Tag: Postprandial Blood Glucose

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Diabetes Care

All You Need To Know About Normal 2-Hour Postprandial Blood Sugar

Whether you suffer from diabetes or any other health condition, your doctor may have advised you to do a 2-Hour Postprandial Blood Sugar test. This can help to make a diagnosis of diabetes or prediabetes, as well as to measure your risk of hypertension and heart disease. Postprandial blood sugar or PPS levels are different from other tests and measures such as the A1C test or fasting glucose test. So, what exactly is postprandial blood sugar (PPS) and why does it matter?

What Is Postprandial Blood Glucose & How Is It Measured?

As the term suggests, postprandial refers to concentrations of glucose or sugar in blood after meals. These blood sugar levels begin to rise within ten minutes from the start of a meal because of the absorption of dietary carbohydrates. Postprandial blood sugar levels are affected by a variety of factors, with peak concentration determined by meal timing, serving size, meal composition, insulin and glucagon secretion, among other factors.

In individuals without diabetes, blood sugar levels peak about an hour from the start of a meal and start to decline quickly, returning to preprandial or pre-meal levels within 2 to 3 hours. At the same time, carbohydrate absorption continues for 5 to 6 hours after meals. The timing of this blood sugar peak is affected by other factors in diabetes patients including insulin dosage, type of insulin, route of administration, suppression of hepatic glucose production, hepatic and peripheral glucose uptake.

The postprandial blood sugar test is done in the same manner as a routine blood test, with a needle used to draw blood for screening. 

2-Hour Postprandial Blood Sugar: Why 2 Hours?

As your body continues to absorb food for hours after a meal, postprandial blood sugar levels can vary depending on how soon the test is conducted after a meal. This holds true for both diabetic and nondiabetic patients. To get the best results possible and standardize testing, 2 hours after a meal is recommended as the optimal time for testing. This is considered practical and is most likely to reflect the peak concentration of blood sugar in patients, giving a fairly good assessment of postprandial hyperglycemia. 

In some cases, the test may be recommended 1 hour after meals, such as when dealing with gestational diabetes.

Understanding 2-Hour Postprandial Blood Sugar Levels

Test results can vary to some extent depending on the specific lab that you use, your age, gender, health history, and so on, but your doctor will be able to interpret them accurately for you. Postprandial blood sugar is measured in milligrams per deciliter and a measurement of 140 mg/dL or less is regarded as within the postprandial blood sugar normal range. Anything higher than this could mean that you have diabetes or prediabetes. Individuals who do suffer from diabetes should still have a postprandial blood sugar level of under 180 mg/dL.

Keep in mind that test results can be inaccurate under the following circumstances:

  • If you smoke during the test period
  • If you are highly stressed with work or studies during the test period
  • If you are unable to have your regular complete meal
  • If you have a dessert or snack after your meal and before testing
  • If you engage in any rigorous activity or exercise during the test period

Be sure to inform your healthcare provider and the lab about any medications you might be taking, including over the counter medications or illicit drugs. This will allow them to provide you with the best advice possible and gauge test results accurately.

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Diabetes Care

Elevation of Postprandial Blood Sugar and Visible Symptoms: What Can You Do to Maintain PPS Levels?

The word ‘postprandial’ means after a meal; hence, PPG (postprandial glucose) concentrations are in reference to plasma glucose concentrations after eating a meal. Several factors determine one’s PPG profile. Glucose concentrations commence to rise approximately 10 minutes after the start of a specific meal as a direct fallout of the absorption of dietary carbohydrates. The overall postprandial blood glucose profile is eventually determined by absorption of carbs and secretion of insulin and glucagon as well as their coordinated effects on metabolism of glucose in the liver as well as peripheral tissues.

Elevation of Postprandial Blood Sugar

The magnitude as well as the peak time of plasma glucose concentration depend on diverse factors such as meal timing, composition, and quantity. In non-diabetic individuals, plasma glucose concentrations generally peak approximately 60 minutes after the start of the meal, rarely exceeding 140 mg/dL (milligrams per decilitre), and then returning to pre-prandial levels with 2-3 hours. Although glucose concentrations return to pre-prandial levels by 3 hours, total absorption of the ingested carbohydrates continues for nearly 5-6 hours post meals.

