wHY TEST 2 HOURS PP?

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Permalink Reply by ravinder on October 29, 2009 at 7:05am

i think peak is inbetween 1 to 2 hour

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Permalink Reply by Terry Keelan on October 29, 2009 at 7:31am

What peaks one hour after the meal? BG? Insulin? Says who?

The peak for BG may be different from person to person. Two hours may be a compromise number used for a baseline. If one hour is more accurate or useful for some people, they should use one hour. But the only way to know when your peak is, is to test.

For Type 1's there may be NO peak in one hour or two hours. For me, my BG will keep going up without end if I don't take some insulin. I use two hours because that's the estimated peak of my insulin. If I test in one hour I won't get any useful information.

Terry

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Permalink Reply by Hana Rous on October 29, 2009 at 9:12am

In those cases where the peak has been tested, it's always been found at about the one hour mark. Peak BG is important. they now think that spikes are as damaging as consistent highs. By 2 hours, Bg is dropping in pretty much everyone.
Hana

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Permalink Reply by Terry Keelan on October 29, 2009 at 10:41am

It can't be true that after 2 hours BG is dropping in pretty much everyone - otherwise there would be no diabetics!!

In addition, if everyone, diabetic or not, spikes their BG one hour after eating that means that everyone, diabetic or not, starts to come down afterwards since, by definition, the 'spike' is the high point. Again - where are the diabetics if that is true? Therefore, testing one hour after eating tells us nothing except what our BG is at the spike. (See Don's comment, below) Your BG is going to go up after eating no matter what. If we want to control how high it spikes, we'd want to test in one hour, but otherwise it's not very useful information.

What we REALLY want to know is whether our BG is coming back down or leveling out to our pre-meal BG. That's why we test AFTER the spike.

Should it be 15 minutes after the peak? 30 minutes after? 60 minutes after? Discuss among yourselves. YMMV. But if our insulin has a two hour peak, it makes sense to test two hours after we've taken it in order to test whether it has had the desired effect - bringing my BG down.

If not, why not? Did I miscalculate my carbs and not take enough? Is the insulin wearing out? Is my infusion site bad? Is my insulin:carb ratio off?

Terry
That's my story and I'm sticking to it.

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Permalink Reply by Hana Rous on October 29, 2009 at 11:18am

I should have said that Bg is dropping in pretty much everyone except untreated diabetics.

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Permalink Reply by Don on October 29, 2009 at 8:12am

For me, testing at the 1 hour mark isn't helpful except to reveal what the maximum bg spike is. My typical post meal pattern is to have the highest spike in bg at about the 1 hour mark and then a significant drop over the following 30 minutes. The 1 hour mark represents the moment when the insulin begins to drop my bg down. Testing at the 1 hour mark won't tell me how well the insulin is working (yet). I could test at the 90 minute mark because that will give me a good idea whether the dose was enough but usually 2 hours is fine unless I suspect something is not right. The action of insulin can vary a little bit from dose to dose, so testing at 2 hours allows enough time to assess for certain that the dose was enough.

Just to be clear. If I graphed it, my post meal bg would steadily rise for about an hour, then it would significantly drop for 30 minutes, and thereafter it will be kind of flat with small up and down swings within 20 points.

Your typical pattern might be different so if you have not already done so, you should test at different times for your typical meals, including the 1 hour mark, until you have get a clear picture of the timing of your particular pattern. This way whenever you test at any point you will have the right context to assess what it means.

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Permalink Reply by Teena on October 29, 2009 at 8:34am

High blood sugars could do damage in our body regardless of when they happen. Personally, (Im a type 2), when I was first diagnosed and my doctor was establishing an appropriate diabetes management for me, the 2 hr post prandial glucose testing after meals was helpful:
- we wanted to establish what specific foods or meals are doing to my blood sugar.
- excessive tiredness/feeling sleepy after eating are symptoms of high blood sugars (The normal range blood sugar level 2 hr after eating is less than 140 mg/dL), therefore, it means my bg is not controlled if it deviates higher.
- We wanted to check to see how well my diabetes medications are working. There are some diabetes medications designed specifically to lower blood sugars after eating.

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Permalink Reply by Hana Rous on October 29, 2009 at 9:06am

Actually, you have extended my question.I was asking why 2 hours and not one. By 2 hours, nearly everyone's BG is falling. The peak of the spike comes at about 75 minutes, so why not then? I personally keep my Bg much lower than 140[7.78]
Hana

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Permalink Reply by nel peach on October 29, 2009 at 10:17am

I have always held the test guidelines as guidelines ...My believe is : there are many factors , why a 2 hour may or not work for a person with diabetes. Emptying of the stomach, other types of diabetes medication one takes , if on insulin , when one delivers the bolus insulin , type of food ( low glycemic/high glycemic ) one consumes .
Looking at Terry's response , I seem to more or less duplicate , what he is saying .And we keep on learning about ourselves by poking .

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