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The 1- and 2-hour thresholds

A

ab.er.rant

Active Member
Messages
26
Type of diabetes
Prediabetes
So several sites have listed 7.8 mmol/L and 6.6 mmol/L as the target post-meal 1-hour and 2-hour BG targets.

How are we supposed to look at them? o_O

Is it "as long as I'm below those thresholds, I'm good"?

Or is it "I'm going to get as much below those thresholds as I can go"?

I assumed it was the latter, but I found that going low carb (3 months) puts me in a generally poor mood, so I'm not getting some of the benefits some low-carbers are getting. I also really dislike the lower body temperature generally associated with low carbs. I find myself needing to go up to moderate carbs to feel better. :meh:

It's possible I'm not consuming enough fat, but trying to acquire and consume more sources of fat (counting calories to ensure I'm eating enough) seems to put me in a state where I'm always full and makes me feel like I'm eating too much. :rolleyes:

Getting caught up in hitting below those thresholds sometimes end up with me being mildly depressed some days. :sorry:
 
@ab.er.rant - Hello:). It is better to test 2 hours after eating and what you are aiming for is between: 4 to 9. A lot of forum members follow the LCHF Diet, it helps to lower blood glucose and can help with weight loss too. Take a look at this: http://www.dietdoctor.com/low-carb/60-seconds
 
The problem is I'm not overweight. In fact, reducing carbs is starting to put me underweight. I'm really at a loss as to how to adjust my diet to maintain body weight while still trying to hit those targets.
 
6.6 mmol/l at 2 hours is not good enough. The body should regain the fasting level by 2 hours, and a healthy fasting level is below 5.5 mmol/l. Conceivably, some prediabetics may have gotten to the point that the body can't get all the way back to these standards. It was taking me 3 hours. I undertook walking many miles a day, and now it takes me 2 hours.

As for fats, I eat a lot of dairy. For lactose intolerant people, there are nonprescription lactase tablets to supply the enzyme needed to digest. Genuine cheeses don't have lactose, so no tablets needed. "Cottage cheese" has lactose.
 
sud5nala said:
6.6 mmol/l at 2 hours is not good enough. The body should regain the fasting level by 2 hours, and a healthy fasting level is below 5.5 mmol/l. Conceivably, some prediabetics may have gotten to the point that the body can't get all the way back to these standards. It was taking me 3 hours. I undertook walking many miles a day, and now it takes me 2 hours.

As for fats, I eat a lot of dairy. For lactose intolerant people, there are nonprescription lactase tablets to supply the enzyme needed to digest. Genuine cheeses don't have lactose, so no tablets needed. "Cottage cheese" has lactose.
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Not correct.

Link here

http://www.diabetes.co.uk/diabetes_...?utm_source=top&utm_medium=dd&utm_campaign=dd
 
ab.er.rant said:
The problem is I'm not overweight. In fact, reducing carbs is starting to put me underweight. I'm really at a loss as to how to adjust my diet to maintain body weight while still trying to hit those targets.
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If you're feeling full it's usually a sign that you're eating enough, and that's how the fat is intended to make you feel, but have a look at one of the low carb nutritional calculators (e.g. http://www.phlaunt.com/diabetes/DietMakeupCalc.php) to check if you're getting the your carbs, protein and fat proportions correct, and right for your weight maintenance. You ought to be able to manage to keep your weight up if you're otherwise healthy as LCHF and ketogenic diets are often used by endurance athletes and body builders.

However if low carbing doesn't agree with you there's absolutely no obligation to eat this way, so look at some of the other alternatives - LCHF isn't the be all and end all just because many of us do well with it!

I think you have to make up your own mind how you're going to manage your glucose levels - the recommendations you see can only at best be a guide: not everyone can achieve them due to various factors often beyond their control, some can reach them , and some can reach them and go on to do far better. What other people do achieve is not necessarily what you're going to achieve, so just work with what you feel able to manage, and in your own good time. Set yourself some realistic (for you!) targets and aim for them - they can be moving rather than fixed targets to make smaller successes achievable, and that worked best for me.

Robbity
 
SunnyExpat said:
Not correct.

