Question re Post-Meal Readings

[labob]

Here's the issue: in the less than three months since I was diagnosed, the certified diabetes educator (CDE) I've seen has given me somewhat conflicting advice. When I was diagnosed in December 2005, she told me to test 1-2 hours after meals and shoot for a glucose level of less than 180 mg/dl. (I presented with an mg/dl of 1,000+ and an A1c of 13.4 -- oh yeah, I was feeling pretty bad -- but in less than a month after diagnosis my A1c was down to 10.2, and I'm hoping for an acceptable reading at my next test in April.) The next time I saw the CDE, she told me that I should test 2 hours after every meal, with a target of less than 140 mg/dl.

Well, based on the advice I first received, I had gotten into the habit of splitting the baby and testing at 90 minutes. I'm almost always below 140 at that time, so things are fine. But this week, I once again indulged in my favorite lunch (Mexican food -- I find it hard to resist the lure of rice and beans, but only indulge once a week). I thought I was being really careful about portion size, but my 90-minute reading was 161, definitely over the target. Out of curiosity, I tested again at the two-hour mark, and I was down to 132, which is still higher than where I usually am at 90 minutes, but still within the range if all I'm supposed to do is test at two hours.

So my question is this: when do you folks test after meals? Should the beloved Mexican platter be off limits (or limited to less than the current once a week fix), or is the two-hour test time gospel? I don't want to appear too anal, but I'll do anything not to go back to where I was pre-diagnosis. On the other hand, from my perspective, one of life's great joys is Mexican food (tell that to my Eastern European grandparents), so I don't want to overreact.

Thanks for any insight.

[seacomp]

or is the two-hour test time gospel?
Thanks for any insight.
What's really gospel is that the highest readings after eating should be tested. It's a rule of thumb that two hours is when the highest reading will occur. But actually it depends on the individual and the food eaten.
As to Mexican food, I use to eat a lot of it, but I really can't anymore, it's all carbs.

[valc3]

2 hours after eating is when you should test. As to the rice, I've given it up, too many carbs.

[JediSkipdogg]

You bring up a situation with no factual answer. This is one that differs between everyone.

The rule of thumb is 2 hours after eating you should be no more than 140 mg/dl above your testing directly before you eat. However, for many individuals that number doesn't work, myself being one. I spike high but always return back to normal. I can hit 200+ easily 2 hours after a meal but 4 hours after first eating be back to normal (100-120.) Therefore I see nothing wrong with what you spike as long as you return back to normal.

As for mexican...it fits into the group of alot of foods. Those are called fatty foods (aka slow digesting food.) That is why you had a late peak. Anything high in fat will make you run low first, then peak, then bring you back to normal. I don't see any harm in that as long as you return to normal 4-5 hours after first eating (unless it takes you 4-5 hours to eat.)

[duck]

Sometimes I thank God he made me dislike Mexican food.

But then, I am addicted to chinese food...

[Ritehsedad]

I think your CDE did sorta the same type of thing mine did. When you have high BG for a while, this causes glucotoxicity which impairs the beta cells' ability to produce insulin.

I would guess that she told you 180 to give you a reasonable target to shoot for initially, now that your BG levels have come down, you have reversed the glucotoxicity and have regained some (but probably not all) of the beta cell function lost to glucotoxicity. So now she wants you to be below 140 at 2 hours, which is reasonable. 140 is generally considered the max that a non-diabetic will reach after 2 hours (but usually not above 130).

My CDE told me to test before meals for a few weeks, which I did. My readings came down.

I wouldn't worry about the weekly mexican, just control your portion side (get a take out container and put half in it) and watch the fat.

Good luck!

[psilocybin]

question does glycemic index effect the after meal readings?

[labob]

Thanks for the advice. In a perverse way, I think this is all very interesting (though I confess that my obsession with glucose levels just might be driving those around me a little bit crazy). While I'm still figuring out what and how much to eat, though, I'm testing 7-8 times a day and adjusting my meals accordingly.

I think I might be one of those people who peak earlier than two hours after eating. Not only did my glucose level after this week's Mexican lunch drop from 161 mg/dl at 90 minutes to 132 mg/dl half an hour later, but when I checked my post-breakfast readings today, it did the same thing: I was at 124 mg/dl at 90 minutes and 79 mg/dl at 120 minutes after I finished eating. I'll try double testing a few other meals to determine when I most often peak and use that as my post-prandial testing time, at least until I'm more confident that I've got the hang of this meal planning thing.

In the meantime, maybe I should invest in the companies that make testing strips.

[Harold]

she told me to test 1-2 hours after meals and shoot for a glucose level of less than 180 mg/dl.Not sure if you or she ment 1 to 2, 1 or 2, or 1 and 2 hours. However the current standard is 2 hours < 140mg/dl. You will find the spike occurs around an hour + or - 15 minutes usually and conditional to what your eat. The Glycemic Index of a food has a direct bearing on the spike, but it is only when you have just that food. Adding other food with it will affect the timing of the spike and for that look up Glycemic Load. Also your own Resistance and your insulin response will also affect your response to different foods. The most effective way to find out how different foods affect you is to keep a food log with your bg readings so you can compare them.

Currently to some degree the medical profession does not consider the amount of the spike to be signifigant. However they will also tell you that one of the problems with this desease is swings and commonly a high spike is also followed by a low swing. This is a problem for some of us, but not all of us, and not all of the time. Partly it's due to our bodies seeing an extreme swing and overcompensating due to the resistance. Some people do consider the spike to be important in that with resistance a large spike may or will contribute an increase in resistance and contribute to the deseases progression. You can make up your own mind about this. :stupido2:

[labob]

Thanks, Harold! Perhaps I need to relax just a little bit (my partner would agree) and just check at the two-hour mark.

[Harold]

Thanks, Harold! Perhaps I need to relax just a little bit (my partner would agree) and just check at the two-hour mark.
Your welcomed! A long time ago on this forum I posted the results of testing every half hour for 3 hours after having two slices of pizza, I think. Pizza is a high GL food and some people report having a spike from it 3 or 4 hours post meal and I wanted to find out how it affected me. I see your last A1c was like 10.2 and would not recomend trying high GL foods untill you can get it below 6.5. Mostly because you will react differently if your bg's are high to begin with. One way to figure out how well your monitoring regime is helping you with control is to average out your readings for the previous 3 months when you go in to have an A1c done. See if your average compares to your A1c with the appropiate converter (http://www.diabetesforums.com/82073-post1.html) the link will take you to. The last time I did this my average meter readings were 115 mg/dl and my A1c was 6.2. Which means I am not catching all of the highs. May be I suffer from the Symogi affect or I am cheating on days I don't use a meter. :hmmmm: Good Luck and don't burn your self out, you will be doing this for a very long time.