Let’s talk about blood sugar, or blood glucose. Maybe you’ve been diagnosed with diabetes or prediabetes and you’re not sure where to start. Or maybe you’ve just been hearing some buzz about “blood sugar-friendly foods” and you’re wondering if you should pay attention.

When blood sugar spikes after eating, it can leave you feeling tired, lethargic and moody. Over time, chronic blood sugar issues can put you at risk for conditions like kidney disease, heart disease and even dementia.

The good news is, you can improve your blood sugar control today with a few simple steps.

What causes blood sugar spikes?

First, let me define what a blood sugar spike is and how it happens. A blood sugar spike occurs when your blood glucose level rises right after eating. This is actually a normal occurrence in all people after eating foods that contain carbohydrates. When this happens, two important reactions take place in the pancreas: an immediate release of insulin and an immediate release of a hormone called amylin.

Insulin works quickly to move glucose out of the bloodstream and into cells. This takes just a matter of minutes. The amylin helps prevent food from reaching the small intestine too fast (where most nutrients are absorbed). Most of the time, the after-meal blood glucose rise is temporary, even hardly noticeable.

But for people with diabetes, these normal post-meal reactions are hampered. In people with Type 2 diabetes, the pancreas makes insulin, but the cells don’t respond to it as they should. This is referred to as insulin resistance.

Since the glucose can’t get into cells, the blood sugar level quickly rises. Diabetics (Type 1 or Type 2) who are on insulin therapy typically experience a significant delay in the reduction of blood sugar because it can take up to 15 minutes for the insulin to begin working. Diabetics also either do not produce amylin at all, or not in sufficient quantities. This causes their food to be digested much faster.

As a result of delayed insulin release and a faster digestion rate, blood sugar levels can rise very high right after eating. Once the insulin finally kicks in, a rapid drop in blood sugar can occur.

How these blood sugar spikes affect your health

Over time, recurrent spikes in after-meal blood sugars can raise your HbA1c level. HbA1c is a measure of your average blood sugar over a three-month period. Having an elevated HbA1c has been shown to increase the risk of other health complications.

Research has shown that frequent high blood sugar levels after a meal can exacerbate the onset of kidney disease and accelerate the progression of retinopathy. Type 2 diabetics may experience more cardiovascular problems when post-meal blood sugar spikes occur frequently.

Cognitive decline, including an increased risk of dementia, has also been associated with after-meal sugar spikes and large variations in blood sugar levels. Other short-term complications can include fatigue, cognitive impairment (also called brain fog), reduced physical ability and changes in mood.

One study conducted on the effects of acute high blood sugar on cognitive function and mood in Type 2 diabetics found that the speed of information processing, memory, and some features of attention were all impaired during elevated blood sugar readings. It was also noted that participants experienced a reduction in energy and increased sadness and anxiety.

Living with type 1 diabetes requires you to regularly check your blood sugar levels before you eat. However, we may not always consider what happens to our sugar levels immediately after we eat; despite it being very normal for people who don’t have diabetes, let alone those who do, to temporarily have high sugar levels.

Given that having high sugar levels can give you symptoms like thirst, tiredness and needing to go to the toilet a lot, learning about ways to try and reduce spikes in your sugar levels after meals may make a difference to your overall health and wellbeing.

Why do people get blood sugar spikes after meals?

When people eat a meal, especially when it contains carbohydrates, it is normal for them to have a temporary spike in their sugar level (often known as a post-prandial spike) before the insulin their body produces immediately starts working to lower the spike. For someone with type 1 diabetes, who can’t produce their own insulin, these spikes can be higher and last longer

This is because it can take longer for the type of insulin they inject (or that is delivered via an insulin pump) to start working, in comparison to the insulin that is produced naturally by the body of someone who does not have diabetes, to reduce these post-meal spikes.

Furthermore, it is important to know that people living with type 1 diabetes may have alterations in different digestive enzymes which will cause faster digestion of our meals (resulting in the glucose reaching the bloodstream faster). This can obviously impact on the size of the spike too.

Why is it important to reduce the size and duration of these spikes?

Reducing these spikes may help you to increase the amount of time you spend in your target blood sugar range (also known as the time in range), which will have a positive impact on your future health. You should consult your healthcare team to understand the best target range for you, as this will differ from person to person. However, the International Society for Paediatric and Adolescent Diabetes (ISPAD) recommends a target of 5.0-10.0 mmol/L (after meals, when there is no longer any active bolus insulin on board).

Symptoms of a high blood sugar level also vary in individuals, but they may cause you to feel thirsty, tired, stressed and need to go to the toilet a lot. In the short term, by avoiding prolonged high blood sugar readings after eating, you should also reduce the occurrence of these symptoms and improve your energy, cognitive (thinking) and athletic ability and overall mood.

How do I detect spikes in my sugar levels?

The exact timing of blood sugar spikes can vary from person to person and meal to meal. However, on average, the post-meal peaks tend to be about one hour and 15 minutes after starting a meal.

