Blood sugar spikes

My sugar spikes within 5 minutes of eating a meal. I have gastro. When should I take my bolus? It usually goes down after 30 minutes but this rising quickly arrow is driving me crazy. I should have know something was up when I had this happen to me about 2 weeks ago. I never had that after lunch and supper only at breakfast. Now I get that arrow straight up after every meal. Any advice?

What are you eating that it goes up within 5 minutes? And how high are we talking and are you verifying the CGM number using a finger-stick?

I’m also interested if you are confirming with a fingerstick.

Yes, I confirm by taking a btest. I have had cabbage rolls and a yellow potato and yogurt w/ sucrolose. I’ m not eating anything different from before. I eat the same things pretty well. For supper I was 7.8 mmol and within the half hour after eating it went to 13.4 (glucometer).I am using the g5.I take ginger and domperidone. I usually do a combo bolus. I had tried 60/ 40 45/55 for 2 hours. They are tricky.

How much time elapses between your insulin dose and your first bite?

You say your mealtime BG was 7.8 mmol/L (140) and it started spiking within five minutes of your first bite and then tops off at 13.4 mmol/L (241). Thirty minutes after your first bite the blood sugar returns to some lower level. Is that lower level 7.8 mmol/L (140)? Or some other level?

I think the best way to resolve this for yourself is write down every detail including times, doses, meal description, and post meal glucose numbers. If it were me I’d record sensor and fingerstick reading every 30 minutes out to four hours post-meal or so. If you do this for several meals, I’m sure you’ll spot some pattern that you aren’t seeing now. Logging often adds perspective you wouldn’t see otherwise.

One thought I did have about your situation. Is it possible that there is some residual food in your stomach from your last meal that perhaps doesn’t release into the small intestine until you start eating your next meal? I’m definitely not a GI doc but I do live with GP myself. I’ll be curious to read what you think about this idea. It could explain a rapid arrow-up rise quickly after your first bite of a new meal.

This morning when I got up I couldn’t eat, but I watched the sensor and it slowly started rising without food. It was 7.3 at 7am then it went all the way up to 11.8 at 9am. I even did corrections and it wasn’t comingdown. I will try an increase in my basal to see if it helps. I am sure my stomach is not emptying when it should. I have never been this much of a wreck as I am now. My D is well managed but gastroparesis makes it more difficult. I have no nausea but I get a tightening feeling in my face and my ears plug and I get alot of mucus. It’s all clear so there’s no infection. I also have insomnia. I guess the good side of this is I haven’t vomitted.

That sounds miserable! With your other not obviously related symptoms, maybe it’s a good time to check in with a doctor. I know heart problems can sometimes manifest in strange ways, like a toothache.

As far as your rising BG not responding to a correction, I have a few thoughts. How long has your infusion site been in place? Have you been pumping a long time and perhaps your favored sites don’t absorb as well as they used to. The next time you need to correct, I would use a syringe to deliver to a separate site.

Do you have any places on your body that have never been used for infusing insulin? A completely fresh site, if it delivered good BGs, would suggest that your usual sites are resisting absorption.

When I’ve run into this type of frustration, I’ve often found that I needed to try something different. Maybe a new infusion site or even new style infusion sets might help.

I’m sorry you’re faced with this situation. Maybe you could reach out to a good diabetes educator who can help you systematically try a variety of tactics. Don’t give up! I think it’s possible to adapt to whatever it is that’s troubling you.

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To add to other’s comments.

I started using a Dexcom CGM just a few years back… love it. It does show you exactly what’s going on… and from that, I have changed my morning routine completely… that might help you too. You are aware of the dawn phenomenon correct? So once you body wakes up… it releases some glucagon…. And your BSL starts going up. So for me… my BSL starts creeping up at 6:00 AM … or not until 9:00 if I sleep in. Getting up and moving equates to BSL going up. SO… to combat this…. I get out of bed… I take 5 units of Humalog immediately. This will keep me even keeled until lunch. I have always done this even before the Dexcom.

So what the Dexcom has changed is my breakfast. Before, I would take a shot of insulin to cover my small breakfast (45g Carb). Before Dexcom, I would test a lunch and be fine. Now after Dexcom… I am seeing that after eating, I would spike high … up to 200… and slowly slide back down to normal by lunchtime. I am finding that my body just does not bring insulin online very quickly in the mornings at all. It just takes it’s sweet time. I would try and take more insulin to cover breakfast to keep it from spiking… which it would… but then I would crash low by the time lunch comes around. For lunch and dinner, I can take my insulin before meals…. not get the spike … and not get a crash after. My body just works differently in the morning.

So for breakfast these days…. I am carb free for the most part. I mostly am just eating a handful of almonds/spiced sunflower seeds/jerky/eggs/cheese/sardines. This has made my numbers a lot better and you aren’t starting your day on the rollercoaster.

As far as when to take in the insulin…. If I am running nice and even… I take my Humalog 20 mins out before dinner. I adjust my timing if I am running low or high of course. The Humalog is suppose to be starting to get to you bloodstream in 15 mins… but that’s just the start.

The other thing I have tried to get the insulin to come online faster in my blood steam is to exercise a bit. So I’ve tried just going up and down my stairs a bunch of times to get my heart pumping decently…. Or walking around the block quickly here at work. It really does help.