This content material initially appeared on diaTribe. Republished with permission.
By April Hopcroft
Many individuals with diabetes – even these utilizing the most recent expertise – wrestle with excessive blood sugar after consuming. We spoke with specialists for tips about how you can reduce these cussed glucose spikes.
We’ve all been there: it’s been an extended, demanding day at work and also you’re excited to sit down down for dinner at your favourite restaurant.
Or possibly you’re desperate to watch the sport and dig right into a feast of wings, nachos, and sliders with family and friends. Maybe you’ve been touring or in your ft all day and are able to gobble up the primary meals you encounter.
Whatever the state of affairs, it’s possible you don’t need to take the time to bolus and wait to your insulin to kick in earlier than you begin consuming. In spite of everything, meals are sometimes a social exercise, and it’s no enjoyable to attend whereas others are chowing down.
However because the meal wears on, you catch a glimpse of your telephone and are startled to see your blood sugar is nicely into the 200s and rising. Quickly, you begin to acknowledge the telltale indicators of excessive blood sugar: achiness, fatigue, and a common feeling of unease.
There’s little doubt about it – navigating meals will be difficult when you’ve gotten diabetes. Even amongst individuals who use automated insulin supply (AID) methods, analysis means that attaining postprandial glycemic management will be tough.
Why do blood sugar spikes after meals occur?
Sudden will increase in blood glucose after consuming are regular, even in folks with out diabetes. After consuming carbohydrates, blood sugar ranges rise as our our bodies break carbohydrates down into sugars.
In folks with out diabetes, this enhance in blood sugar triggers the rapid launch of insulin. Inside minutes, insulin begins transporting glucose from the bloodstream into cells, serving to to cut back blood sugar after consuming. Put up-meal blood glucose spikes are often non permanent and sometimes go unnoticed in these with out diabetes.
Nonetheless, in folks with diabetes, blood sugar spikes will be extra pronounced and last more. Insulin delivered by way of injections or an insulin pump takes longer to begin working in comparison with the insulin produced naturally by the physique, that means blood glucose will proceed to rise whereas the injected insulin kicks in.
Folks with diabetes produce other hormonal variations that may have an effect on the pace of digestion. These with out purposeful beta cells additionally can’t produce the hormone amylin, which helps sluggish digestion and reduces post-meal glucose. Meaning folks with out sufficient amylin could expertise challenges with excessive glucose ranges after consuming.
If you happen to’ve been scuffling with post-meal hyperglycemia, take inventory of your present circumstances and should you’ve skilled main life modifications not too long ago, recommended LaurieAnn Scher, licensed diabetes care and schooling specialist.
Have you ever skilled stressors, comparable to finding out for an enormous examination, switching jobs, or shifting? This will set off the discharge of stress hormones like cortisol, which might promote weight acquire and have an effect on metabolism, together with insulin resistance.
Possibly your consuming or train patterns have shifted, maybe because of modifications like beginning faculty, shifting in with a companion, or navigating parenthood. Weight-reduction plan modifications can lead folks to realize extra muscle or fats. With a special proportion of fats and muscle mass, insulin resistance can fluctuate, impacting your insulin wants, Scher added.
Many different elements can have an effect on insulin resistance and blood glucose administration, comparable to utilizing contraception, environmental situations, dehydration, and extra.
Why is it essential to cut back blood sugar spikes?
Excessive blood sugar after meals raises your danger of diabetes issues, together with kidney illness, heart problems, and diabetic neuropathy. Put up-meal hyperglycemia also can have an effect on high quality of life, resulting in destructive results on temper, diabetes misery, and points like mind fog or sluggishness.
To place it merely, excessive blood sugar after consuming “doesn’t really feel nice, and it may be arduous to suppose and see,” mentioned Scher.
Analysis additionally suggests that higher glycemic management after meals is linked to improved A1C and fasting glucose ranges.
Based on the American Diabetes Affiliation 2024 Requirements of Care, it is best to goal for blood sugar to be lower than 180 mg/dL inside 1-2 hours after you begin consuming. Against this, in most individuals with out diabetes, two-hour postprandial blood sugar ranges are usually lower than 120 mg/dL and barely exceed 140 mg/dL.
Tips on how to forestall blood sugar spikes after consuming
From medicines to weight loss program and bodily exercise, there are various completely different methods to forestall bothersome blood sugar spikes after meals. As with all components of diabetes care, it’s essential to acknowledge that what works for one particular person could not work for another person.
“It’s all about tailoring to the affected person’s wants, consolation stage, background, what they’ve tried, and what they’re keen and excited about,” mentioned Rina Hisamatsu, a registered dietitian on the Michigan Collaborative for Kind 2 Diabetes (MCT2D).