The best way to measure post-meal patterns is by using a continuous glucose monitor (CGM) or Flash monitors. These devices can give you a clear view, including graphs, of what happens with the glucose levels after meals without the need for finger pricking (image below). You can ask your diabetes health team if they are available for you as they are not available to everybody.

If you are not using a CGM, then please speak to your healthcare team about the best way to do this for you with finger prick testing.

How do I know it is a spike?

There is no universal answer or specific guidelines on when a sugar level is too high after meals. However, if post-meal readings are consistently above your target range (or the recommendations from ISPAD 5mmol/L to 10mmol/L), then you should discuss whether it would be beneficial for you to address these spikes and how to do this, with your healthcare team (see below for some suggestions for your discussion).

If you are reviewing your post-breakfast sugar levels, you should also be aware of changes in your hormones in the morning, which cause increases in sugar levels (this is known as the dawn phenomenon). This Digibete video may help.

Diabetes management takes awareness. Know what makes your blood sugar level rise and fall — and how to control these day-to-day factors.

When you have diabetes, it’s important to keep your blood sugar levels within the range recommended by your healthcare professional. But many things can make your blood sugar levels change, sometimes quickly. Find out some of the factors that can affect blood sugar. Then learn what you can do to manage them.

Food
Healthy eating is important for everyone. But when you have diabetes, you need to know how foods affect your blood sugar levels. It’s not only the type of food you eat. It’s also how much you eat and the types of food you combine in meals and snacks.

What to do:

Learn about planning balanced meals. A healthy-eating plan includes knowing what to eat and how much to eat. Two common ways to plan meals are carbohydrate counting and the plate method. Ask your healthcare professional or a registered dietitian if either type of meal planning is right for you.

Understand carbohydrate counting. Counting carbs involves keeping track of how many grams of carbohydrates you eat and drink during the day. If you take diabetes medicine called insulin at mealtimes, it’s important to know the amount of carbohydrates in foods and drinks. That way, you can take the right dose of insulin.

Among all foods, carbs often have the biggest impact on blood sugar levels. That’s because the body breaks them down into sugar, which raises blood sugar levels. Some carbs are better for you than others. For example, fruits, vegetables and whole grains are full of nutrients. They have fiber that helps keep blood sugar levels more stable too. Eat fewer refined, highly processed carbs. These include white bread, white rice, sugary cereal, cakes, cookies, candy and chips.

Get to know the plate method. This type of meal planning is simpler than counting carbs. The plate method helps you eat a healthy balance of foods and control portion sizes.

Use a 9-inch plate. Fill half of the plate with nonstarchy vegetables. Examples include lettuce, cucumbers, broccoli, tomatoes and green beans. Divide the other half of the plate into two smaller, equal sections. You might hear these smaller sections called quarters. In one quarter of the plate, place a lean protein. Examples include fish, beans, eggs, and lean meat and poultry. On the other quarter, place healthy carbohydrates such as fruits and whole grains.

Be mindful of portion sizes. Learn what portion size is right for each type of food. Everyday objects can help you remember. For example, one serving of meat or poultry is about the size of a deck of cards. A serving of cheese is about the size of six grapes. And a serving of cooked pasta or rice is about the size of a fist. You also can use measuring cups or a scale to help make sure you get the right portion sizes.

Balance your meals and medicines. If you take diabetes medicine, it’s important to balance what you eat and drink with your medicine. Too little food in proportion to your diabetes medicine — especially insulin — can lead to dangerously low blood sugar. This is called hypoglycemia. Too much food may cause your blood sugar level to climb too high. This is called hyperglycemia. Talk to your diabetes health care team about how to best coordinate meal and medicine schedules.

Limit sugary drinks. Sugar-sweetened drinks tend to be high in calories and low in nutrition. They also cause blood sugar to rise quickly. So it’s best to limit these types of drinks if you have diabetes. The exception is if you have a low blood sugar level. Sugary drinks can be used to quickly raise blood sugar that is too low. These drinks include regular soda, juice and sports drinks.

Exercise
Exercise is another important part of managing diabetes. When you move and get active, your muscles use blood sugar for energy. Regular physical activity also helps your body use insulin better.

These factors work together to lower your blood sugar level. The more strenuous your workout, the longer the effect lasts. But even light activities can improve your blood sugar level. Light activities include housework, gardening and walking.

What to do:

Talk to your healthcare professional about an exercise plan. Ask your healthcare professional what type of exercise is right for you. In general, most adults should get at least 150 minutes a week of moderate aerobic activity. That includes activities that get the heart pumping, such as walking, biking and swimming. Aim for about 30 minutes of moderate aerobic activity a day on most days of the week. Most adults also should aim to do strength-building exercise 2 to 3 times a week.

If you haven’t been active for a long time, your healthcare professional may want to check your overall health first. Then the right balance of aerobic and muscle-strengthening exercise can be recommended.

Keep an exercise schedule. Ask your healthcare professional about the best time of day for you to exercise. That way, your workout routine is aligned with your meal and medicine schedules.

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