Why You Need to Know About Postprandial Glucose
Anyone diagnosed with diabetes knows that checking their fasting blood glucose (glucose levels after 8 hours of not eating) is integral to understanding their optimum blood glucose range and keeping their diabetes in check. However, once-daily glucose checks are no longer sufficient for providing full information on your day-long glucose highs and lows. Postprandial glucose checks now make up the second half of the full glucose monitoring picture. Here’s what you need to know about postprandial glucose:
What It Is
Postprandial Glucose, or PPG, defines blood sugar levels after a meal. Glucose levels start increasing 10-15 minutes after a meal and peak 1-2 hours after that. In non-diabetic individuals, this blood sugar spike usually settles to premeal levels (under 140 mg/dL) within 2-3 hours due to efficient insulin action.
However, the absence or underproduction of insulin in someone with type 1 or type 2 diabetes means that blood sugar remains elevated well above the American Diabetes Association (ADA) recommended 180 mg/dL. These unprecedented spikes, if left unnoticed for long, result in numerous diabetes complication over the years.
PPG and HbA1C
Hemoglobin A1C levels are top of the list in any diabetes management program. This is because high HbA1C drastically increase the incidence of diabetes-related complications, particularly diabetic neuropathy (nerve damage), retinopathy (eye damage), and nephropathy (kidney damage).
The normal A1CE for someone with diabetes is 7%. However, even the most minor and insignificant PPG spikes, if allowed to increase unchecked, can elevate HbA1C to dangerous levels, resulting in gradual damage to the eyes, nerves, and kidneys.
How PPG Control Aids Diabetes Management
In addition to preventing diabetes-related complications, regularly checking postprandial blood glucose levels alongside fasting and pre-prandial levels provides the following benefits:
- Aiding the care team in find ways to normalize A1C levels in people with problems reaching their target A1C goals. The user-friendly GluSage blood glucose meter helps ease the process by storing your blood glucose data safely within your smartphone after every reading.
- Helping to determine the effectiveness of an overall diabetes plan.
- Helping doctors determine and adjust optimum pre-meal insulin requirements in people with type 1 diabetes.
Who Should Check Their PPG?
While PPG requirement and frequency varies from person to person and requires consultation with one’s care team for determining individual target goals and testing regimen, certain factors may require more frequent PPG checks:
- Trying new insulin or a new insulin dosage
- Uncontrolled diabetes
- A history of Postprandial glucose elevation
- Taking multiple medications
- High risk for hyper- or hypoglycemia
- Pregnant women with type 1, type 2, or gestational diabetes
Ways to Keep PPG in Check
- Sugar Check
Always do a PPG check 90 minutes after a meal, as this is when the injected insulin or ‘analogue’ insulin has reached maximum effect. In people with type 1 diabetes, blood sugar levels should generally be between 5-9 mmol/litre after 90 minutes.
- Carb Counting
Since carbohydrates elevate PPG levels more than either fats or protein, checking and adjusting the amount of carbohydrates in your meals can help with achieving optimum PPG levels. This is especially true for people with type 1 diabetes, who have to inject their pre-meal insulin by estimating the total calories in every meal to avoid hypo- or hyperglycemia.
- Low Carb Diet
Some people may benefit from following a low-carbohydrate diet that involves limiting whole grains and starchy vegetables and fruits to small once or twice daily portions, or replacing them with non-starchy vegetables, healthy fats, and protein.
This aids natural insulin with easily processing the consumed sugars (since carbohydrates convert to sugar in the bloodstream) in people with type 2 diabetes, and eases the lengthy insulin calculations for those with type 1 diabetes. You can start off with some healthy, low-carb lunch ideas. However, consult with your doctor before adopting a low-carb diet, especially if you take blood sugar-reducing medications or insulin, as it may result in hypoglycemia if the dosage is not lowered.
Note: Always wash your hands before PPG testing as any food residue can be included in the final reading.
Daily blood glucose monitoring is a positive step on your part towards diabetes management. However, checking your fasting, pre-prandial, and postprandial blood glucose can help ensure that your diabetes remains controlled and free of complications.