I would love to hear what any of you think of normal glucose readings. I’ve always believed that if you’re “normal” (not diabetic), your bg won’t go much above 120 when you eat. Maybe if you drink a pop or something it may go up a bit higher, but I’ve never tested a normal person’s bg after eating and seen it above 120.
My husband, who is type 2, and my endo say that being 180 half an hour after you eat is normal. I think the normal pancreas is on top of things pretty quickly.
I’m aiming for really tight control: between 80 and 120, always. I can’t use insulin yet because I’m honeymooning with adult onset type 1, and I’ve been hypoglycemic. But I’d like to use bolus insulin to keep my bg from going above 120.
While there is a lot of variation, on average a non-diabetic shouldn’t peak at more than 120 mg/dl. The graph below shows data collected from non-diabetics who ate a “normal” (i.e. high carb) breakfast. That being said, whether or not you can actually use a bolus insulin to keep from going above 120 mg/dl is an entirely different question. I can’t do it and I suspect that the majority of people with T1 can’t do it either.
I have absolutely no medical info to add to this topic but have seen graphs of people without diabetes who have wore CGM’s and surprisingly they do have swings. It of course never swings to high or to low for a long period of time but everyone has those swings.
And as far a normal levels. This is one of those things that drives me nuts. What’s normal for me will not be normal for the next person. So I just think everyone needs to find their normal. My range on my CGM might make some people cringe or might make some jump up and down with joy. My target could throw some to a fit and some thinking could I ever reach that target. We are all different and all our own normal. I
I’m type one and get discouraged if I’m over 140. I test two hours after eating so that is my goal. I haven’t had a hypo event sans one time when I first got on insulin. I think setting these goals is a good thing. We just have to remember that if we see a higher number to realize it’s not the end of the world and learn from it.
While I do go over 120, I do set my goals to stay between 70 and 120, and am successful at that 86% of the time (over the last 90 days). I think that’s a reasonable level of success. To do that, though, I have had to adopt a fairly low-carb diet (I aim for 50-70g of carbs a day), and have some exercise daily. I do deviate from the diet approach on weekends, which probably accounts for the majority of the deviations from my limits - if I would eliminate that, I think I’d see even better results (but have less fun along the way! ).
Like you, I still produce some of my own insulin, but that has been diminishing fairly steadily. I am planning to try and maintain good control when it’s gone, but I suppose all bets are off when that happens? We’ll see!
Note: Dr. Richard Bernstein says he maintains that level of control (and better!) and has done so for many, many years. He uses an even lower-carb (30g) diet. That’s too low for me, when I’ve tried it, but it works for many.
I’m still somewhat new to diabetes myself, but it’s my understanding that those spikes aren’t that much of a problem in the short-term, as long as it comes back down quickly. I think having consistently high blood glucose is a much bigger problem. But if you’re over 120 for like an hour after eating, I don’t think that will have any deleterious effects. If you’re over 180 for hours at a time, that might.
I have diabetes. My blood sugars are abnormal. Please God, grant me the serenity to accept the things I cannot change, the courage to to change the things I can; and wisdom to know the difference.
If I know the difference and make the right decision, I know God will love me and that I did the right thing.
My approach is roughly like Thas’s description above as well. You can (and in my opinion should) aim for the tight range even as you remember that as a person with non-functioning pancreas it will not happen most of the time. And certainly not “always.” Watch the trends and try to increase the overall time in range. That would be my advice.
Furthermore, if your and your husband’s endo is not on board with this approach (which means s/he is not up on the current literature), you might want to look for a new one. Not only for general support and being on the same page, but also because in order to achieve tight control safely you will need numerous prescriptions and “medical necessity” notes for endless test strips. (At least if you live in the US and have a standard insurance policy which covers some laughably low number of strips per day.)
I wore a CGM transmitter for a week, am non-diabetic (as far as I know, a1c of 5.4…) During that week my average BG was 92 but I had spikes as high as 140 for several hours (pizza eaten at midnight), as well as many spikes briefly up to 120 or 130 for about 30 to 45 minutes.
I think people without diabetes do spike. I’ve seen people post on Facebook adamant that people without diabetes stay at 83 or 86 (or whatever number Bernstein quotes) 100% of the time. I just do not believe that. I’ve tested numerous people without diabetes and none of them have been at that level, much less all the time. Aiming for that tight control and getting worked up when a number is outside that range is just unrealistic and stressful, in my opinion.
