make sure your blood glucose level is not too low before doing so. Some meals, such as pizza, which have a ton of carbs and fat, are probably better addressed by taking the meal time insulin as a combination or dual wave bolus, if you are using a pump, or taking your meal time injection just before you eat because the glucose from this type of meal tends to enter the blood stream at a much slower rate.
Checking your blood glucose before, as well as 1 and 3 hours after a meal will help you work out the right dose and timing of your insulin for your meals. You might also like to try continuous glucose monitoring (CGM). CGM uses a tiny filament inserted just under skin which is then attached to a transmitter. Depending what system you are using, the transmitter sends information to your smart phone or a CGM receiver. The sensor measures the glucose in the tissue under your skin every few minutes and provides a trend graph that makes it easy to see exactly what happens to your glucose levels after meals. It also lets you know if you are dropping low or spiking overnight.
At Total Diabetes Care we are lucky enough to have several CGM systems that we can loan you and we are currently offering you the chance to trial CGM for just the cost of the sensor ($100). We will also spend time with you after you have worn the sensor to help you and your referring doctor identify strategies to smooth out your blood glucose levels. Send us a message or contact us via our website if you are interested in doing this.
Written by Jane Overland