1. Experiment with completely different insulins and dose timing
For any diabetes remedy, Scher suggested, “Don’t set it and neglect it.”
That’s, it is best to frequently look at basal and bolus insulin, alongside along with your different medicines. You could want to regulate your insulin routine and tweak bolus doses and timing all through your life.
There are a number of various kinds of mealtime insulin, every with its personal time to onset of blood glucose decreasing:
| Kind | Names | Time to onset | Peak | Length |
| Brief-acting (common) | Humulin R and Novolin R (NPH) | half-hour | 2-3 hours | 3-6 hours |
| Fast-acting | Apidra (glulisine) Humalog (lispro) Novolog (aspart) |
Quarter-hour | 1 hour | 2-4 hours |
| Lyumjev (lispro) | Quarter-hour | 2-3 hours | 4-7 hours | |
| Afrezza (inhaled) | 12 minutes | 30-60 minutes | 1.5-4.5 hours | |
| Quick-acting | Fiasp (aspart) | 3 minutes | 1-3 hours | 3-5 hours |
The timing of rapid-acting insulin performs an enormous position round mealtime. For some meals, you could want a 30-minute pre-bolus earlier than, whereas others may require a shorter pre-bolus of 10-Quarter-hour earlier than consuming.
Some folks discover they like an prolonged bolus, which implies the insulin is delivered over an prolonged interval, as an alternative of .
Digestion charge additionally elements into the timing of mealtime insulin, particularly for folks with situations like gastroparesis or exocrine pancreatic insufficiency.
2. Strive a brief quantity of bodily exercise
Being lively for even only a few minutes after consuming may help decrease blood glucose and stop blood sugar spikes.
Any motion is healthier than no motion, regardless of how small. And most significantly, Hisamatsu mentioned, attempt to discover an exercise that you just take pleasure in to be able to make it a sustainable behavior.
Taking a stroll – whether or not inside your condominium, across the block, or on a motorbike path – goes a good distance towards regulating glucose. Past taking a stroll, there are various different choices for brief bursts of train like:
- Climb a set of stairs in your own home or office.
- Leap rope, jog in place, or do leaping jacks – these take up little or no house.
- Do squats at your desk. Since squats train the biggest muscle tissue in your physique (your glutes and quads), they’re very efficient at decreasing glucose. “The quads and glutes are like sponges, they suck up all of the glucose and use it way more readily than smaller muscle tissue,” Scher mentioned.
- Have a dance celebration – put in your favourite songs and jam out to your coronary heart’s content material.
Analysis exhibits that breaking apart a sedentary way of life each hour can enhance insulin sensitivity (how effectively your physique’s cells reply to insulin) and post-meal glucose.
If you happen to choose to suppose forward, contemplate the various kinds of train that you are able to do all through the day that enhance insulin sensitivity. Power coaching earlier than consuming has been proven to enhance post-meal blood glucose in folks with prediabetes by enhancing insulin sensitivity. Likewise, analysis suggests that exercising earlier than meals can enhance insulin sensitivity and enhance total glycemic management in folks with sort 2 diabetes or gestational diabetes.
In fact, any type of train can result in drops in glucose ranges and trigger hypoglycemia. If you happen to use insulin, it’s subsequently essential to contemplate your insulin on board and take steps to forestall hypoglycemia throughout train, Scher mentioned.
3. Eat high-fiber meals
In distinction to different carbohydrates, fiber can’t be digested by the physique, so it has much less of an influence on blood glucose ranges. Consequently, it helps you are feeling full and glad.
Fiber additionally performs a key position within the intestine microbiome, serving to sweep micro organism from the colon and holding bowel actions common. You possibly can eat extra fiber by including fruits, greens, legumes, and complete grains to your weight loss program.
“We are able to contemplate fiber one in all our greatest pals,” Hisamatsu mentioned, as fiber-rich meals are typically low-calorie however have a excessive nutrient density, notably non-starchy greens.
Likewise, Scher mentioned fiber is sort of a parachute. Whenever you pair fiber-rich meals with carbohydrates, it helps forestall blood sugar spikes and likewise reduces speedy drops in blood sugar.
Including an excessive amount of fiber too rapidly could trigger some GI misery, so Hisamatsu recommended going “low and sluggish” when rising fiber consumption and ensuring to remain adequately hydrated. Begin by considering of meals you already take pleasure in and attempt to add some greens or complete grains. For example, add sauteed greens to spaghetti, tuck some beans right into a quesadilla, or swap whole-grain bread for white bread.
4. Offset carbs with fats and protein
Understanding the various kinds of carbohydrates is vital to managing post-meal blood sugar spikes.