Different people with different types of diabetes and different “other” things going on achieve different diabetes control. Some are able to stay between 70-120 almost all the time. Others need a wider range. I’ve found it’s best to shoot for a range that’s tight enough to provide a challenge, but not so tight that you constantly feel like you’re failing. For me, that’s about 70-145. But there are still many days, like today, where I spend most of my time outside of that range, for whatever reason. The key, for me, is to not get frustrated about it (hard to do for me!). If you can aim for 80-120 all the time and achieve that kind of control without getting stressed, I say go for it. BUT keep in mind that, if you are still producing even a small bit of insulin, control likely will become much more difficult once that tiny bit of insulin is no longer helping to buffer things—so don’t get upset or frustrated in the future if you are at some point no longer to achieve such tight control.
That’s not unrealistic at all. But you need to eat low carb, low glycemic and exercise daily. Exercise is the only way to bring down a higher bg without insulin. Since you are “honeymooning” you need to treat it as type 2 for now. How does your doctor treat your T1?
I try to keep my bg between 80-120 2 hours after meals. I can’t, even with lower carb, low glycemic and exercise, keep it there all the time. My A1C has been in the mid 5’s for over four years. I was dx at age 49 and already had minor neuropathy and kidney damage - I must have had very high bg all the time for a couple of years. I do my best, but no longer make myself crazy if out of my optimal range, but correct or take a brisk walk if higher than I want to be. I worry all the time about my quality of life in the future. I have too many dreams to let T1D get in the way!
Write everything down, use Excel or find a good app. Bg, food, exercise and stressors should all be logged. I test between 6 (on a very good day) to 15 (on a very bad day) every day. As soon as you see your bg running higher consistently, insulin should be prescribed. If not, you might want to find another endo.
[quote=“Jen, post:13, topic:56442, full:true”]
I think people without diabetes do spike. I’ve seen people post on Facebook adamant that people without diabetes stay at 83 or 86 (or whatever number Bernstein quotes) 100% of the time. I just do not believe that. I’ve tested numerous people without diabetes and none of them have been at that level, much less all the time.
[/quote]Belief isn’t required, Jen, 'cause empirical data refutes such a silly position.
Here’s the dirty little truth: There’s no such clear thing as “diabetic” and “non-diabetic”. Rather, there’s a continuum from those with exceptional endocrine systems that keep there BG in a very narrow range, all the way to those of us who can’t control it at all.
In between there are people – millions of them – who spike up to, say, 150 after eating cake and ice cream, then drop right back down to 100 after 2 hours.
And they never get any more “glucose intolerant” than this, for the rest of their lives.
Some of these people will have even more “impaired glucose tolerance”, never qualify at overt diabetes according to the bright line health care has defined, yet still have a higher risk of heart disease, stroke, etc. and be a part of the statistics.
So these discussions about what “normal” people’s BG control looks like is a bit of a fools errand.
I mostly try to keep my sugar between 70 - 120, as much as I can.
I think the issue about going high is how long you stay high for. If you go high for 30 - 60 minutes or so and then come right back down, I guess it may not be such an issue… but that also depends on your management philosophy and how tight you want to control things.
I find that if I go high from eating without using bolus then I will stay high for hours and hours - For example, this can mean if I am 120, then without doing something to reduce it, I will stay at that level for most of the day… Therefore I use small doses of insulin to cover carb foods, and bring my back down to my baseline target - which is in the 80s, if I am higher than I want. Assuming you are not too insulin sensitive, you should be able to experiment with what 1 or 2 units of insulin do for you.
Given that you are going to be using insulin sooner or later, and you want to control things tightly, I don’t see the risk in using low doses of fast acting insulin to keep you where you want to be.
There is a possibility that the hypoglycemia you experience is a rebound from the relative highs you experience. It may be that if you can dampen the highs then you may reduce the frequency of lows… also worth trying.
With diabetes, we are all our own personal science experience. People wiser than me refer to YDMV (your diabetes may vary)… and this just means you have to find what works for you and your own comfort level of management.
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I for one love that you are on this site. You are so knowledgable and have great words of wisdom. Thank you.