Finger prick blood tests before/after meal - look odd

[SaWi]

Hi,

I am not sure why I got the results I did this morning (see below) - what might be going on?

I've started reading a Jenny Ruhl book, and there is a graph of continuous blood glucose monitoring at the end of chapter one from a 2006 study of non-diabetic subjects. It shows low, median and high blood sugars from 6am to 12 noon, with breakfast at 7.30am, and if my translation from mg/dL to mmol/L is OK, then the results at specific times after the meal appear to be

Results traced on the graph
Low* 0 mins, 3.3 mmol/L; at 45 mins (peak), 5.2mmol/L; at 120 mins, 3.2
Median 0 mins 4.4 mmol/L; at 45 mins (peak), 7.0 mmol/L; at 120 mins, 4.7
High* 0 mins 5.5 mmol/L; at 45 mins (peak), 8.8 mmol/L; at 120 mins, 6.3

So the rise after 45 minutes is generally more than 2, but after two hours, the rise is less than 1 mmol/L. After reading this, I thought I might include a 45 min and a 90 minute test.

I didn't test my blood sugar when I got up this morning, but just before breakfast it was 5.2.
My next results were:
45 minutes, 7.0
90 minutes, 7.0
120 minutes, 7.6
150 minutes, 5.8

So after 90 minutes, I thought the peak would probably have been between 45 and 90 minutes, and it was a shock to see it rise again at 120 minutes. I tested again at 2.5 hours, and it had finally started to come down again.

*Having had another look at the graph, the high and low are not particular individuals, but instead +/- two standard deviations using the aggregate data. It seems the "high" and median results take longer about three hours to return to normal (the "low" has a dip at 90 minutes and returns to normal after two hours).

 

[bulkbiker]

What was breakfast?

 

[ert]

Welcome. These results will depend on what you have eaten. If you're concerned, I suggest you keep a food diary and experiment with different combinations and types of fats, protein and carbohydrates.

 

[SaWi]

I've been following the 800 calorie, low carb ideas (45-65 g protein, 30-50 carbs, 20g fibre) for a couple of months, since diagnosis as type 2, and have just subscribed to Fast800 to widen my meal choices. I'm usually eating my main meal for breakfast - last night the family meal was salmon, so this morning I had salmon, green beans, olives, parsley, followed by cottage cheese and apple with cinnamon.

Totals for breakfast were protein 47g, CHO 19g, fibre 5g, calories 600. Supper tonight will be quite a bit lighter, but I am going to end up with 990 calories today.

I'm trying to make sure that I balance out the CHO across the two meals each day.

 

[xfieldok]

In order to control my numbers, I was starting out with a very high one, I started a keto diet, under 20g per day.

I did not count calories only carbs. Everything you thought you knew about diet is turned on its head.

The weight dropped off as a by product of the diet.

The only fruit I eat is a few berries and double cream. I wouldn't eat an apple. Cottage cheese can be a bit dodgy as well. We are all different and a food that suits me may not suit you.

 

[Mr_Pot]

The human body does not work like a science experiment, there are too many uncontrolled variables. Many of us who take a more pragmatic approach have had success with modifying their meals to achieve a rise of less than 2 after 2 hours and seen their HbA1c reduce to normal without any complicated calculations. Remember that this is a lifestyle change and the simpler you make it the more likely you will keep to it.

 

[Rachox]

Hi Sawi and welcome to the forum. As you are new I’ll tag in @daisy1 for her useful info post.
I notice you are eating your main meal of the day at breakfast time. You might want to rethink this, I and others find their tolerance of carbs is better later in the day. I only eat around 7 of my 30-50g daily carb allowance at breakfast time. Might be worth testing before and after all your meals to see if this applies to you too. I never see a rise of over two mmols at the two hour post prandial reading, far less and sometimes the post reading is actually less than the pre meal one. Just something you might like to consider.

 

[SaWi]

In order to control my numbers, I was starting out with a very high one, I started a keto diet, under 20g per day.

I did not count calories only carbs. Everything you thought you knew about diet is turned on its head.

The weight dropped off as a by product of the diet.

The only fruit I eat is a few berries and double cream. I wouldn't eat an apple. Cottage cheese can be a bit dodgy as well. We are all different and a food that suits me may not suit you.

