Pre and post meal blood glucose testing

[Administrator]

We are just putting together a feature for the community site, and wondered if people on the forum could provide a few patient perspectives on why they find it useful to test before and (2 hours) after each meal, if they do so?

If you don't mind, we'd like to use these patient perspectives within the piece...

Regards,

Admin

 

[ronjo94]

I was diagnosed type 2 about 4 years ago. I tested before and 2 hours after initially whilst testing the water to find a suitable diet (my clinic is not much help) and made a log so to be able to analyse the results. I found that my annnual HBa1c results differed in that they were lower than my own readings.My averagewas 8.2 against the HBa1c of 6.9 the 1st year. I am aware that self monitoring is only a guide and cannot mimic the HBa1c reading howevr, after much experimenting I found that, if I took my readings 3 hours after a meal rather than 2 hours after, my results came close to the HBa1c results. This method for me therefore provides a better indication of my sugar levels thoughout the year(between annual check), and I only need to occasionally need to check my levels to maintain an average. Having said that, I am unable to control peaks which accasionally can be as high as 14. If I had an inexhaustable supply of strips I could maybe iron out the peaks and therefore improve my HBa1c figures. Alas, 100 strips last year and I have just had to beg for a meagre 50 does not enable me to provide consistant control. I would point out that these peaks are NOT due to a diet change but, if I was able to be able to note every one, I might be able to effect some change. I realise that this is a long screed but it may gel with someone who has similar problems as I know that we all differ in our needs. Incidentally, just to give an example. I can have a reading of say 7.5 before my evening meal which could consist of 2 slices of homemade (and therefore no un-necessary additives) granary bread, with a low salt and fat spread plus a little tinned tuna followed by a cup of cocoa or barley drinl with no sugar, just a little Splenda and,3-4 hours later go to bed with a reading of 12. The following morning before can be 8-9 and 3 hours later 6.5, It's a problem.

 

[meisonlyme]

I test before every meal and before going to bed. I find this useful as I am a carb counter and knowing what my blood glucose level is before eating tells me a number of things: 1- whether I need to include a "correction" dose of insulin with the meal I am about to eat to bring my level back down to within an acceptable range. 2- whether I accurately worked out my previous meals dose of insulin correctly based on the amount of carbs I believed I was eating.

I test before bed as I have a sliding scale of long-acting insulin doses depending on where my blood glucose level is, if I give myself the wrong dose because I didn't test then this can result in my blood glucose being elevated in the morning, therefore being a bad day of feeling lethargic and tired or having a hypo in the night which is also not pleasant, or waking up with sugars lower than would be preferred which means I have a headache. The testing at night therefore means I can have a good day the next day, which is true about 95% time (the other 5% is when I am ill and there is no rhyme or reason to what my blood glucose levels do despite all the testing I do because of infection levels).

 

[Synonym]

When I was first diagnosed and had seen the DN who advised me to eat my normal diet as it was very good I was feeling very unwell and so I found the advice confusing and inadequate. In the beginning I needed to know what was making me feel so ill and when I started testing before meals and 2 hours afterwards I was able to actually see what levels I was starting from on my normal diet.

The testing enabled me to cut down portion sizes first of all to see what difference that made. I was then able to isolate which food was causing the spikes and by gradually cutting down on some and eliminating others from my diet I was able to control my BG levels effectively. I have discovered how combining some foods can ameliorate or lessen the effect that some of them have on my BG levels.

The self test results have enabled me to work out different ways of making favourite meals using alternative ingredients and to have a number of recipes which I know are safe for me. This has also meant that when visiting friends I now have the knowledge to choose my foods wisely. I find that testing when I eat out is essential to enable control.

I was very interested to note that T2 friends did not always react to foods in the same way as I do. Different things make them spike and they need to use different ways to help them avoid spikes and control their BG levels.

When I am unwell I have noted that my BG levels are again very different and if I test I am able to select my foods to afford a measure of control on these occasions when my levels would otherwise be sky high.

When I am anxious or under stress I have also noted the rise in BG levels and testing before and 2 hours after meals has been very helpful on keeping a greater measure of control.

I noted that when I went to bed, if my BG level was too low, the morning reading would be much higher than usual and it would be hard to get the numbers down throughout the day. Through testing and eating a small snack to prevent BG levels becoming too low before bed time I have been able to ensure that this does not happen.

Clearly the standard advice to eat plenty of starchy carbohydrate was not appropriate for my body and following it made me very unwell so testing has been the only way to work out the way to a better quality of life.

 

[jenrose]

When I was first dx 4 years ago I was prescribed test strips and I used them to test before meals and 2 hours afterwards in order to determine what effect the food I had eaten, or what drinks, affected blood glucose levels. I also used the meter when I felt hypo. At first I would feel like I was hypo when the bg level was 5.0 mml/mol. Now if I had eaten what is recommended for a hypo I would have then gone too high. After a couple of years I found that after walking twice as far as usual with the dog that I would regularly go below 4.0 mmol/l and once went as low as 2.9 mmo/l. About 2 years ago I was not given any prescriptions for test strips so I purchase them myself. Recently I had lunch at 12 noon and had 1 digestive biscuit in the afternoon as I knew I would not be eating until late that evening (6.30) and when I tested I was surprised that it was 8.0 mmol/l. Now I have heard people say that there is no need for a type 2 on Metformin to test because there is nothing that can be done about the result. In my opinion the result gives a person knowledge and with that knowledge they then have a choice - if bg is on the high side before eating then a choice can be made of what to eat and what to avoid. Testing first thing in the morning now and then will also give an idea of whether they are keeping on track especially if not seeing the nurse for 10 months for a hb1ac result.

