what are the most important BS levels to monitor?

[Carina1962]

I'm a little confused as to what BS levels i need to be concerned about when monitoring. Some say the fasting levels and some say the 2 hour post-meals. Which ones do i need to monitor the most and why? I am Type 2 and have to watch how many test strips to use as i don't get them on prescription. I am fairly newly diagnosed (October) and i have my first HbA1c results in Jan. thanks

 

[Tezzz]

I'm a little confused as to what BS levels i need to be concerned about when monitoring. Some say the fasting levels and some say the 2 hour post-meals. Which ones do i need to monitor the most and why? I am Type 2 and have to watch how many test strips to use as i don't get them on prescription. I am fairly newly diagnosed (October) and i have my first HbA1c results in Jan. thanks

Hi Carina,

Personally I always check first thing after I wake up and 2 hours after eating something new.

Have a look at this site http://www.phlaunt.com/diabetes/ and look at the section How to Get Your Blood Sugar Under Control.

 

[Northerner]

Hi Carina, the fasting level is certainly important, as this will represent your 'background' level of coping with the glucose that is constantly being released into your bloodstream by your liver. This happens in order to keep important organs like the heart, lungs and brain supplied with energy when you are not eating (like when you are sleeping). Depending on the level of your insulin resistance, the fasting levels may be above what is desirable for a fasting level - improvements to your diet and in particular, activity levels, should help lower this resistance by making your body's cells more sensitive to the insulin you are still producing.

Beyond that, it is important to test when eating new meals containing carbohydrates. Some say test at 1 hour, some at two - a lot will depend on the type of carb and levels of other food groups in the meal, like fat and fibre, which can slow digestion of the carbs. You are aiming to discover the 'peak' of the glucose release of the meal and try to keep this as near to the upper limit of 'normal' as possible (about 6.5-7 mmol).

It is a slow task, building up a database of knowledge and experience over a period of time, so don't feel that you need to know everything at once - be patient. As long as you are following a healthy diet and getting as much exercise as you can, the testing will help you to 'fine-tune' your food intake and levels over time. The HbA1c will help to show your progress.

Hope this helps!🙂

 

[Caroline Wilson]

Even if you don't get free prescriptions yet (you get them if you are on medication), ask for the test strips on prescription. The cost of a prescription is still cheaper than buying test strips. Tell your doctor regular testing will help you gain and keep better control, so you'd like the test strip on prescription.

Can't add any more to advice already given.

 

[Carina1962]

thanks for the advice. I am still confused about the post-meal levels. If I am to aim for a level of 7.8 or below (this is based on articles i have read to date) then what should the range be at 1 hour post-meal? should it be the same? if so then at 2 hour post-meal it should have dropped considerably - still all very confusing!

 

[Northerner]

thanks for the advice. I am still confused about the post-meal levels. If I am to aim for a level of 7.8 or below (this is based on articles i have read to date) then what should the range be at 1 hour post-meal? should it be the same? if so then at 2 hour post-meal it should have dropped considerably - still all very confusing!

Hi Carina, you're right - it is confusing! You need to be aiming for keeping 7.8 as your 'peak' level, whenever that might occur according to what you have eaten. Unfortunately, there is no smooth and consistent rise and fall that we can apply to all meals as there can be many other factors involved (like time of day, how active you have been in last 24-40 hours etc. - these are things that affect me and many others).

So, 7.8 should be the highest your levels get, ideally - whether it is one or two hours after eating. But it will take time to achieve this consistently and to spot what is happening, so try not to become too stressed about it in the early days.

For example, you might eat jacket potato and beans. After 1 hour your level might be 6.5, but after two hours it may have continued to climb and be 8.5 - the only way to find out is to do the one hour test the first time and then maybe test again at two hours, or test at two hours the next time you have jacket potato and beans, then you will have a better idea of where the peak is and if it isa acceptable, or if you should avoid that meal in the future.

The situation can be very different for insulin users, but I won't confuse you further by talking about that!

 

[wallycorker]

Hi Carina,

You've had some great advice already.

I agree that your 'on rising' fasting level is very useful because it seems to give many of us Type 2s a good indication as to how good we are doing overall. Once things settle down that reading usually tends not to vary a great deal day-to-day therefore if you test that say two or three times a week that gives you a fair idea of how things are going.

As someone else as said, when testing after meals then I think that you ought to be trying to find your peaks and that is more difficult with a limited number of strips. I'd recommend testing one hour after finishing eating a meal and see which meals take you high - and then try to work out what caused any figures that you think are too high - you really won't have to look much further than the carbohydrate content of the meal. Once you see what is happening to your levels, then just keep working at making changes to your diet to try avoid high readings in the future.

Again, as someone else has already said, it is very important not to get stressed by it all. Just keep working at it and everything will gradually fall into place. You will find it very satisfying when you manage to get control and see your levels starting to drop.

Best wishes - John

 

[Carina1962]

so if for example i test after 1 hour and say my level is 9.5 then if after 2 hours it drops to say 7.5 is that good or bad? or what if it is the other way round? for example, the other week i went out for a 3 course meal and when i got back home i decided to go on my excercise machine as i was trying to 'work off' the high sugars. After my 15 min excercise i tested and it was 7.3 which i was quite pleased about but then when i tested after the 2 hour mark it was 11.3 so i don't know if i hadn't done any excercise whether the reading would have been higher. My meal consisted of mushrooms in a stilton sauce for starter then my main was a carvery meal and i was careful with the carbs as i only had one small roast potato and one yorkshire pudding (the rest was meat and veg) then (and maybe this was my downfall) i had some profiteroles but only ate 3 and gave the other 2 away. It was the first time that i had a low reading an hour or so after the meal and a high one 2 hours after.

 

[Vanessa]

Carina, the targets set in the UK for people with Type 2 are <8.5mmol/l 2-hour post meal (See DUK's website). There is no figure given for 1-hour post meal. This target has only been adjusted in the past few years from <10.5 but indicates that the trend is downwards as more is learned about the effect of post meal levels overall. The reason I give these figures are that your GP - if focused on anything other than your HbA1c - is more likely to accept these if you raise it with him/her.

The UK target is higher than the International Diabetes Federation and the American Association of Clinical Endocrinologists (7.2). I don't think any of them give a 1 hour target but Jennifer's advice often referred to by some gives one hour post meal of <8 and two hours post meal of <6.5.

In terms of the meal you described then the fat content would have been pretty high and this could have slowed down your absorption of the starchy carbs giving you a later peak. In addition, some people also find that exercise pushes blood glucose levels up a bit before they drop and/or has an impact on glucose resistance.

Diabetes management is by no means an exact science - just as we think we've got a grip on it along comes something that sends us awry. Personally I'm having an interesting time working out what my body can cope with having stopped gliclazide - feel a bit like I'm beginning all over again as I'm revisiting what and how much I eat to hit initally <8.5 post every meal, something I'll review further once I've got there.