Link here

http://www.diabetes.co.uk/diabetes_...?utm_source=top&utm_medium=dd&utm_campaign=dd
Click to expand...
Really, there is a lot of interpretation involved in choosing these targets. Above all, how ambitious is the patient's goal for recovery? Although @ab.er.rant 's post was ambiguous, they have hinted that their optimism is on the high side. I am not going to insist on particular target values. I am going to explain the considerations.

The numbers you linked to seem to reflect conventional medicine's assumption about diabetes, which is that the patient will not return to the normal range of glucose, which is of course true for many. (Just like many arthritics will never again be like new.) There is a popular modest treatment guideline of keeping the A1c under 7.0% (53 mmol/mol in IFCC units), which is above the bar for diagnosing diabetes. You must distinguish between what is healthy and what a permanently unhealthy patient has to settle for (a patient who is deemed permanently unhealthy). But of course many patients do go back to below 6.5% (47.5 mmol/mol in IFCC units) or even below 5.5% (be it with or without the help of medications). Likewise, many patients get back to fasting level below 5.5 mmol/l, which is the upper range of normal. For 99% of us, a fasting level above 5.5 indicates unhealthy.

I was sedentary for 20 years. Now after one year of cardio, my postmeal rise has shortened from 3 hours to 2 hours. To disagree with my numbers of 2.0 hours and 7.8 mmol/l is only justified if you believe that the patient cannot hope for better. While there are many patients who have permanent damage and cannot hope for better, others can adopt the LCHF diet or other measures and regain normal levels. For the postmeal rise to exceed 2 hours is prediabetic or close to, even though it doesn't guarantee full progression to diabetes. @ab.er.rant reports being prediabetic and seems to be hoping to stop being it. In that case, I repeat: the end of prediabetes is when fasting goes below 5.5, regaining of fasting is quicker than 2 hours, and the postmeal peak -- there is no published figure on what is an upper limit of normal postmeal peak, but clearly it would lie between 6.0 and 7.0.

Next, play with the shape of the graph of glucose level after a meal. The higher its peak, and the more minutes it lasts, the higher the average daily glucose is going to be. The average daily glucose is the A1c.
 
sud5nala said:
Really, there is a lot of interpretation involved in choosing these targets. Above all, how ambitious is the patient's goal for recovery? Although @ab.er.rant 's post was ambiguous, they have hinted that their optimism is on the high side. I am not going to insist on particular target values. I am going to explain the considerations.

The numbers you linked to seem to reflect conventional medicine's assumption about diabetes, which is that the patient will not return to the normal range of glucose, which is of course true for many. (Just like many arthritics will never again be like new.) There is a popular modest treatment guideline of keeping the A1c under 7.0% (53 mmol/mol in IFCC units), which is above the bar for diagnosing diabetes. You must distinguish between what is healthy and what a permanently unhealthy patient has to settle for (a patient who is deemed permanently unhealthy). But of course many patients do go back to below 6.5% (47.5 mmol/mol in IFCC units) or even below 5.5% (be it with or without the help of medications). Likewise, many patients get back to fasting level below 5.5 mmol/l, which is the upper range of normal. For 99% of us, a fasting level above 5.5 indicates unhealthy.

I was sedentary for 20 years. Now after one year of cardio, my postmeal rise has shortened from 3 hours to 2 hours. To disagree with my numbers of 2.0 hours and 7.8 mmol/l is only justified if you believe that the patient cannot hope for better. While there are many patients who have permanent damage and cannot hope for better, others can adopt the LCHF diet or other measures and regain normal levels. For the postmeal rise to exceed 2 hours is prediabetic or close to, even though it doesn't guarantee full progression to diabetes. @ab.er.rant reports being prediabetic and seems to be hoping to stop being it. In that case, I repeat: the end of prediabetes is when fasting goes below 5.5, regaining of fasting is quicker than 2 hours, and the postmeal peak -- there is no published figure on what is an upper limit of normal postmeal peak, but clearly it would lie between 6.0 and 7.0.

