Repeat Highs

I've noticed a strange phenomenon, and I was wondering if anyone else finds that this happens.

If I eat a lot of carbs in one meal, I am more likely to be high after the next meal, even if I don't eat many carbs. This happened today, and it's happened before, too, though I usually don't pay too much attention to it.

This also happens if I'm high at one point during the day--I'm more likely to spike from minimal carbs later, too.

I don't think this is a matter of "running high", because I'll have pretty good blood sugars up until that point and then BAM, I'm high for the rest of the day.

To me it sounds like my body's running out of insulin to compensate for the highs or the "high carbs" (which is never more than 40--more than I usually eat, but not terrible overall). I could be wrong, though, and it sounds pretty weird either way.

Highs cause insulin resistance, so maybe it has something to do with that?

I know when I spike high after a meal (or for almost any reason) it takes hours to come down. My blood sugar was literally perfect all day today. Then I had sushi for dinner (which I now regret). Been stuck at 250 ever since, despite a combo bolus and numerous extra corrections. Once it comes down it'll be fine, but man, it takes its time (I think because it causes increased insulin resistance).

I don't know if I'm honeymooning because we don't know what type I am. I tested negative for antibodies two years ago, but things have gotten so much worse over the last year and a half or so that I wonder whether I'm really LADA despite my age.

Another explanation has to do with the two phases of insulin response. Our bodies constantly produce insulin and we bankroll a store of insulin in the secretory cells of the Islets of Langerhans. Then when we eat, this stored insulin is released in a first phase response to maintain our blood sugar as the surge of glucose hits our bloodstream. The beta cells, also located in the Islets of Langerhans, will then kick into high gear in a second phase insulin response to produce additional insulin to restore a normal blood sugar. The problem is that that the second phase is slow to respond and doesn't produce much insulin at once (at least compared to normal storage).

For this reason, as your diabetes emerges, your insulin production lags and you cannot store enough insulin for a phase 1 response. And in your case, what might have happened is you depleted the stores of insulin with your first carby meal and then you had "nothing left in the tank" to handle your second meal and depended on your second phase response.

It is also for this reason that many people believe that early diagnosis of diabetes should be based on this first phase response, the response of your blood sugar to a meal. After all, that is the real "challenge."

Without being able to prove it, I strongly suspect that Brian's explanation is the correct one. That's exactly what I would have suggested, only he said it better.

Jen - I'm a T1D and have noticed the same thing when I was taking more insulin. Since I've been able to decrease my total daily dose of insulin, my high BG corrections respond with a few hours. I remember highs that would not come down before I was ready to eat again. I was then faced with skipping a meal and going hungry or continuing the high, seemingly indefinitely. Not sure if my T1D experience sheds any light for guitarnut since she's not sure of her D-type.

Even spills over into the next day for me.