Post-meal spike corrections are just plain tough to get right. Over correction and stacking are hazards. That often leads to swings in BG going from hyper to hypo and back to hyper – not good.
I know you are looking for immediate short-term tactics to address post-meal spikes and I can suggest a few of those but I think you should also consider the overall context of these spikes.
I’ve found that the best tactic is to prevent these spikes and that is not always easy. As a group we are keenly focussed on blood sugar levels and that is understandable. In this case we might be better served if we also consider insulin sensitivity.
Many of us struggle with dawn phenomena and the feet on the floor (FOTF) effect. These are situations where the body resists the typical action of insulin due to other factors like an increase in cortisol secretion and/or signaling that provokes the liver to release an inappropriate amount of glycogen.
I delay my first meal to mid-day for this reason. This may not work for everyone but it’s been a good tactic for me as a T1D. I still, however, must take actions everyday to increase my insulin in the morning to hold my glucose closer to normal.
This means increasing my pump basal rate from the more usual 0.3-0.5 units/hour all the way up to 1.4 units/hour from 6:00 a.m. to 1:00 p.m. It also means delivering a 1.5 unit bolus when I arise each day just to counteract a rise due to FOTF. Your needs, of course, will vary.
In addition, I often add one 4-unit cartridge of Afrezza when my BG starts to rise through the 110 mg/dL level. Afrezza shines in this situation due to fast-on, fast-off action and rarely over-corrects into hypo territory.
What can you do to increase your insulin sensitivity so as to minimize post-meal spikes? Exercise, even relatively light exercise like walking, timed to occur when your meal insulin dose peaks is an amazing way to limit post-meal spikes. For me, this is about 60 minutes after the meal insulin dose.
I choose to limit carbohydrate consumption for this very reason. I know about and respect others diet choices but this tactic works dependably well for me.
Fasting provides another tool to increase insulin sensitivity. If you struggle with post-meal spikes often for the same meal each day, why not just skip that meal one day and see what happens?
Another factor that increases or maintains good insulin sensitivity is getting a good night’s sleep. Most people who regularly enjoy good sleep go to bed at the same time every day. Our bodies like this regularity and it is reflected in insulin sensitivity.
Stress is another factor that we can manage. Higher stress levels increase cortisol which drastically raises insulin resistance. We can do many things to manage this stress every day: meditate, exercise, pray, sing, play a musical instrument, eat every meal in conversation with your immediate family (no screens!), engage in any creative pursuit and breathing exercises. Regular, as in every day, stress relieving practices will increase insulin sensitivity.
It’s not simple but our bodies are complex organisms. If we pull back and consider the larger context, we can often discover more remote factors, when combined, will give us the results we want.