CGM findings (help please)

(Malin Hallett) #1

Hi gang

I got myself a two week continuous glucose monitor to understand what spikes my blood sugar and therefore my insulin. I got it because I find it all quite interesting and want to try to understand myself better.

I’ve only had it got 24 hours and two things that has surprised me has happened:

  1. I had a massive blood sugar spike (up to 13 mmol/ L) after having a meal consisting of a burger, cheese, bacon and halloumi. With a Pepsi max. It was in a restaurant so I can’t be sure what was in the burger but I doubt they’d be able to put enough breadcrumbs in to spike that much. Could it have been a reacting to the sweetener in Pepsi Max? All I read is that sweetener does not spike you blood sugar so that seems unlikely. Maybe they accidentally gave me a normal Pepsi??

  2. I had three events on low glucose during the night. One was very low (3 mmol / L). Is this to be expected on a keto diet or should I be worried?

I am a little concerned by these readings and would really appreciate some advice from those of you who understand the science behind glucose / insulin and the keto diet. My “normal” fasting glucose appears to be around 4.7-5.7.

Many thanks

(Alec) #2

Mal
My thoughts:

  1. Don’t worry about low blood sugar readings at all. The body knows what it’s doing in controlling blood sugar. Let it do its thing. No danger here.
  2. But glucose spike after a restaurant meal….Hmmmm…. It is possible they gave you a non-diet Pepsi. Like you I can’t really see how those ingredients would spike you that much.
  3. It is possible that sweetener would make you secrete insulin, but that would result in your blood glucose going down, not up.
  4. It is all highly suspicious BUT, that’s why you get these tools to see what happens. I reckon you should go back again and order exactly the same thing and see if your body reacts in the same way.
    Cheers
    Alec
(Marianne) #3

I’ve never used a CGM and will be interested in reading the comments from some of the experts here. I’m wondering if you could tell/feel when your blood sugar spiked or when it was very low? I would think that the longer you are on this, the more your body and metabolism will normalize. Like Alec said, I think the body knows what it is doing in controlling blood sugar (ketones and everything else), especially after being consistent with your woe for as long as you have now.

(Bob M) #4

That is a big blood spike. One night, I ordered a “safe” meal from an Asian restaurant, with soup that had no rice or noodles in it, seaweed salad, and fish. Massive blood sugar spike, I’m guessing from whatever they used (corn starch?) to thicken the soup. This is what I made up for this;

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Note: The software I had back then only gave a reading when you read the sensor, so I don’t know how high my blood sugar actually went.

I always got my lowest readings at night. Not sure that’s me sleeping on the sensor, though I doubt it because it was always low at night. I can’t have been on it all the time. My highest readings (for a normal keto day) were in the morning.

This shows the lows, almost always at night;

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Note too that the first time you eat carbs, you’ll have a higher blood sugar because there are two phases of insulin response, one that’s based on what you’ve been eating, and one due to the food. Since you have been eating keto, you don’t really have first phase. This comes from Ben Bikman, not me. You’ll get the first phase “back” if you eat carbs a few times close together.

(KM) #5

Chinese commercial cooking also (at least used to) contain a lot of MSG. It’s possible this or some other flavor enhancer in the meat of the burger could have had a spiking effect.

(Malin Hallett) #6

Thank you, that’s super helpful. Unfortunately I can’t go back as we were away visiting friends and we are only in the area once or twice a year. Having had a full day of eating keto under my belt I feel like they must have given me full sugar pepsi. Such a bit spike couldnt have been caused by anything else.

Your comment regarding my low blood sugar has helped calm me down a bit as Google seemed to suggest I should be worried! It’ll also be interesting to see if my lows are as low tonight after a day of stable blood sugar and perhaps it could have been caused by the massive spike 🤷

(Malin Hallett) #7

I 100% felt the blood sugar spike, it was awful and I actually reached for my phone to check my levels during the meal as I could feel my heart starting beating really quickly. We ate around 6pm and I couldn’t go to sleep until midnight even though my blood sugar normalised really quickly (the caffeine maybe?). Not a pleasant feeling at all. Sparkling water for me from here on!

Re the dips, I had no idea, didn’t feel them and was not aware at all 🤷

Yes I hope it can only get better and better now, I’m also pleased that the monitor has showed me I’m not diabetic or pre diabetic as my fastic glucose is normal.