 

[crowjon]

I have been a T2 now for about 12 years. I have done the regular testing, no testing at all, and the timed testing occasionally. My Clinic always asks for my recorded results but I usually say I forgot them. Why? Because I feel that they are really meaningless in the small picture, but maybe relevant in the big picture, as is implied in some of the posts. My Hb1ac is generally lower than 7 but has recently gone up again on last 6 monthly. This has happened before, and I know why, it was 6 months of stress previously. As a T2 I have learned to listen to my body, and know now when things are not right or they are OK, and usually when I go for my annual and 6 month checks I am accurate to within a few points in my forecast of the Hb1ac results. So I am not sure what regular testing for established T2s achieves, but it is definitely a good thing for newbies as they can find out what is going on and then think about how they feel (listen to their body) and eventually it should become second nature. I know this may not be easy, as it is for me being a holistic healer, but I am sure with some practice most people (T2 at least) can do it. Hope this helps.

On the point of 'Healing' therapies, has anyone got experience of healing with diabetes. I have done some research and found no evidence so far of effective results with spiritual or reiki or similar healing modalities, but I have heard of some good results with natural remedies.

 

[Jen&Khaleb]

If you test before the meal you can work out how much insulin to administer and if you test afterward you can find out if you were right. This is a T1 perspective of a parent treating a child. I tried the crystal ball but it didn't work.

 

[cugila]

I have been T2 Diabetic for over 12 years. During that time I once never tested at all, relying on the odd HbA1c tests. These all seemed fine at the time so I thought I was doing OK. Then all sorts of complications started and gradually I realised that I had no idea what was actually going on in my body regarding blood glucose levels.

Then I came here to this forum some 15 months ago and saw that many people whether newbies or not were regularly testing their Bg levels throughout the day. So, I started to do the same.....what an eye opener that was ! Bg levels up in the 15's and higher yet my HbA1c was always supposed to be OK. How was that ?

I found that because of testing before meals and then 1 and 2 hrs after meals, sometimes 3 and 4 hrs even, there were certain foods which were definitely BAD for me. I cut these foods out totally first of all using a low carb diet. This worked for a while but I found it too restrictive and started to carefully re-introduce them back in very small portions. That kept the Bg levels under control providing I kept strict control by testing frequently. I now use a reduced carbs/low GI/GL method to control my bg levels. This seems to work very well for me.

I was then put on hypo inducing drugs, Byetta and a small amount of Gliclazide. The pre and post meal testing then was imperative as I frequently found my Bg levels, because they were well controlled during the day started to plummet after meals and I ended up in hypo territory. Not a place I relished ! I had to test to know this. It was also important as a person who drives long distances frequently I needed to know exactly what was going on. I couldn't just guess what my levels were. It would be criminal to drive with low or high Bg levels. I usually feel bad whichever direction my bg levels are going but I have to test to know which way as sometimes the symptoms can be similar. We are all different in this respect.

I have just gone through 6 months of Cancer treatment and my HbA1c climbed to 7% :shock:
For me that was horrendous.......I now find that my HbA1c has dropped to 6.8% despite the fact that I almost daily had Bg levels of up to 23.9 mmol/l because that was a side effect of the drugs I had to take ! If I only used the HbA1c as a benchmark I would be totally wrong in how well my Diabetes was controlled. My daily averages were sometimes as high as 9 mmol/l, that is the true indicator not my HbA1c level. A graph of my daily readings looks like the plans for an Alton Towers Rollercoaster ride........ :shock: The levels are still dropping thank goodness. Mainly now I am aware of all this and can take steps to get back my previous good control which was all levels 98% on target as compared to the present 34% which is improving all the time. Without testing pre and post meals I would have no idea what is going on.

Good control allowed me to discard glasses which I needed for distance and my eyesight has gone back to pre 2001 levels......all because of tight control, even after 12+ years. I am sure that I have also staved off other complications which can result from poorly controlled diabetes.

This is all from my own experience over time and what I do/did may not work for some. It worked for me and I am a staunch advocate of regular testing, particularly for newbies and even if you are experienced. No two days are the same and there are always variables which can affect Bg levels so I never take things 'as read'. A little testing doesn't stress me out, doesn't make me paranoid, just gives me peace of mind and power over my Diabetes. I remain firmly in control which is exactly how I like to be.

Ken

 

[Debloubed]

if I didn't test before, how would I know how much insulin to dose?! and if I didn't test after 2 hours, how would I know if it had worked? Common sense for me to test before and after, I would SO love it if I could stop testing and know 100% that each meal time would produce the same results but unfortunately, my body thinks otherwise! I can probably predict the same results for approx 7 days in a row. After that, a change is inevitable.

 

[catherinecherub]

So is what the original poster saying that because he is a holistic healer then he possesses "special powers" and is in tune with his body and does not need to test? It would seem that it is easy for a holistic healer but with practice we could all do it.
I'll stick to the testing I think.