“I’ve at all times mentioned there’s nothing that an individual with diabetes can’t eat, besides poison and meals with poison,” Scher mentioned. “You possibly can have cake, sweet, and many others. You’re human. You simply must learn to handle it.”
Carbohydrates will be divided into two common classes:
- Easy carbs are sugars. These carbs are damaged down rapidly and often result in large spikes in blood sugar. Examples embrace soda, baked items, breakfast cereals, and fruit juice.
- Complicated carbs are damaged down extra slowly and result in extra predictable, gradual will increase in blood sugar. Examples embrace beans, fruits, greens, and complete grains.
Hisamatsu recommended beginning with “low-hanging fruit” by figuring out components of your weight loss program the place you are inclined to eat extra refined or easy carbohydrates. Possibly you’re flying out the door to work within the morning, so breakfast has develop into a sugary granola bar. Otherwise you crave fruit juice at lunch and a cookie for dessert.
When you’ve recognized these areas, contemplate methods so as to add extra advanced carbs and fiber-rich meals. Begin with small modifications and check out behavior stacking to make sure sustainable modifications.
General, Hisamatsu beneficial specializing in rising fiber and protein consumption, whereas including fats for taste and fullness.
“Once we can give attention to a stability of various meals teams, it may be useful to enhance one’s postprandial glucose,” she mentioned.
5. Strive setting a short lived basal charge
In the identical method that some folks select to decrease their basal insulin charge throughout train, you might contemplate quickly rising your basal charge by a sure share earlier than or after meals.
Likewise, some insulin pumps help you set a decrease pre-meal goal, comparable to 80 or 85 mg/dL fairly than 95 mg/dL earlier than consuming.
Setting a short lived basal charge will be useful once you’re consuming meals that has vital refined carbohydrates in it, comparable to pastries, bread, pasta, pancakes, pizza, and even white rice. This technique could also be particularly useful for these with extra insulin resistance.
You might need to experiment via trial and error to determine what works greatest for you. Seek the advice of your healthcare supplier to search out the best basal charge for mealtimes.
6. Use CGM as a instrument to tell selections
Steady glucose screens (CGM) present precious info that may enable you handle post-meal blood sugar.
Since everybody responds otherwise to meals, Scher mentioned CGMs help you perceive your physique’s distinctive response. For example, some folks with diabetes can eat white rice with none blood sugar spikes, whereas many others will expertise excessive blood sugar shortly after consuming rice.
“People with sort 2 diabetes, whether or not or not they’re on insulin remedy, could profit from utilizing a CGM,” Hisamatsu mentioned. “In tandem with way of life change, CGM could be a useful information for sufferers to see real-time information and the way meals and way of life influence postprandial glucose which may help establish areas for enchancment.”
The development arrows on a CGM may help inform mealtime insulin dosing. Use time in vary to establish patterns and make changes as wanted – you may want a special insulin-to-carb ratio or correction issue relying in your mealtime.
Even if in case you have sort 2 diabetes and your insurance coverage doesn’t cowl CGM, skilled CGM could also be an possibility for you.
“The trick is discovering a supplier in your space that may enable you do an expert CGM trial,” Scher mentioned. In most states within the U.S., insurance policy will cowl one or two trials {of professional} CGM per 12 months.
7. Keep hydrated
Staying hydrated all through the day is essential to many bodily capabilities, from regulating blood stress to physique temperature to blood glucose.
Whenever you’re dehydrated, the quantity of water in your bloodstream decreases, making the glucose in your blood extra concentrated. This will result in barely greater blood sugar ranges or trigger speedy spikes.
Certainly, analysis suggests that not consuming sufficient water results in worse glucose management in sort 2 diabetes. Dehydration can result in a cycle of upper glucose ranges, so it’s particularly essential to hydrate nicely when it’s sizzling exterior.
Whether or not it’s investing in a colourful water bottle or pairing hydration along with your morning espresso, remember to get your fluids in.
The underside line
Blood sugar spikes after meals are a standard a part of life when you’ve gotten diabetes. Whereas having a constant meal construction may help forestall giant spikes, it isn’t at all times potential to plan all of your meals.
To handle post-meal blood glucose ranges, it’s a good suggestion to construct a “toolbox” of methods. Everyone seems to be completely different, so you could must undergo some trial and error to determine what works greatest for you.
“We’re not check tubes,” Scher mentioned. “What works for one particular person, could not work for another person.”
It’s additionally essential to know when to succeed in out to your healthcare supplier for skilled recommendation.
“We’re right here to help you and to work as a crew,” Scher mentioned. “If one thing doesn’t really feel proper, let’s work as specialists collectively to assist determine it out.”
