Two-hour Postprandial Tests Irrelevant?

[Colin_G]

My consultant has told me more than once that testing after meals is irrelevant, despite my always testing at exactly two hours.

Am I way off the mark? I thought post-meal testing was just as important as pre-meal.

Does he have a point? If he does, can anyone tell me what it is please?

[spike]

My consultant has told me more than once that testing after meals is irrelevant, despite my always testing at exactly two hours.

Am I way off the mark? I thought post-meal testing was just as important as pre-meal.

Does he have a point? If he does, can anyone tell me what it is please?

Does he have a point? hmmm...let me think for a moment...NO!!! There is not going to be agreement from the diabetic community that testing 2 hours after meals is "irrelevant". That's how you know you are taking the correct amount of insulin or meds, and/or confirming that your carb count was accurate. You don't want to go sky high after meals.

:) And you can tell your "consultant" that I said that.

[lelggren]

Does he have a point? hmmm...let me think for a moment...NO!!! There is not going to be agreement from the diabetic community that testing 2 hours after meals is "irrelevant". That's how you know you are taking the correct amount of insulin or meds, and/or confirming that your carb count was accurate. You don't want to go sky high after meals.

:) And you can tell your "consultant" that I said that.
Well Said!! The 2 hour is sooooo important! Really, testing at any time is very important. But, as spike said, the 2 hour gives you a lot of info about how your body is processing the food that you take in, and how accurate that your doses are. Just keep testing the 2 hour, and say pooh to the consultant on that issue.

[Tokyo Cate]

Does he have a point? If he does, can anyone tell me what it is please?

I just finished reading the ADA's Complete Guide to Carb Counting and it has some sensible advice about monitoring.

The frequency with which you check your blood glucose and keep records will vary based on your needs and desires, whether you have or need to make an adjustment to your regimen, and whether you regularly adjust your insulin doses based on your results. Some people with type 2 diabetes on one type of medication check their blood glucose two to three times a day a few times a week. Some people with type 1 diabetes on an insulin pump check their blood glucose upwards of six times a day every day. No matter how often you check, keep in mind that you want to check smart versus a lot. Checking smart means checking strategically. Always have in mind why and what you are checking and what information that check will provide.

The book stresses that when checking strategically, all the bases should be covered in a week (fasting, pre-meal and postprandial) though not necessarily in the same day.

I don't feel a need to test postprandial following breakfast because I have the same thing every day, with the same insulin:carb ratio and the same sensitivity factor; however, I will always to a postprandial test if I am unsure of the carbohydrate content or suspect that I am going off target.

[JediSkipdogg]

I myself find the 2 hour check useless. Depending on what I ate it can either go up or down. I find a 4 hour check with no corrective actions to be the most useless. For some a 2 hour check may help them make adjustments, but for me, I can run 250 at 2 hours, correct it to 100, and then 2 hours after that be running 50 without a problem.

It's all in the eyes of the beholder and what they do with that 2 hour check. I for one don't do it.

[psilocybin]

i do test all the time 2 hours after meal....but that is just me liking to know whats going on with my body and sugars..i feel alot more comfortable knowing what my sugars are at

[Cyborg]

I've been consistently testing at 2 and 4 hours after eating since being on the pump, 6 weeks now. The 2 hour test informs me, as Spike states, whether I've under or over bolused for my meal and whether to take a correction or to possibly expect a low (or take action to prevent one).

I will often not take a correction at the 2 hour test to see what the 4 hour test shows. Ideally, I want my bg to be at my target bg 4-5 hours after my meal bolus without a correction bolus. This will happen if the insulin-to-carb ratio is correct. If I were to take a correction bolus at the 2 hour test, then I would have to take into consideration the ISF and I would not be able to truly test the insulin-to-carb ratio. :captain:

[Colin_G]

Thanks for your input, guys. I think Tokyo Cate (or her book) has a point in saying quality versus quantity (or something like that).

I do find the two-hour test useful, but only after lunch and evening meals. The post-breakfast one I find is consistently in double figures (anywhere between 9 and 20 mmol/l) but since it always settles by lunchtime, I've learnt not to let it bother me.

Thanks again.

[drgovind]

i feel 2 hr checking is the best modality to check bsl to see whether ur insulin dose is correct or not.it is useless if u give a dose and ur bsl level actually increases after two hrs.so for the adjustment of the dose it is required to check 2hrs post lunch bsl.

[playgtar]

When I got my pump, they set my duration at 3hrs. So that's when I try to test. That way I don't have any insulin on board, and can see if I've dosed correctly. Then I can make a correction if needed. It's just what works for me. I have tested at 2 hrs in the past. I'm almost always under 200 at 2 hrs, so I like to see if I'm in my range at 3 hrs, when my insulin has supposedly reached its duration.

[Cyborg]

When I got my pump, they set my duration at 3hrs. So that's when I try to test. That way I don't have any insulin on board, and can see if I've dosed correctly. Then I can make a correction if needed. It's just what works for me. I have tested at 2 hrs in the past. I'm almost always under 200 at 2 hrs, so I like to see if I'm in my range at 3 hrs, when my insulin has supposedly reached its duration.

Keep in mind that your bolus insulin really lasts about 5 hours. The tail is usually truncated when you set your duration, but it does have a slight effect still. Something to remember when doing a correction bolus close to bedtime.

It seems that most of the pumpers on the forum set their duration for 3-4 hours. I started a poll recently and it can be found here (http://www.diabetesforums.com/pumping-insulin/8642-novalog-duration.html?highlight=duration). The poll was done for Novalog. I've tried Humalog and Novalog while on MDI and I thought the Novalog had a slightly longer duration for me. I recently changed my pump duration for the Novalog from 3 to 3.5 hours and I'm having less lows now while on the pump. I still test at 2 hours and I will do a correction if the IOB wizard says it is ok to do so.

[rzrbks]

No matter how often you check, keep in mind that you want to check smart versus a lot. Checking smart means checking strategically. Always have in mind why and what you are checking and what information that check will provide.

To cynical ol' me, that sounds like caving in to the HMOs.