Testing times

[sweetenoughthanks]

I was diagnosed in June 2011. Type 2 - fasting blood test 7.5.

Started on metformin and statins. Had terrible stomach and nausea so switched to slow release and I'm now feeling much better,

My question is re blood testing at home.

I tested myself before dinner and was 5.9. Then had a dinner which consisted of a pretty balanced meal of protein, carbs and veg washed down with a glass of water - nothing untoward in my opinion. Two hours afterwards my bg was 15.9.

I am confused - one person told me that 2 hours after a meal is when, if your meds are working, your bg should have returned to "normal" and another person said that the 2 hour mark is when your sugar peaks and then starts to come down.

Which is true?? I would appreciate any advice anyone can give me!

 

[daisy1]

Hi sweetenoughthanks and welcome to the forum Your 15.9 was probably caused by the carbs you ate in your meal. You obviously shouldn't eat the same carbs in the same quantity again. Your 2 hour afterwards reading should be approximately similar to your before meal reading - this is what tells you that what you have eaten is suitable for you. Sometimes, if you have eaten long acting carbs, for example pasta or rice, or a lot of fatty foods which slow down the absorption, your levels won't go down to this level until 3 or even 4 hours but the 2 hour rule is the usual one to go by. You can try eating this same carby food in smaller quantities until you can get your post meal reading approximately the same as the pre-meal reading, or you may find you have to cut it out altogether. We can't tell you how much you can eat as everyone has different tolerances to certain carbs.

Here is some information which we give to new members which should help you to understand more about how to look after your diabetes. Ask as many questions as you like as there is always someone here who would like to help you.

BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you’ll find well over 30,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.
There are two approaches to controlling your carbs:

• Reduce your carbohydrate intake
• Choose ‘better’ carbohydrates

Reduce your carbohydrates
A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes ... rains.html

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 8.5 mmol/l

Blood glucose ranges for type 1 diabetes (adults)

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 9 mmol/l

Blood glucose ranges for type 1 diabetes (children)

• Before meals: 4 to 8 mmol/l
• 2 hours after meals: under 10 mmol/l

However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips
The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

• structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
• self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic

Note: This post has been edited from Sue/Ken's post to include up to date information.

 

[sweetenoughthanks]

Thanks for your answer, and your advice.

Everything I eat seems to make me go higher than the recommended bg level at 2 hours after my meal!

This morning my bg was 6.1. Had 2 slices of wholemeal toast, no butter, with some peanut butter on it. 2 hours later my bg level was 9.8!

If this is the case does it mean that maybe my meds are not working or not suitable for me?

 

[pianoman]

Hello and Welcome.

It can take a few weeks for Metformin to have full effect, but 2 month seems like enough time I'd have thought.

The other place to look is at what you are eating... how many grams of carbohydrate (not just sugar but starches as well) was in the toast and peanut butter? It seems our tolerance for carbohydrates can vary through the day; so while you may get away with toast and PB later in the day, you might be better off with eggs and bacon at breakfast-time, or avocados, nuts and berries -- for example.

 

[Daibell]

Hi, as others have said you need to watch the carbs both type and quantity and the best way is to use the meter and find what affects you. Ref the 2 hours testing that is the time period for a non-diabetic to return to pre-meal levels assuming the average person and the average meal. Most Type 2s will find it difficult to return to the pre-meal level after 2 hours; the nearer you can the better. Your sugar peak time point will vary depending on you and the meal. At 2 hours at you should be aiming for lower than around 9.5 mmol. When I was first diagnosed I was at least in double figures all the time! Now with all my meds I rarely go into double figures after 2 hours. Hopefully with the Metformin and keeping the carbs under control wou will be OK but you may have to go onto additional meds eventually. The HBA1C test your GP/Nurse will arrange normally annually but may be 6-monthly until you have good control will show your average BS level which should be 7 mmol or less to avoid further meds etc

 

[sweetenoughthanks]

Thanks! It's all very confusing isn't it? I hope I get the hang of it soon!