It doesn't matter how long I wait. I can wait 5 minutes or 30 after I take insulin. My blood sugar spikes to like 250-300 whenever I eat burgers or sandwiches.
Does anyone else have this issue? Why does this happen?
Edit: I meant bread.
Sounds like your insulin to carb ratio may be off, or adjusted for bread.
I seem to have to do 1.5 my insulin to carb ratio for tortillas....
I do about 500* for pizza (not really, but I basically dump insulin)
Hahaha same..
I take insulin for type 2 but have never heard of insulin to carb ratio
It is a calculation. I built mine from 6 years of experience.
The definition is how many grams of carbohydrates is covered by 1 unit of insulin. For example, some people use 1 unit to cover 10g or 1:10. Others who react better to insulin use 1:15 or 1:20. Myself use 1:8g unless it is breakfast, then it is 1:4g. Tortillas are 1:6g for me.
There is a correction factor too. Where 1u of insulin drops glucose levels Y points. Useful for reducing highs from bad carb estimates, or slow carbs with fat lasting longer than insulin (Pizza).
We (Type IIs) seem to get short changed on information about insulin a lot of the time.
The only reason I learned about sliding scales was because I was hospitalized, they kept feeding me carbs, and then freaking out, and tweaking my dosage to bring it back down. (The entire experience was pretty stressful, but in retrospect, that part was actually kinda funny.)
This is why I feel like it is valuable for T2s to be seeking the care of an Endocrinologist if they are taking short acting insulin.
I really need to see an endocrinologist, it's been too long
This only applies to short acting (bolus) insulin not long acting (basal).
Awesome, I take both.
I didn't know that was a thing that some diabetics do...
I do it too. Normally, my ratio works really well. But for burger buns, I have to add a bit more. The beauty of the cgm is you can see that data and make adjustments.
Also, the reason you stay high after a burger is due to the fat and protein. Fat and protein can absolutely cause spikes and stubborn highs
I've never had even a nudge in my bg from carb-free meals, but when you consume carbs with fat and protein it does tend to prolong the response curve.
Yes but you likely would have a much higher spike without the protein and fat.
Absolutely, it's a longer, shallower response curve which is good!
My dietician taught me the way... First the oils and protiens, then the fibre or vegetables then the carbs. Even just adding some olive oil to carbs seems to slow it down
100%, I neglected to point out that despite being prolonged it's also a lower maximum.
Thank you. This is very helpful information. It also explains why I go high when eating a hamburger steak throughout the day.
So this really bothers me because I love burgers and sandwiches. Now I need to find healthy alternatives which is going to suck for my budget.
No guarantees, but try other kinds of bread. Sometimes you'll react better to specific grains than others. No idea exactly why. So, white bread may be out, but whole wheat might be fine... or at least, spike you less.
Worst case, lettuce wrapped burgers might work for you.
So I found the issue: White bread kicks in really freaking fast for me. I did a test run and gave my insulin an utterly massive amount of time to kick in (like 45 minutes) and I'm only 193 after eating and waiting an hour or two.
Yeah, seems like white bread is basically just sugar disguised as bread. (Not literally, of course, but those carbs are really accessible.)
You're probably going to need to be doing tests like this with a lot of foods, carefully documenting how much you spike, how long, and then taking it to your doctor as you can.
Yeah forget what I said. An hour or two later my glucose spiked to 300 and is still in the process of coming down. I think white bread needs an adjusted glucose ratio. I will schedule an appointment to ask my endo about it.
Yeah, spiking to 300 is not something I'd be comfortable messing around with.
Talking to your endo about this is probably the best call.
Well I would say that I just needed to wait 45 minutes but now my glucose is 300 and I haven't eaten anything since those burgers.
Listen to the Juicebox Podcast Pro Tip episode on fat and protein. It will make a lot more sense. Also, assuming you’re Type 1, many type 1 diabetics bolus for protein, even if there are no carbs.
bread is carbs
I know it's carbs but my insulin should stop it from spiking my blood sugar, right?
It seems to work for some but not all. I try to avoid carbs because in order not to spike I'd have to do a ton of insulin which would cause me issues an hour or two after the dose. In essence, biochemistry is complex and everyone is different.
Yeah, if I ate a quarter pounder I would require a TON of fast acting insulin it's easier to avoid bread, pasta, rice, cakes, pastries, and potatoes tbh
Not all bread was created equal. There are some i fibre low GI formulations where i am that seems great. Wholegrains also seem to slow it down. But the general from Walmart white squares are going to be the fast digestible kind.
The type of wheat the bread is made out of can make a difference (i.e. whole wheat vs. white) but when it comes down to it bread is a lot of carbs in a form that gets metabolized very fast.
