FAQ: I have a glucose spike from literally everything. I can’t eat any carbs. What should I do?
FAQ:
I have a glucose spike from literally everything. I can’t eat any carbs. What should I do?
Answer:
We appreciate your concerns here and understand how frustrating this can be when trying to optimize your health goals.
First, let’s get on the same page as to what a 'spike' is in the app. Not every glucose rise is considered a glucose spike.
While there isn't a great scientific definition of a spike, the Levels app will register a spike when your glucose exceeds 109 mg/dL and the difference between the start of your spike and the peak of your spike is +30 mg/dL. So let's say you're glucose is around 100 mg/dL and you have a meal and see your glucose rise above 130 mg/dL, that would be considered a spike. If it only rose by 25 points we wouldn't count that as a spike.
You can find more information about glucose response here. That article explains the 3 components we assess when analyzing a spike:
- Glucose Increase: How high glucose rose.
- Glucose Slope: How quickly it went up.
- Area Under the Curve: How long it stayed elevated before returning to baseline
Keep in mind that the spike itself does not necessarily indicate an issue. With a large enough carb/glucose load many of us will spike, what matters most is how high glucose remains elevated. Ideally we'd want to see glucose return to baseline within 90 minutes to around 2-3 hours, as this helps us understand how long our body takes to clear a large glucose load.
Also, some people become more insulin resistant in different stages of life, and that can make it feel like any amount of carbs leads to a very large glucose spike. More context on these articles:
What is insulin resistance?
What causes insulin resistance?
How to avoid insulin resistance and why it’s important
Glucose Increase:
When you see a glucose rise, this is your body's response to the carb load in the meal. There are a few factors that can impact how your body handles the carb load within a given meal.
- The total amount of carbs in the meal. Beyond a certain threshold, your body may have a hard time processing larger amounts of carbs at one time.
- Eating 'naked carbs' or having a much higher carb to protein, fiber, and fat ratio.
- The more fiber that's contained in the meal, typically the slower the glycemic response.
- The fat and protein content also works to slow the absorption of glucose especially.
- Whether or not you were fasting before eating the meal. Breaking a fast can often lead to a larger glucose response so it's best to break a fast with meals higher in protein, fat, and fiber and slowly reintroduce carbs.
- Proximity and frequency of exercise and movement. Regular movement primes the body to be ready for glucose uptake. Therefore regular movement throughout the day is a great mechanism to improve your body's glycemic response.
Glucose slope:
The next thing we look at is the slope of the glucose curve, how long and quickly the glucose rises. This metric correlates most with how quickly you took in a high-carb meal or a meal that has a carb load that is too easily broken down. You may see this occur after having a sugar-sweetened beverage, a large quantity of 'naked carbs' on an empty stomach. A 30+ point rise that goes straight up vs. a 30+ point rise that slowly rises may also feel different in your body.
Area under the curve:
Next, we look at the 'area under the curve'. This is simply the space under the curve. What we're looking for here is the least area under the curve. Does your spike look more like a line with a rapid rise and return, or does it rise and stay elevated for a long time? Our current understanding of metabolic health indicates that a spike that remains elevated for more than 2-3 hours is correlated with worse metabolic health.
A quick note on return to baseline:
Regardless of how high you spike, we want to see a quick return to baseline. If you see your glucose fall beyond the start of the spike, we'd consider this a hypoglycemic response and you may feel terrible as your glucose bottoms out. Often you'll see a subsequent rise as your body works to stabilize your glucose levels. This occurs when our body releases too much insulin in response to a high glucose or carb load. This is why we want to avoid sudden glucose spikes and why we prefer to see steady undulations of glucose.
What should I do?
There is plenty you can do to keep your glucose steady, prevent long-lasting spikes, and decrease the area under the curve.
First, consider reducing the overall portion of carbs. We want to be sure our energy intake matches our energy needs. For example, we wouldn't want to eat a high-carb meal if we're going to be sitting and working most of the day, however, a meal with moderate carbs may be perfect before a hike, a long run, or a bike ride.
Second, try increasing the ratio of fat, fiber, and protein in your meal, maybe add in a slice of avocado, some olives, and a bit more protein.
Third, if you are going to have a meal higher in carbs we definitely recommend walking or doing some kind of movement 10-15 min after your meal. When we walk or move our body it allows our muscles to absorb and use the glucose immediately. You can even see this in your CGM data.
Fourth, you can play with the meal order, while this trick doesn't work for everyone, it's definitely worth a try. Some members find eating their carbs at the end of their meal makes a big difference in how their body metabolizes a spike.
Overall, the main reason you'd want to wear a CGM is to understand the impact of your actions (how you eat, sleep, move, etc) and how your body responds. When you log a meal, exercise, or sync your health data to your Levels App, you'll have a 2-hour Glucose Response window related to this and to other logs you created within proximity of each other. The Levels App will provide you with all the personalized feedback, insights, and actions to help you see and improve how food, exercise, sleep, and other lifestyle choices affect your health.
If you have any additional questions please reach out to the Levels Support team at support@levelshealth.com.
Further reading: