How high should BG be (2)hrs after a meal ??

[Katmandu]

How high should BG be (2)hrs after a meal ??

[xMenace]

I'm happy under 180, but I believe '145' is the official target.

[carokaye]

I've been told below 140.

[mg_2204]

I've been told 6.9 or lower (124 mg/dL).

[Cyborg]

From this graph (http://www.diabetesforums.com/forum/diabetes/17046-normal-blood-glucose-graph.html?highlight=graph#post202889), it appears to be 90-160...

[DeusXM]

Back to what it was before the meal.

[Cyborg]

Back to what it was before the meal.

Not in 2 hours as the insulin is still working. 4 hours is more realistic to return to target...

[slipperyelm]

I prefer to be under 100. (T-2. low carb)

[owlyn]

The "don't be scared if... " levels are <180 at 3 hours and < 150 at 2 hours. Preferred targets are much lower, however.

[duck]

From this graph (http://www.diabetesforums.com/forum/diabetes/17046-normal-blood-glucose-graph.html?highlight=graph#post202889), it appears to be 90-160...

Wow, Cyborg: Am I right in reading this graph, that it says we should NEVER be higher than 160 after a meal at any point?

[Cyborg]

Wow, Cyborg: Am I right in reading this graph, that it says we should NEVER be higher than 160 after a meal at any point?

The graph represents bg levels after eating and represents values for non-diabetics. The 160 is on the high end of the results. So, I suppose if you want to keep non-diabetic bg values, you should try to stay below 160 (or even lower if you take the mean average value of 140).

[notme]

I always shoot for <140. If I am in the 180 range, I might do a very small correction.

[LancetChick]

I aim for 100 (5.5) or less, even though non-diabetics have post-prandial spikes that go over that, because non-diabetics don't see highs from stress hormones, liver dumps or having their pancreas miscalculate an insulin dose. I figure that if I can avoid post-prandial spikes, I'll have roughly the same sort of balance that a non-diabetic has.

[cheryl]

I am fine with 140 and under, i want it the same as when i ate, and i get it there, and then i eat a snack....works for me.....i get a snack with no added insulin, takes a bit of work to figure what ratio will do this, but i got it down....eventually and I am happy with this because during stress and hormones i will see a 140 or higher post meal, so those few times or sometimes that it happens, is not a big deal so i save the bad blood sugars for things i cannot prevent....

Cheryl

[Harold]

How high should BG be (2)hrs after a meal ??
The way I read this question my response would initially be 70 (3.9). To clarify, between 80 and 120 (6.7) was the old official line. Personally I like to be between 80 and 100. This gives me enough glucose to get through till snack time or the next meal and A1c's below 6%. At least that's what I shoot for.

[someone]

Ideally, you should have as small of a spike as possible meaning that 2 hours after your meal you should be close to what you were before the meal. Sometimes this may require bolusing a few minutes before you eat. I have noticed that exercise also has a huge effect on how large the spike after meals is. If you are just going high and remaining high after meals, you might want to revise your insulin-carb ratio.

[sofaraway]

I would want to be the same as what i was before the meal (unless i was also correcting). which would be below 7mmol/l.
i don't ever test before the 2 hours, so I don't know how high I do spike, but as long as I am back down by 2 hours I am happy with that.

[Cyborg]

If you are taking insulin, it doesn't make sense to try and return to your target bg 2 hours after eating. Even the fastest insulins available last about 4 hours and hypos aren't that fun...

[cheryl]

If you are taking insulin, it doesn't make sense to try and return to your target bg 2 hours after eating. Even the fastest insulins available last about 4 hours and hypos aren't that fun...

Exactly that is why you learn how many carbs you need at that two hour mark and not get the hypo......I know i can eat from 8-18 carbs depending on my activity level.....it works....for me....cause insulin your right lasts....then only time it is hard for me to judge is dinner time, but I am at home and after the 2 hr mark, i test again after the three hour mark and if it is lower then I know i need a snack if it levels off still I am good to go, if that makes any sense.....

And I am being totally honest, I have not suffered any hypo's at all doing this only in the middle of the night here and there, those are tricky because depending on your activity before bedtime i just still can't judge it LOL....

Cheryl

[princesslinda]

When I spoke with the diabetes nurse just after diagnosis, she gave me the goal of 140 or < 2 hrs after a meal, saying the closer I got to non-diabetic ranges, the better I would be complication-wise in the long run.

Usually, i'm in the high 70's just before a meal, and usually in the low 95-110 range 2 hrs after (I eat a low carb).

[DeusXM]

If you are taking insulin, it doesn't make sense to try and return to your target bg 2 hours after eating. Even the fastest insulins available last about 4 hours and hypos aren't that fun.

After two hours though, their effect is severely diminished. If you eat a meal which has slow-acting carbs in it, providing you do it right then you'll match the decreasing action of the insulin with the decreasing carb absorption from the food.

[Funnygrl]

The graph represents bg levels after eating and represents values for non-diabetics. The 160 is on the high end of the results. So, I suppose if you want to keep non-diabetic bg values, you should try to stay below 160 (or even lower if you take the mean average value of 140).
I'm reading this differently- the 160 is 2 standard deviations away from the mean.

[pdxdennisj]

The American Society of Endos suggests an A1c of
6.5 as a target for acceptable control. If you enter 6.5 into the conversion program on this page you get "Result: An HbA1c of 6.5 is equal to an average blood glucose of 154.1 mg/dL. Great control!" I would think if an *average* of 154 is "Great Control" we must be looking at highs on the order of 180 or so. My Endo (Head of the Dept. at my hospital) is really happy with an A1c of 6.3 for me.:D

[kgm0612]

My target range set by my endo is under 140. I prefer to be in the 110-120 range, but that doesn't always happen! LOL

Karen

[Gary_W]

After two hours though, their effect is severely diminished. If you eat a meal which has slow-acting carbs in it, providing you do it right then you'll match the decreasing action of the insulin with the decreasing carb absorption from the food.

I am having far better luck doing this with the Apidra than I did with Novorapid. Whilst the Apidra certainly still lasts 4 hours for me it seems like it has done 80% + of its work by hour 2. Novorapid was more like 50-60%. For this reason, I am generally within 1 mmol/L (18 in US figures) of pre-meal levels after 2 hours. On the Novorapid, I would often eat a little less at the meal and over-inject slightly. My levels would be pretty good at hour 2 then I'd have an apple to mop up the rest of the insulin contained in its slightly longer tail. It's pretty rare that Apidra sends me hypo if I am down at a BG of 5 at hour 2, though that depends on what I ate; if it does, a couple of glucose tabs is usually enough so it's not much.

Coincidentally, I tested this morning at hours 1, 2 and 3 after breakfast. Before breakfast, I was 5.8 (104) which is a little high for me of a morning. An hour after breakfast I was 5.0 (90), at hour 2 I was 6.7 (120) and at hour 3 I was 4.9 (88). I stayed there quite happily until lunchtime :) I could never imagine a 'peak free' morning before, and it's only now I've been lucky enough to achieve it. Breakfast was wholemeal toast with marmalade and a grapefruit with fructose. Around 60g of carbs in total.

To answer the OP, I think the answer differs between types 1 and 2. For type 2 my feeling is that you should be as close to pre-meal level as humanly possible. For type 1, you should be as close as possible without risking going hypo in hours 3-4. How well you can do this depends on your metabolism, which insulin you take, what you typically eat etc.

Gary

[Cyborg]

And if you apply Dr. B's rule, less carbs means less insulin, which means less room for error (and hypos)...

[LancetChick]

If you are taking insulin, it doesn't make sense to try and return to your target bg 2 hours after eating. Even the fastest insulins available last about 4 hours and hypos aren't that fun...

Returning to your target level at 2 hours post-prandial doesn't necessarily mean that you've taken too much insulin, and you're headed downhill. My digestion is fairly slow, and matches well with insulin for quickly digested foods. When digestion is stretched out over a period of time I double or triple bolus to match the digestion curve. If I see a reading of 110 2 hours after eating, I know that I've under-bolused and need more insulin. If I eat a hot fudge sundae with Cool Whip (made of corn syrup) and maraschino cherries, I don't expect to see a blood sugar spike. Yes, it's sheer luck I suppose, but I'm diabetic, and my share of the statistics still counts.

[shockme]

my dr follows the ada guidelines.she tells me 180 or lower 2 hrs. after a meal...reading all the other responses-that seems high...trish

[cherokee_psh]

I was told under 140. But others in the same educational class were told higher amounts. It seems to be a range that is determined by your treatment team based on factors specific to you.

[someone]

If you are taking insulin, it doesn't make sense to try and return to your target bg 2 hours after eating. Even the fastest insulins available last about 4 hours and hypos aren't that fun...

I COMPLETELY disagree. I think you should at least put an effort towards having a minimal BG spike. Having had a CGMS for a couple months now, I have found ways to keep my BG in range the majority of the time, including after meal. What has the most significant effect on my post-meal BG is exercise. Exercise and proper bolusing can be used to almost eliminate the spike. When I have not been very active, I try to bolus 15-30 minutes before eating a high carb meal.

[sofaraway]

If you are taking insulin, it doesn't make sense to try and return to your target bg 2 hours after eating. Even the fastest insulins available last about 4 hours and hypos aren't that fun...

I take novorapid and I've found it's almost done by 2 hours. If I am not low at 2 hours then I will not go low. if I am high then I will often correct because I'm not going to go much lower. It depends on how high I am as to whether I decide to correct or not.

[Cyborg]

If you don't bolus for protein, then the 2 hour mark may be safe and your bg may stay level. If you don't eat alot of carbs, the same applies.

When it comes to pre-bolusing, I'm all for it and I do participate. I think it's a great way to contro the PP bg spikes. I took the question as a type 1 taking insulin right away when they start to eat...

[pdxdennisj]

I think that type 1s sould check before they offer advice to see if the person they are addressing is a fellow type 1. Type 2s seldom are placed on fast acting insulin and thus cannot adjust the amont of insulin they take to the degree that a type 1 can.

[ubergeek]

Wow, I was always told to shoot for a target of 180 or lower. I think this never gave me enough control, so I am going to shoot for lower. I have found since starting Symlin last week I am getting better 2 hour pp blood sugars.

[LancetChick]

I think that type 1s sould check before they offer advice to see if the person they are addressing is a fellow type 1. Type 2s seldom are placed on fast acting insulin and thus cannot adjust the amont of insulin they take to the degree that a type 1 can.

True, but we all share the common goal of achieving a satisfactory blood sugar level 2 hours post-prandial, no matter which method is used to get there. If you find that your 2-hour readings are unsatisfactory, you have many options for making improvements, including changing meds, adjusting diet and possibly starting an insulin regimen that includes a fast-acting insulin if you seek more flexibility. I'm not a type 2, but I don't believe that you guys are stuck in a box. What 2-hour levels would you find acceptable if you had more flexibility?