140 mg/dl [7.8 mmol/l] 1 hr after eating: Can this be done w/o hypoglycemia later on?

I've heard this mentioned as a blood glucose target, but I can't imagine being 140 mg/dl [7.8 mmol/l] one hour after eating and 120 mg/dl [6.7 mmol/l] two hours after and not having a terrible crashing low before my next meal. As it is, I'm generally 144-180 mg/dl [8-10 mmol/l] two hours after eating and I'm almost always low before my next meal. (Note: I use an insulin pump, and have a pretty low basal rate--about 6 units/day).

"Healthy Blood Sugar Targets": http://www.phlaunt.com/diabetes/14045621.php

Tags: A1c, after meal blood glucose, after meal blood sugar, postprandial blood glucose, postprandial blood sugar, target

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I'm doing 140 or lower one hour after meals and am on MDI without a CGM. I'm 6.5 months pregnant, so this is a must. I don't go too low too often afterwards. But, then again, due to pregnancy, I'm also eating way more often than I would have if I weren't pregnant. So, it's possible. If you had asked me last year if it was possible, I would have laughed in your face and said NO. But... it is. I've even proved myself wrong.

Type 1 for 13 years- 10+ BG tests per day, 20+ MDI per day, no CGM, no pump
I rarely go above 120 PP if I don't eat something like potatoes. Whole grains and dosing 20 min before I eat keeps the spikes from happening and the come down steady. I sit usually between 70-85, so that also make a difference for what is considered high.
This is a little aside, but one thing I have learned since having a CGM is that testing, no matter how often you do it, is just a brief snapshot in time. Test a little earlier or a little later, and you can get different results. This has really amazed me since I have readings every 5 minutes now. So, someone who tests at 1 or 2 hours and gets good results may still be spiking later, and never know it, even if they check often. This happens to me a lot, especially with meat, cheese and hummus. I am great early on, and then spike, and go back down later. The spike can occur several hours later. Even if I were testing hourly, I would have no idea this was going on, as I might go from 120 to 180 and then back to 110 within the time between finger pricks. I used to test 10x and realize now how much I was missing.

I love my CGM for this reason and I think everyone who can get one should give it a go. But I also have to warn people, "Flatlines" on CGM's can be real or very deceptive. Yesterday my BS stayed between 67-77 for more than 4 hours. I suspected that this was too good to be true and in fact it was. I tested and my actual BS was 63 points higher. This frequently happens to me, this was on day 2 of my sensor, but it often happens toward the end of my sensor life, and is how I know to replace it. It gets somehow "stuck" on a lowish reading, usually in the 60's or 70's (stuck within a range, not on one specific number) Also sensors sometimes will show a spike, but it may not be as high as my meter says it is. I recently had a reading where my sensor stopped climbing but my meter showed a reading 100 points higher. I think when this happens, my BS has gone up and then back down quickly and the CGM doesn's always keep up.

In short, depending on what you eat, your spike might come much later than 1-2 hours. Or it may come at 30 minutes after a meal. And, the CGM is a great tool, but sometimes it does not catch highs very well and flat readings are not always true. In my experience, sometimes yes and sometimes no. .
I also love my CGM, but if I got those results on day 2 I would be calling for a replacement sensor I am on day 18 and spot on! The spikes out of nowhere are frquently a sign of a dead sensor. Which CGM do you use. I have the Dexcom 7 plus and it is my best buddy!!
dickengel-
I have the MM and the sensors don't last as long as Dex. Not by a long shot. Approved for 3, the best I have gotten is 6. Very different system!
I would still call and ask themto replace it only 2 days - they charge somuch theyshould work as advertised. I have had a couple dex sensors that messed up before the promised 6 days and I call and they will replace no charge
I was on the Dex for about 3 months to learn my spikes and rhythms and it really does teach a lot about BG. But the variances and alarms just drove me crazy. I am seeing much better results without the CGM as I'm a bit obsessive about things like that. I almost went NUTS one day because the CGM wasn't responding (I had taken a Tylenol). I thought I was going to die. That's when I figured I'd better stop depending on the Dex so much. I disconnected and haven't looked back.

I'm glad you're learning from it. I learned a whole lot from using one for even the short 3 months.
Sorry to hear the u gave up on the CGM - Thats like driving with blinders on - its worth figuring out the peaks and valleys and after just three months i'll never give up my dex, as i get to know myself better, the dex does not beep at me near so much but when it does, I know something needs attention!
The same thing happens to me at lunch, if I have a 140 at the two hour mark. I will totally bottom out 2 hours later, and I cannot lower my basal any lower as I have it set for 00.00 from 1:00-4:00, very frustrating.
To the original poster - I totally agree with what you are saying. What I did was increase my insulin to carb ratio and then I was low at 2-3 hours but I would top out at 130. Now, knowing that I will be low at 2-3 hours I have a nice 10g carb snack after meals to balance the remaining insulin, like an apple, orange, crackers to avoid the low that I know is coming.
I am using 150 units via pump daily and adjusting at one point I was using 400units daily.
I freaked one EC out by letting him see me use 80u of Apidra w/o eating. There are some of us that have a heck of a resistance and elevated A1C's and stay on it but go no where.
I keep my after meal BG spike below 120 mg/dl. My BG would go too low if I would not eat a snack 2 hours after a high carb meal. So what? I don't consider this a penalty. I always look forward to the snack. I get the best of both worlds: BG under 120 mg/dl and a snack.

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