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The Question
Wed Sep 12 19:50:46 UTC 2012

Is it normal to spike to over 200 with maybe approx 45 carbs, even if I come back down to 110 say 3/4 hours later. New FP thinks that is ok.I disagree
Asked By: pmaridon  

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type 2 for 11 years, always had good control. Regular walking but maybe not the best portion control. Have lost some weight but even if I exercise any carbs send me shooting straight up. I was on 120 Victoza & 2000 metformin.My last a1c approx 7 weeks ago was 5.6 which sounds great however, I tried to explain that while waiting to get 1st appt with new fp, I supplemented some Janumet with my Victoza for approx 2 weeks. I believe that skewed the a1c. Once I started testing more frequently, I have been surprised to see morning spike over 200 and lunch around 170, again, that's with a lowfat yogurt & an apple. Getting paranoid to eat. Dr. insists no need for change because of a1c and that's ALL she looks at? I think those spikes are stressing my pancreas out and if I needed to change over to some basal insulin with say Janumet or even adding some glipizide. I am trying to work out more, but I want to enjoy some good stuff every now and then without worry so much. Your thoughts?
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Expert Answers (1)
2012-09-18 20:35:54.0


Thanks for asking dLife.

You are correct that A1C only provides part of the story. By increasing your diabetes medication weeks prior to A1C could very well influence the lab result. Variations in blood glucose (sugar) levels throughout the day complete the story.

A single high blood sugar reading usually would not be a cause for alarm. However, blood glucose levels frequently remain high would definitely be a concern. The goal is for after-meal blood glucose levels to return to pre-meal range within one to two hours. If glucose values raise 50-80 points from before the meal to two hours after the meal, then the meal was OK. Blood glucose values exceeding 250 mg/dL would be considered toxic to the insulin-producing cells of the pancreas.

Are you are eating less food (fewer carbs) to keep the blood glucose within target range? Diabetes medication and dosage should match a healthy lifestyle.

I recommend that you talk with a registered dietitian specializing in diabetes to fine-tune your meal and exercise plan. Continue to monitor your blood glucose levels and keep them as close to normal as you can. This is crucial for maintaining good diabetes control and reducing your risk of diabetes complications.

Read about after-meal spikes!

Take care.

Answered By: Liz Quintana
Accreditations: EdD, RD, LD, CDE
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*** All information contained on dLife.com is intended for informational and educational purposes only. Our Expert Q&A is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.

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