When it comes to those with type 2 diabetes, peak insulin levels are delayed and are not sufficient to control PPG excursion in the right manner. In both type 1 and type 2 diabetic individuals, abnormalities in the secretion of glucagon and insulin, uptake of hepatic glucose, suppression of hepatic glucose production, and uptake of peripheral glucose led to higher as well as more prolonged PPG excursions in comparison with those without diabetes.

Because food absorption persists for around 5-6 hours after meals in both diabetic as well as non-diabetic individuals, the optimal time must be determined when it comes to measuring postprandial blood sugar levels or PPS levels. Practical considerations often limit the total number of samples of blood that can be obtained. Typically, a measurement of plasma glucose around 2 hours after the commencement of the meal is practical, generally approximates the peak value in those with diabetes, and offers a reasonable assessment when it comes to postprandial hyperglycaemia. Certain clinical conditions such as gestational diabetes or a pregnancy that is complicated by diabetes may benefit by testing 1 hour after meals.

Visible Symptoms of Abnormal PPS Levels

Frequent or persistent high blood glucose levels can lead to damage to the blood vessels, nerves, and organs. It can also lead to several other complications. Those with type 1 diabetes are more prone to the build-up of acids in the bloodstream, which is a condition known as ketoacidosis.

If you develop type 2 diabetes or if you are risk of developing this condition, readings outside the postprandial blood sugar normal range can lead to a serious and deadly condition, wherein your body cannot process sugar: hyperglycaemic hyperosmolar nonketotic syndrome (HHNS). Initially, you may urinate frequently, and then much less often, but the colour of your urine may become dark with severe dehydration in the body.

Early Symptoms

  • Increased hunger and/or thirst
  • Blurry vision
  • Frequent urination
  • Headaches

Additional Symptoms

  • Tiredness and fatigue
  • Loss of weight
  • Slow healing of cuts and sores

What Can You Do to Maintain PPS Levels?

  • Intake medication that works for you. The right insulin and medication program can eventually make a significant difference. To cover post-meal blood sugar spikes, those drugs that kick in quickly and for a brief time are better in comparison with drugs that work slowly over a longer duration. Your doctor will surely explore all options.
  • Keep fasting blood sugar levels in check. In this way, even if your blood sugar levels tend to spike post meal consumption, it will not be so severe.
  • Keep a close check on what you consume. Limit the intake of pasta, rice, potatoes, white bread, and sweets. These foods trigger spikes in postprandial blood sugar levels.
  • The type of fat you consume may also play a crucial role. One study has shown that you may be able to better control blood sugar spikes after you eat if you give butter a miss and instead consume a meal prepared with a dash of olive oil instead.
  • Eat a healthy breakfast every morning. Even when you are in a rush to get out the door, do not skip breakfast. Studies indicate that those with diabetes who skip breakfast will experience higher blood sugar spikes post lunch and dinner.
  • Your ideal morning meal must be packed with protein. A smaller study indicates that when individuals consume a 500-calorie breakfast comprising 35% of protein, their postprandial blood sugar levels were lower in comparison with those who began their day with a high-carb diet. Crosscheck with your doctor what works for you.
  • It is ideal to take a walk post dinner. Walking is an extremely healthy habit for all; however, if you have diabetes, it is an optimum way to burn surplus glucose obtained from meals.

To Sum It Up:

Those with diabetes frequently experience postprandial blood sugar spikes, which is also known as postprandial hyperglycaemia. The most common symptoms include increase in thirst and hunger, frequent urge to urinate, headaches, blurry vision, and fatigue. On the brighter side, there are several ways by which you can keep these PPS levels within the target range by taking your prescribed medication on time, skipping unhealthy foods, and devoting time for exercise, to name a few.

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Latest Updates

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.

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