Next, play with the shape of the graph of glucose level after a meal. The higher its peak, and the more minutes it lasts, the higher the average daily glucose is going to be. The average daily glucose is the A1c.
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The guidelines for 'normal' is the range that works for normal people.
You appear to have jumbled a fair few targets up in your interpretation, the link is quite easy to read if you need to.
 
Remember we as diabetics should not be too hard on ourselves and set unrealistic targets two hours after meal. We should be happy if it does not go over 10.0 two hours post meal.


Sent from my iPad using DCUK Forum
 
Keesha said:
Remember we as diabetics should not be too hard on ourselves and set unrealistic targets two hours after meal. We should be happy if it does not go over 10.0 two hours post meal.


Sent from my iPad using DCUK Forum
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I agree we should set ourselves realistic targets, but I disagree that 10 is acceptable. It is not acceptable. NICE has issued guidelines that type 2s should be under 8.5mmol/l at least 90 minutes post meal, and these are the guidelines the NHS folllows. If 10 were acceptable, they would have issued guidelines accordingly. There are reasons why this target was set - partly to keep it an attainable target for everyone, and partly because much higher may lead to complications. Most experts agree that 8.5 is also too high. 8.5 is not unrealistic on a suitable diet and, if appropriate, with the help of meds.

Personally I hate seeing the odd 7, never mind anything higher.
 
Bluetit1802 said:
I agree we should set ourselves realistic targets, but I disagree that 10 is acceptable. It is not acceptable. NICE has issued guidelines that type 2s should be under 8.5mmol/l at least 90 minutes post meal, and these are the guidelines the NHS folllows. If 10 were acceptable, they would have issued guidelines accordingly. There are reasons why this target was set - partly to keep it an attainable target for everyone, and partly because much higher may lead to complications. Most experts agree that 8.5 is also too high. 8.5 is not unrealistic on a suitable diet and, if appropriate, with the help of meds.

Personally I hate seeing the odd 7, never mind anything higher.
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If 'normal' is under 7.8 after 2 hours, what information have you chosen your target from?
 
SunnyExpat said:
If 'normal' is under 7.8 after 2 hours, what information have you chosen your target from?
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My aim is to be as flat as possible with as little variance as possible. It clearly isn't possible all the time, I am human, but I do aim to have gentle and small curves. Rising from 5 to 7.8 is not acceptable to me.
 
Bluetit1802 said:
My aim is to be as flat as possible with as little variance as possible. It clearly isn't possible all the time, I am human, but I do aim to have gentle and small curves. Rising from 5 to 7.8 is not acceptable to me.
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I go with the idea the rest of the population varies up to 7.8, they don't have any diabetic complications, it's the natural ceiling for the human race, I must admit, I find I'm there as well now, so I tend to be happy with that.
 
To all these people who set unrealistic targets, remember one thing and that is, you all are diabetics. To expect blood glucose to get back to fasting blood glucose is only meant for non diabetics. I know I can never attain the levels of a non diabetic, and I have come to term with it.


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@Keesha They aren't unrealistic if they are achieved on a sustainable diet that you enjoy. For those that are able, the aim is to reach non-diabetic levels. I understand not everyone is able to, and this is why we must all set our own targets, but it is not wise to have targets that are higher than the NICE guidelines.
 
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Bluetit1802 said:
@Keesha They aren't unrealistic if they are achieved on a sustainable diet that you enjoy. That's why we must all set our own targets. For those that are able, the aim is to reach non-diabetic levels. I understand not everyone is able to, and this is why we must all set our own targets, but it is not wise to have targets that are higher than the NICE guidelines.
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I think it's a shame to waste my life chasing targets below non diabetic levels.
There is no benefit is chasing numbers below normal figures, but it severely limits the life you could be living.
 
Keesha said:
Remember we as diabetics should not be too hard on ourselves and set unrealistic targets two hours after meal. We should be happy if it does not go over 10.0 two hours post meal.


Sent from my iPad using DCUK Forum
Click to expand...
Sorry but I would be most disappointed if I had a reading of 10 at any time..unless I had eaten a carb heavy meal.. but why would i do that as it doesn't help me control the condition I have.
 
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