I was worried about it- it is the first apple I've had since diagnosis. I was also a bit surprised to see the carbs in the cottage cheese, which I think of as "cheese", i.e. minimal carbs, but I suppose it is more like milk, with lactose.

I did wonder whether it was something to do with the two courses, with all the carbohydrate coming a few minutes later. I did eat the whole meal in 18 minutes though.

I find I can't get my carbs down to 20g a day if I am going to aim for 20g fibre - how did you do it?

 

[SaWi]

The human body does not work like a science experiment, there are too many uncontrolled variables. Many of us who take a more pragmatic approach have had success with modifying their meals to achieve a rise of less than 2 after 2 hours and seen their HbA1c reduce to normal without any complicated calculations. Remember that this is a lifestyle change and the simpler you make it the more likely you will keep to it.

I know, I know, but I do want to experiment and understand as much as I can! Currently I'm happy with the blood sugars - I'll see next month whether the HbA1c is better than the March result - but I am unhappy about my waist measurement and I'll see if I can keep going until it's nearer the 80cm mark.

I shall certainly need to simplify everything once I go back onto normal calories/day.

 

[SaWi]

Hi Sawi and welcome to the forum. As you are new I’ll tag in @daisy1 for her useful info post.
I notice you are eating your main meal of the day at breakfast time. You might want to rethink this, I and others find their tolerance of carbs is better later in the day. I only eat around 7 of my 30-50g daily carb allowance at breakfast time. Might be worth testing before and after all your meals to see if this applies to you too. I never see a rise of over two mmols at the two hour post prandial reading, far less and sometimes the post reading is actually less than the pre meal one. Just something you might like to consider.

That's really interesting, I hadn't thought about this. The diabetic nurse suggested taking readings on rising, and before and after dinner, and my results began to look OK quite quickly. It was only after I'd seen the 2006 study that I started testing before and after breakfast, and was disappointed to see that the readings were not as good. I just assumed that I had not been as resolute at 30g CHO and 800 calories.

I can easily swap round meals, I'll try it. Many thanks!

 

[kitedoc]

Hi @SaWi,
1) i assume you converted mg/dL to mmol/l by dividing the former by 18
2) as @bulkbiker queried, what did these non-diabetics eat?
3) non-diabetics respond quite individually to the same meal see https:/www.sciencedaily.2015/11
4) unless the 45 minutes bsl reading was much higher, it is not seen as significant. Rarely someone's stomach empites very rapidly and sends the bsl way high. Not here ( see mayoclinic.org dumping syndrome)
5) on the home page of this site you are posting on under 'Living with Diabetes' ( menu, horizontal bar, top) is a heading on blood sugar ranges on far left.
The normal bsl range for what is regarded as the after meal bsl is set at greater than 90 minutes. And usually measured at the 2.hours, 120 minute mark.
6) as exemplified in 3) we vary person to person as to how we respond to the same food. What the authors of the study reference in 3) suggest is for non-diabetics at least that the bowel bugs each of us carry plays a part in how food and insulin interact to influence bsl readings
7) on reltively quite low carb diets, one's liver may convert some protein into glucose appearing as such in the blood nearer the 3 hour mark, but one's metabolism, insulin response etc can all influence such things
8) as @Rachox rightly points out, usually insulin (whether produced by one's own pancreas gland or injected) seems less effective in lowering blood sugar in the morning compared to later in the day. Time is not of the essence, timing is.
I hope that helps provide some more answers or at least pulls some of the answers together.

 

[xfieldok]

I was worried about it- it is the first apple I've had since diagnosis. I was also a bit surprised to see the carbs in the cottage cheese, which I think of as "cheese", i.e. minimal carbs, but I suppose it is more like milk, with lactose.

I did wonder whether it was something to do with the two courses, with all the carbohydrate coming a few minutes later. I did eat the whole meal in 18 minutes though.

I find I can't get my carbs down to 20g a day if I am going to aim for 20g fibre - how did you do it?

I totally ignored any thing but carbs. Whatever I was eating, I didn’t have any problems in the bathroom.

 

[daisy1]

@SaWi
Hello and welcome to the Forum Here is the Basic Information we give to new members and I hope you will find it both interesting and helpful.

BASIC INFORMATION FOR NEW MEMBERS

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 600,000 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

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.

Over 145,000 people have taken part in the Low Carb Program - a 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

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.