(Malin Hallett) #8

On a normal “keto day” my blood sugar is also highest in the morning which ties into why my ketones are lower, all due to the dawn effect I’m assuming. Saying that I had a BBQ today and had a burger, sausage, chicken thigh and some mayo and my glucose went up to c8mmol / L. Which I thought was odd, maybe I’m one of those people whose bodies like to make glucose from protein?

Do your photo results mean you view 6.5 as a high spike? In which case my 13 really is very high!!

I am hoping the next couple of weeks will provide more clarity!

(Bob M) #9

13 is high, but I got my CGM when I had already been keto for quite a few years (about 4). And I had done a ton of fasting in that time, which likely helped return me closer to normal.

Usually, the people who make glucose from protein have a more delayed reaction (meaning glucose goes up hours later), but I’d guess we don’t really know. CGMs are still relatively new (at least in the US – we still can’t get them over the counter here, have to go to a doctor). For things like this, I’d like to see what happens when thousands of people start using CGMs.

So, you had a burger, sausage, chicken thigh, and mayo and hit 8 mmol/l (144 in US units)? That is high for that food. I can’t think of a reason why that would be. I would say let’s see what happens to a similar meal a few months from now. I’d be interested to know.

(You've tried everything else; why not try bacon?) #10

  1. A normal Pepsi is the most likely explanation. The serving staff is often careless, and they also seem to think that people who ask for diet drinks or decaf coffee are being unnecessarily fussy. What they forget is that there are people, like my late mother, who would end up in the hospital if given the wrong thing.

  2. This is perfectly normal on a keto diet. If you are not experiencing symptoms of low blood sugar (trembling, sweating, palpitations, nervousness), then you are fine, because your liver is making enough ketones to feed your brain. However, if you are taking insulin and your blood sugar drops like that, then it’s an emergency, because you overdosed your insulin and need to bring your glucose up with carbohydrate, to compensate, before the symptoms start.

(Bob M) #11

Good points, Paul.

One of the reasons I decided to go and stay keto is that I saw my dad (mainly) become a Type 2 diabetic. He had to have his pasta. My grandmother and grandfather also ended up being T2. I said to myself that (1) this was wrong, people should have told them they didn’t have to be diabetic; and (2) I was not going to end up that way.

(Malin Hallett) #12

Thank you that is reassuring. I don’t have any symptoms not do I have diabetes so I trust all is well!

(Malin Hallett) #13

Similar story here. My mum passed away at 55, unhealthy in many ways. My dad is an alcoholic, has type two diabetes, has had several strokes. My life has been pretty much dedicated to break the cycle, I refuse to go down the same route.

(Patric) #14

Hi,
My son is T1 diabetic, and uses CGM all the time, so I’m used to interpreting results, sometimes if we got leftover, I use it on myself.

  1. Maybe the Pepsi was spiked with some normal pepsi, I know people say Fat & Protein my raise BG, but in reality it is not really a thing ,you wouldn’t be pick up as a spike on the cgm. I used with my son the blood glucose monitor (those for finger picking), and put it in the coke zero, to see if it contains sugar, yes that works.

  2. Forget lows, you’ll never be low when not using Insulin injections. Depending on where you put the CGM you may apply pressure on it in bed, that is named a compression low, as the cgm is not funcitonning under these circumstances. BG lows is only a thing for people using insulin, or if you have immune condition.

cheers

(Malin Hallett) #15

Thank you very much! :slight_smile:

(Marianne) #16

Does a CGM read values from a finger prick/blood, or how does it work? I know nothing about them.

(Bob M) #17

It reads interstitial fluid in your arm. This has more detail:

The one I used had a sensor with a thin wire that you stuck onto your arm, and a reader. The sensor was round and had a sticky substance on the edge that acted as a seal and prevented water from getting in. I had to read the sensor at least every 8 hours. I then downloaded the data from the reader to a computer. The data was limited, as I only really got actual readings when I used the reader. For instance, I could eat something carby, and I’d get a graph of it, but no actual numbers unless I happened to read the sensor during the spike.

Now, they link with your phone usually. I also think you have more access to the actual data.

Here’s an example:

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This was a glucose tolerance test (you drink glucose then wait for a few hours). I have no idea how high my peak went, because I got so sleepy (early Saturday morning) that I forgot to download the data. I’d love to know how high my blood sugar got.

(KM) #18

The C is for “continuous”. A micro-needle in a stick-on patch is continually monitoring glucose in your body fluid (it doesn’t need to be inserted into a vein, just under the skin).