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11/21/09 02:14 PM

"My BS peaks 2 1/2 to 3 hours after meals, testing 2 hours after meals does not give me accurate post meal readings. Is it all right to test at 3 hours"
Asked By: highcountryhiker  
Category: Blood Glucose Monitoring

Background Info Hide
I was diagnosed as a Juvenile Diabetic at the age of 19. A few months ago, prior to having surgery for what they told me was an exploding cataract (which came on suddenly) it was discovered my blood sugar was 254. I have now been re-diagnosed as Type 2 diabetic. I weigh 140 lbs at 5'4" but am told by my endo. he is not concerned. I'm currently on 500mg Metformin twice a day, test before and after meals and try to keep by BS and diet under tight control. In the past three months my A1c has gone from 9.9 down to 6.0. I've been testing 2 1/2 - 3 hours after meals to make sure my levels are dropping and not still climbing. Years ago, (the result of numerous tolerance tests) I was told my blood sugar continues to climb for about an hour after the normal peaking of 1 - 2 hours and drops fast.. Should I go back to testing 2 hours post meal, even though I might still be climbing? Since my A1c levels are coming down is it alright to continue testing as I am doing now? Is there any danger?

Expert Answers (1)

12/03/09 12:56 PM

HelloHighCountryHiker: Thanks for asking dLife, good job with bringing that A1C into the recommended range! Blood glucose readings are influenced by many things :
  • (under normal conditions),medications
  • balanced by foods
  • then activities. Testing 'guidelines' are established by those observing best practice for 'most' , I do believe these guidelines establish a reference point and should be individualized based on one's glucose results trends, per MD. These guidelines suggest: 'when A1C targets are 'NOT' met, it is important to check plasma glucose levels 2 hours after the start of the meal if pre-meal blood glucose values,(<110mg/dl), are within the desired ranges.

    Glucose readings are derived via absorption which is a multi-faceted process. Carbohydrates, which convert to 100% of the blood sugar, beings to be digested in the mouth, continue into the stomach, and completes in the small intestine. The individual variables you bring: perhaps you consume more protein and fat which require a longer digestive time, protein fuels the blood glucose at approx. the 3-4th hour post start of meal, and fat fuels the glucose slightly at 4-6th hour post start of meal. These are ranges due to the individual digestive processes of

  • absorption/digestion
  • and the content %(carb, protein, and fat) of the meal. I would suggest a nutrient analysis via www.Fitday.com or www.Sparkepeople.com, as to identify what % of carbs, protein and fats are in the diet. While many variables fuel the glucose, when it comes to monitoring, (now that the A1C is good), to get the biggest value from testing
  • continue 2 times per day,
  • vary all the times, by the
  • end of a week you have 14 different times,
  • do a excel spread sheet,(log/spread sheet/share with healthcare team. Readings, regardless of the time, should not exceed 140, per American Diabetes Association-180 mg/dl-per American Association Clinical Endocrinologist. Hope this helps, be your best. Regards Sue
    • Answered By: Susan Throop
    Accreditations: RD, CDE, MA
    Sources Show

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