If you are Australian, baker's delight have used some sort of dietician sorcery to mane soft fluffy white sandwich bread that isn't going to cause a straight upward spike. Sometimes I like the luxurious feeling of those itty bitti fancy sandwiches when I'm sick. You know the cucumber and cheese or similar genre lol.
Okay, so shouldn't the insulin counteract it eventually? Even hours later, my blood sugar is still high. Is there a reason for that?
Generally speaking, you're not using enough insulin to cover the amount of carbs you're eating.
People are downvoting you but I understand you're learning and have questions. It has taken me a long time to understand diabetes better and I still have many questions.
It's whatever. It's internet points. Learning the info this post has given me is more important. This has been a very helpful post.
I'm a non-insulin-dependent type 2, but my understanding is that as a type 1 you need to be injecting enough insulin to cover all of the carbs you consume, and that you use your personal insulin/carb ratio to calculate how much insulin that is.
Everyone's insulin response - and response to carbs - is different. I can eat brown rice and barely spike. Baked potato barely phases me. But white bread sends me sky high. I've found whole wheat doesn't phase me as bad.
I always keep whole wheat bread, peanut butter, and jelly on hand. Sometimes my Omnipod works a little too well... good way to counteract a low.
Also, even "rapid" insulin like Novolog or Humalog (and their generics) can take awhile to work. For me, Novolog takes about 3 hours to make a significant difference if I'm trying to correct after a meal. Though before a meal it will crash me if I use it more than 10-15 minutes before eating.
Wanted to add, also insulin can hit differently in the same person. I've had multiple mass diabetes association emails this holiday season to remind us heat waves change how you absorb it. Faster iirc
Also depends on how much you exercise. I bike 20+ miles a week (did over 20 in a day recently). I always have to make sure I don't have any insulin for a few hours before a ride, and keep some candy with me. Rarely ever need it, at least.
But then there's weeks where I don't ride at all. I'm out of town visiting my mom and stepdad right now... I do have access to his bike, but it's one I gave him because the frame is too big for me. No trails nearby either. Thrown off my omnipod's algorithms a bit.
Normally the body would release insulin in a glucose dependent manner which is why GLP1s were such a breakthrough if you can still make your own insulin. Basically one standard ammount of insulin will always be wrong. If you still produce your own then a basal(sorry if the word is wrong) dose is your doctors best guess at bridging the gap between the lower level you produce now compared to before diabetes. Our type 1 friends Basically do lots of math all day every day to do the calculations the body would naturally do to figure out how much insulin. Which will change even if the meal is identical. The hot weather, resting metabolic rate that day, periods, and so on. Using outside insulin will never be perfect but the aim is to get the most time in range. Its not an insulin will cover
As someone who eats relatively low carb, I can assume the problem is fat and protein vs carbs. When you first eat a burger with all the fixings. Your body starts to break down the carbs first, hence the rise in blood sugars. Then, it realizes that there is a bunch of fat and protein that need to be metabolized. It stops working on the carbs and does what's called glucogenis on the fat and carbs. This takes a long while and is not as susceptible to insulin as straight carbs are. By the time your body gets through all the fat and protein, it has used up all the onboard insulin and doesn't have anything left for the carbs on board that need to be dealt with.
Short answer is your carb to insulin ratio can be used as a calculation for fats and carbs. Split it in half for protein and fat and a
I think that gluconeogenisis is the term that you were looking for. It when the body breaks down proteins, etc into glucose. This raises blood sugar.
Glycogenisis it when your body store glucose by creating glycogen, mainly in the liver and muscles. This lowers blood sugar.
You are correct
That's normal. Bread is carbs. Carbs break down into sugar. Everyone reacts differently to different kinds of foods so finding your balance if part of mannaging diabetes.
Insulin to carb ratio isn’t a one size fits all thing.
Yes, in theory your insulin should cover the carbs you eat. But depending on your body, your exercise routine & the type of food that ratio can & will change. Typically doctors start you off on a common ratio for your level activity, weight & age. That ratio can go up or down depending on need. It’s best to keep a food journal and call your doctor to make a decision about adjusting your dosages.
Bread isn’t the only thing that will act strangely once you eat it. There are many foods out there that will be metabolized by your body differently and the only way to figure out the correct way to handle them is to experiment with it.
And once you find the correct ratios that doesn’t mean that they won’t change in the future as your bo
Try a keto bread. They're more expensive, but don't spike my sugar. Also many "regular" breads also have sugar in them. Regular white bread is especially bad for my sugar.
I second this. I struggled living without bread since I became a t1 in 2021. When I found out about keto bread, I jumped on board and never looked back. I freeze what I can't eat right away. Nothing goes to waste.
Yes! I also appreciate the fiber in the keto bread to meet my personal goals
I'm gonna have to, it seems.
Yeah happens to a lot of people. Different carbs can spike people in different ways. I treated myself to some toaster strudels the other day for breakfast and I didn’t really spike (a little higher than usual but surprisingly not bad). But if I have a bowl of oatmeal I tend to go into the mid 200s.
It’s important to know what foods you are more sensitive to, and try to avoid to find alternatives. If you eat white bread, try wheat or whole grains, etc. There are some foods I’ll rarely if ever have because it’s not worth the spike.
yes get rid of most of the bread. for example I get a double whopper and because they microwave the meat with the bottom bun that bun has no sauce or cheese. I just remove it and eat it like an open face sandwich. likewise pinch off small side pieces of the other bun that are empty as well. their bread is usually pretty sad anyway. that way I eat much less carbs.
Bread can be a real tough one.. one thing that always helps me is to eat something prior that is low in carbs to blunt the spike and allow your insulin to do its work.
T2 here not on insulin. However, I have seen bread is one of the worst kind of food for spikes (discounting simple sugar rich desserts). Whole grain or not, it does not make a difference for me. When I eat burger, I avoid most of the bread, and still able to enjoy it fully.
I have switched to 100% whole wheat bread. I only have to take 1 unit per slice plus whatever else. As the one comment said your carb ratio most likely needs to be increased.
What I don't understand is why it's specifically bread and why delaying my meal after my insulin doesn't help.
Tomorrow I'm going to get some Subway and delay my meal by about 30-45 minutes and see if that prevents a spike.
I'll tell you the thing I learned from this group that I consistently share. If I'm going to have carbs I will have fiber first (usually a vegetable) and then I can have carbs. Protein before carbs can also work. Honestly even just a stick of cheese will do it. So, it I'm going to have pizza I start the meal with a side salad or roasted vegetable. When I don't feel like making an effort I start meals with a handful of baby carrots.
How does this work? I've never heard of this.
It works by slowing down the digestion of carbs. It takes longer for the body to digest fiber, protein and fat than carbs.
If you really enjoy your sandwiches consider, switching to a whole wheat bread amd having a side salad before hand.
See if that helps to blunt the spike from the bread.
I eat carb control bread/burger buns. Aunt Millie's carb control bread is good as well as Kroger carbmaster burger buns.
I didn't know these were a thing. I'll have to check them out.
Also mission keto tortillas
If you can get on a CGM so you can see in real time what's happening to your blood sugar when you eat something. I did that about 4 months ago and my doctor changed my fast acting insulin to a different kind because the standard fast acting wasn't doing the job. Plus the new one comes in a nice little dial-up pen that makes it a hell of a lot easier to inject me. My CGM shows me exactly what happens whenever I eat anything. And yeah I make myself sandwiches I eat pizza and of course Ben & Jerry's ice cream.
I'm going to start putting notes in my CGM so my doctor can tell what is happening.
How long does it stay up? I can be low (in the 80s), take insulin, eat bread, and my sugar will go above 200 for about an hour.
Several hours. Sometimes, my insulin just never brings it down, only brings it down partially, andI have to take more later.
bread is like demented cake. sure, it isn't sweet and typically doesn't have sweet stuff added on it unless you are putting jam/jelly/preserves on it but it is basically cake.
try eating your burgers and savory sandwiches "naked" in a bowl or using large lettuce leaves as a wrap.
Do you bolus for protein/fats along with the carb bolus? Extended bolus? Ask your endocrinologist or specialist to assist you with this. We generally don't bolus only for carbs (every T1 is very different so it may not apply to you of course).
Have you checked the type 1 subs, you may get more type 1 specific comments. Every type has different treatments, so is ee a lot of dietary management comments, but not type 1 specific, just so there's no confusion here. r/diabetes_t1 and r/type1diabetes has some threads about warsaw method or bolusing for proteins. Aslo, are your i:c ratios different according to time of day?
I only bolus for carbs. I have an appointment scheduled with my endo for next month. My ratios do not change for the time of day.
Here's some resources to give you more info to discuss with your endocrinologist. Apologies in advance if you have these already but just in case.
The book Think Like a Pancreas by Dr. Gary Scheiner. IMO should be a must-read for all type 1's and can give you some info to discuss with your endo.There's a resources page on his clinic site some good info there. https://integrateddiabetes.com/store/
Sugar Surfing by Dr Stephen Ponder is great, he has a downloadable version on his site I think there's a free version as well; this one really helped me before I started DIY Looping: https://www.sugarsurfing.com/
The 42 Factors that influence blood glucose: [https://diatribe.org/diabetes-management/42-factors-affect