Recent Advancements Made in the Field of Managing PPS

Mealtimes can tend to become an extremely challenging experience for those with diabetes. Post consumption of a meal, blood sugar levels could soar during the process of digestion of food or unexpectedly crash if an insulin shot would be much more than what the meal needed.

The Endocrine Society convened a panel of diabetologists to examine how advancements in medications, technologies, and lifestyle changes can help in managing the challenges that are associated with post-prandial blood sugar levels.

While advancements in the field are offering more data on postprandial blood glucose levels, a lot more research is needed to help those with diabetes to set concrete goals, according to recommendations that have been published in the Journal of Endocrine Society.

Some of the advancements include faster-acting insulin, new classes of drugs, highly flexible insulin-delivery systems, and improved CGM (continuous glucose monitoring) devices. These pave the way to successfully tackle postprandial blood sugar management; however, concrete goals, as well as strategies for how best to adopt these new, exciting therapies, need to be clearly defined.

High PPS (postprandial sugar) levels after mealtimes can cause those with diabetes to feel a tad sluggish, thus leading to negative changes in mood and disrupted sleep. Merely seeing an abnormally high reading after a meal can cause those with diabetes to feel fearful, anxious, shameful, or even hopeless when it comes to blood sugar management. An increasing amount of evidence also indicates that difficulty in achieving a postprandial blood sugar normal range can lead to adverse health outcomes.

Healthcare providers and those individuals with diabetes can take adequate steps to successfully manage this ever-increasing number of challenges. Fabulous advancements in the field of diabetology, such as CGM systems and ultra-rapid—acting insulin are providing new avenues for individuals to successfully manage postprandial blood sugar levels.

Experts have recommended that additional research is required to help in pinpointing a target blood sugar number or range post meals as well as the amount of time to remain within the range, which would surely improve clinical outcomes. Growing use of CGMs offers an excellent opportunity to gather and act on real-time data as well as answer questions about how factors such as portion size, presence of nutrients, and timing of meals can eventually affect blood glucose levels after meals.

Moreover, by developing further behavioural strategies and the use of newer medications, those with diabetes could gain more control when it comes to postprandial blood sugar levels.

Researchers have stated that there is a need to continue developing as well as critically testing intervention strategies that are highly safe, extremely effective, and immensely practical in the management of blood sugar levels.

Now, let us look at two key advancements in the field of managing PPS: (1) CGM and (2) Continuous Subcutaneous Insulin Infusion.

CGM

By offering dynamic and real-time measures, CGM systems have contributed immensely when it comes to comprehending postprandial glucose (PPG) excursions along with the overall scenario of glycaemia.

CGM systems accurately measure interstitial glucose concentration to provide individuals who use them with real-time glucose readings and trend arrows that indicate the direction as well as rate at which the values of glucose change.

By offering this info in the context of historical data, CGM systems offer wearers as well as their healthcare providers critical insight into both current and retrospective trends.

Individuals using a CGM system can see in a direct way how and when diverse meal types, exercise, behaviours, and medications affect PPG. They can then make adjustments to both insulin timing and dosage by successfully combining blood sugar readings and trend arrow data with crucial insight into the time needed for insulin absorption.

CGM data also provides info to patients about the overall impact of insulin-timing that is relative to meal ingestion, thus improving the potential to successfully reduce both postprandial hyperglycaemia (PPH) and delayed hypoglycaemia along with post-meal dosing.

Studies of individuals with type 1 diabetes who use CGM have indicated that they eventually spend more time-in-range than do those who receive usual care, reducing both hyperglycaemia as well as hypoglycaemia, besides decreasing glucose variability.

Continuous Subcutaneous Insulin Infusion

Continuous subcutaneous insulin infusion therapy (or CSII), which is also known as an insulin pump, primarily aims to mimic normal secretion of insulin though continuous infusion of rapid-acting insulin at pre-selected rates, with bolus doses activated by patients at mealtimes or as corrections when it comes to hyperglycaemia.

Besides bolus-dose calculators that take into account the carbohydrate intake, current blood glucose concentration with blood glucose target, and insulin on board, some devices come with presets for different portion sizes, and most of these provide options to extend delivery of insulin over a specified time, especially for high-fat or high-protein meals or for those individuals with gastroparesis who need to extend the prandial dose of insulin to successfully match delayed digestion as well as food absorption.

To Sum It Up:

Successful management of PPS levels can be quite challenging. Several advancements have been made over the years to help those with diabetes to stay within the targeted blood sugar range. Two of the many advancements that need special mention include CGM systems and CSII therapy, which is also known as insulin pump. Despite the invention of CGM systems and increasingly sophisticated device features, errors, and inconsistencies, when it comes to dosage, are quite common. Present dosing algorithms predominantly rely on intake of carbohydrates as well as sensor or capillary glucose; however, they do not account for several of the diverse factors that influence postprandial glucose and, ultimately, glucose variability.