Post meal blood sugar query - type 2

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Cat2

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Hi, I was diagnosed with type 2 earlier this month. My gp (and also my gp brother in law when I asked his opinion) don't think type 2 should use blood glucose monitors regularly but when I previously had GD I used one so based on that and advice on here I have bought and used one.

However because this isn't supported by my gp I've had no official advice on what to aim for, so working off this from this website:

"If you have Type 2 diabetesbefore meals: 4 to 7mmol/ltwo hours after meals: less than 8.5mmol/
lIf you have gestational diabetesFasting: below 5.3mmol/lOne hour after meals: below 7.8mmol/lIf you’re not able to check until two hours – rather than one hour – after a meal, you should aim for below 6.4mmol/l."

My question is this. Does anyone know the reason for advising testing after 2 hours for type 2. I've been doing that and thought I was mostly staying within target well, however I recently read that your sugar peaks after about an hour and a quarter, and I have found testing then is higher. Looking at the GD guidelines they also assume higher numbers after 2 hours than one, so advise testing after 1 hour.

So, I guess my question is, do the guidelines focus on 2 hours for type 2 because it doesn't need to be quite as tightly monitored as GD, so if blood sugar briefly goes higher after an hour or so it doesn't matter or much as long as back down within 2 hours? Or, knowing that I'm generally a bit higher at 1 hour than 2, should I be testing at one hour instead?

Interested particularly hear from people who actually know the reasons behind the guidelines.
Thank you!
 
I think It’s more that with gestational diabetes there is a much larger need for tighter control on numbers because there’s two lives. With the two hours it is that you numbers will need to be back in target 2 hours after eating as it shows that your body is able to handle the carbs properly
 
Everyone’s blood sugar peaks when we eat carbs. What you are testing is that your body recovers fast enough, not the highest peak. A spike of 10mmol/l which lasts for 15 minutes is of little concern whereas staying at 10mmol/l for hours is more worrying.
To be honest, different food peaks at different rates and the testing after 2 hours is, as with most of diabetes, a good approximation/average.
As a rule of thumb, fatty foods will peak later and sugary foods will peak earlier.

If you are interested in viewing your full range of values for a couple of weeks, you could register for the free Libre trial on their website.

If you Google Libre graphs for people without diabetes, you will see how high a “normal” person with a healthy pancreas will peak after something like a pizza.
 
With all this sort of thing the suggested sampling time is based on averages, how quickly an individual metabolises food, what the food is composed of, how many carbs in that meal. So the suggested limits give a good guesstimate for people to make meal to meal comparisons as opposed to absolutes as there will also be other variables which come into play, did you sit and watch TV, did you go for a walk, do some housework, dig the garden etc, etc.
As for the recommendation from your GP friends, ask them if they would drive their car if it didn't have a working speedometer. I suspect they would be driving over the speed limit more than 50% of the time.
 
Leadinglights said:
As for the recommendation from your GP friends, ask them if they would drive their car if it didn't have a working speedometer. I suspect they would be driving over the speed limit more than 50% of the time.
Click to expand...
@Cat2 , I would go further than using the speed limit analogy. Ask them how would they feel driving or even travelling in a car without a fuel guage and wanted to be sure they could complete their journey, without having to wait for help.
 
Leadinglights said:
With all this sort of thing the suggested sampling time is based on averages, how quickly an individual metabolises food, what the food is composed of, how many carbs in that meal. So the suggested limits give a good guesstimate for people to make meal to meal comparisons as opposed to absolutes as there will also be other variables which come into play, did you sit and watch TV, did you go for a walk, do some housework, dig the garden etc, etc.
As for the recommendation from your GP friends, ask them if they would drive their car if it didn't have a working speedometer. I suspect they would be driving over the speed limit more than 50% of the time.
Click to expand...

Thanks. Yes I get that these are just averages with many variables, it was more why the earlier testing time for GD and if I should be aiming to test at my likely peak or if sticking with the reading at 2 hours was OK. I think the first couple of post confirmed my thinking about that.

I agree about the speedometer analogy hence getting my own kit but as far as i understand the guidelines for GPs are that they don't prescribe testing kits for all type 2s, only in certain circumstances. So if i understand correctly it's not about convincing individuals? My brother in laws view was that it was about long term change not individual readings but he understood my reasons for wanting one. But it's my own GP's opinion that would make a difference to me getting one free and he was very definite about the guidelines!
 
I think the first question should be
"Why do you want to test"
Many say it's to find what their spike is, then try to keep it as low as possible.
My personal view is I want to avoid diabetic complications, and non diabetics certainly spike, so two hours works for me.
And yes, long term trends are important, one bad meal in the past didn't affect me though.
 
travellor said:
I think the first question should be
"Why do you want to test"
Many say it's to find what their spike is, then try to keep it as low as possible.
My personal view is I want to avoid diabetic complications, and non diabetics certainly spike, so two hours works for me.
And yes, long term trends are important, one bad meal in the past didn't affect me though.
Click to expand...
Absolutely testing has to be for a purpose, for me it was /is to test if certain meals are Ok, it quickly revealed that pasta (now swapped to bean based pasta) followed by a pancake was not a good choice.
 
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