What is your target post meal BG? My doctor has never given me a number, but I've found between 110-180 works best for me. Below 90 or so, I know I'll be going low in 1-2 hours, and above 200 or so, I know I won't go back down.
Also, how long after eating do you test? I had heard 3 hours post meal recommended, but I've found I need to do 2 hours post to catch any highs b/c my sugars tend to spike 3 hours after. So, if I'm 240 2 hours after and don't do a half correction, I'll likely end up at 300 at 3 hours. (Of course, I'm finally going back on the CGM next week after about a year off, so that should give me even more info for better or worse...)
I was just curious for your input b/c no endo has ever given me a target number b/c my a1c's are fine, so I'm kinda making this up as I go ...
I shoot for under 140, which I believe is the general recommendation. And I've always heard that you should test 2 hours after eating. For pre-pregnancy and pregnancy, the goal my doctor gave me was under 120 an hour after eating. Talk about tough! Alas, I'm getting ready to go down that road again. I get my CGM on Thursday, so hopefully it will be a lot easier this time around.
I agree that I have to give myself a correction if I'm over 200 at 2hours post-prandial.
Wait... seriously? What are you guys eating that you don't spike any more than 140?? I'm happy if I never go over 200ish after a meal. Usually it takes me 2-3 hours to get back in "normal" range, too. Very few times have I ever topped out below 150...
Haha! Kim, I said I shoot for under 140 - not that I hit it all the time! Usually, it's more like 160 - 180. If I'm consistently over 200 post prandial, then I know it's probably time to change the insulin to carb ratio for that meal.
Assuming my numbers are normal before I eat, I should be anywhere between 135 - 150 at the 2-hour mark. Number returns to normal another 2 hours later. If it stays higher, I either didn't do the bolus early enough or I didn't take enough insuin.
my goal is anything below 180. i only hit that about half the time. it's usually taught to check your BGs 2-3 hours after food because that's (typically) when both the food and insulin are peaking (of course there are some exceptions). i also forget to check 2-3s hours postmeal roughly half the time :o)
I guess my goal is 150ish but I haven't been paying very close attention to my post-meal numbers.
I don't know when you all bolus/inject relative to eating but I've found that 15-20 minutes before a meal helps with the spikes, though I only ever succeed in doing this with dinner...
I check pretty much 2 hours after i eat... if im in the high 100's iike 190 ill give an extra unit.. if im in the low 100's ill prob go low... but it also depends on the time of day.. in the morn I shoot for a low 100 reading cause it doesnt drop... in the afternoon i purposely go for a higher reading cause i go to the gym after work.. at night i like a good 140/150 ...
Thanks guys, this has been helpful! Even when I was pregnant, I didn't hit the 120-140 mark after a meal at times, so I'm glad I'm not the only one!
On a semi-related note, I don't have a pump, so I have to remember to test 2 hours post. It's so scary how my internal clock reminds me over half of the time! I'll think, "Hmm, I haven't tested in a while," look up, and realize it's 2 hours post. Weird!
The ADA recommends a post-prandial glucose of <180 mg/dl where as AACE (american academy of clinical endocrinologists) recommends post-prandial value of 140 mg/dl or less. Optimal post-pranding testing usually is between 1 and 2 hours. Whoever told you 3 hours is likely misinformed. However, some meals may delay the post-prandial spikes, particularly those high in fiber, fat and protein.
I think achieving either of these goals can be a challenge. Its impossible to know if you are meeting the goals without a CGM due to the variability of time from meal to peak glucose. One way to blunt the post-prandial spike is using a lag time. An alternative is using Symlin.
Post-prandial hyperglycemia is largely under-recognized due to the standard four times daily monitoring. Usually by the time we test for the next meal, the preceding meal's insulin has had time to catch up to the hyperglycemia and bring it down somewhat. This is the bane of diabetes care. Injected insulin simply is not physiologic and takes time to start working. After an hour, only 10% of an injection/bolus has taken full effect!