Is there any point?

[dawnmc]

Was advised by the nurse to test 4 hours after eating instead of 2 hours. Question is what would be the point of that and is there any reason she would tell me to do that.

 

[MaryJ]

Morning Dawn

errrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr

dunno

I know we have to pick a point to test and it's generally regarded as the numbers should be coming down to pre-meal levels at 2 hours

So, like you I can't see the point in a 4 hr reading. Surely you will be at pre-meal levels, which will not tell you how the meal performed for you?

Mary x

 

[jopar]

Very much depends on what you'll eating

If you eating a high fat content, or something like Pasta, Rice Pizza, pastry etc, then these foods can still be impacting on the blood glucose hours later, so at the 1 hour, 2 hour mark everything longs fine, 3 or 4 hours it raises the BG...

 

[Grazer]

Very much depends on what you'll eating

If you eating a high fat content, or something like Pasta, Rice Pizza, pastry etc, then these foods can still be impacting on the blood glucose hours later, so at the 1 hour, 2 hour mark everything longs fine, 3 or 4 hours it raises the BG...

:***: :***: :***: I can absolutely assure you that a T2 on diet only like dawnmc will NOT look fine at 1 or 2 hours if she eats pizza, rice pastry or pasta in anything other than tiny quantities! :***:

 

[borofergie]

If you eating a high fat content, or something like Pasta, Rice Pizza, pastry etc, then these foods can still be impacting on the blood glucose hours later, so at the 1 hour, 2 hour mark everything longs fine, 3 or 4 hours it raises the BG...

With respect, it'd be pretty dumb for a diet-only-T2 to be eating large quantities of Pasta, Rice, Pizza and pastry. If you do that, you don't need a meter to tell you that you are going to get one hell of a spike.

The only advice I've ever heard is to test 1 or 2 hours after eating. If you're eating a sensible diet, then you'll be just back to fasting levels at 4 hours, which will give you a false impression of your control. I'd humbly suggest that this nurse doesn't know what (s)he is talking about.

 

[Paul1976]

I've been told to test at 3 or 4 hours by the team BUT that's only because the Byetta I inject slows my stomach emptying significantly,prior to that i always tested at 2 hours post prandial.

 

[jopar]

Stephen

Foods that I mentioned take a long time to adsorb into the system... This type of spiking is called the 'Pizza' effect and can catch the insulin user out... At an hour mark could suffer a hypo, 2 hour mark everything looks fine but test at 3 or 4 hours, the bloods levels start rising!

So yep if the 4 hour test is the only test being done (the OP doesn't make this clear) it's a bit pointless, but combined with a 1 or 2 hour test it could tell a story...

 

[Grazer]

This type of spiking is called the 'Pizza' effect and can catch the insulin user out... At an hour mark could suffer a hypo, 2 hour mark everything looks fine but test at 3 or 4 hours, the bloods levels start rising!

The OP is a diet only T2!! Read the profile!

Foods that I mentioned take a long time to adsorb into the system...

Rice, pizza and pastry will NOT look OK at the 1 or 2 hour mark, and will give a spike very quickly in a diet only T2!

 

[borofergie]

So yep if the 4 hour test is the only test being done (the OP doesn't make this clear) it's a bit pointless, but combined with a 1 or 2 hour test it could tell a story...

Seems clear enough...

Was advised by the nurse to test 4 hours after eating instead of 2 hours.

Don't quite understand why you have brought insulin into a discussion with a diet only T2.

 

[Pneu]

I can see no purpose to a +4 hour post meal test in isolation.

+4 hour tests in conjunction with say +2 hour tests can be useful where you have eaten high fat / high carbohydrate meals.. I can't however see the relevance of such a test to a diet controlled type II who by definition should not be eating high carbohydrate.

The cynic in me is thinking in the nurse suggested this because at +4 hours you should have recovered to lower levels..

As a diet controlled type II the majority of your tests should be done at +2 hours.. you may want to do some +1 hour tests on new foods to rule out high spikes.. should you eat hi-carb / hi-fat meals as a 'treat' then you want to do +2 and +4 hour tests... but in reality if you want to be eating this sort of meal more than once in a bluemoon you need to consider a different approach to controlling your type II.

 

[lucylocket61]

May I ask respectfully if we could differentiate between advice to different Diabetes types please? Perhaps a head or foot note of which type it is directed to?

I keep getting lost.

 

[Pneu]

What Jo has said isn't technically 'wrong' it's just not explained clearly... as a T1 insulin user she is aware of how hi fat / hi carb effects at longer than 2 hour durations and thus has applied that logic to her answer.. again the answer isn't incorrect and the OP maybe eating hi-fat / hi-carb... however typically a type II diet controlled wouldn't be and therefore we need to view the question in that light..

Benedict made an addition to the forum rules recently that can be found here: viewtopic.php?f=1&t=5019#p272032

One of those changes is in relation to answering questions on different types of diabetes.. I don't think here the information given is incorrect it just needs to be tailored to the OP rather than being 'generalised'. When posting we all need to be more aware of the type of diabetes in question and the OP's method of control to ensure that we are providing answers that make the most sense.

 

[Grazer]

With respect, I think it is incorrect in suggesting that tests will "look fine" at 2 hours after eating rice, pastry, pizza etc. it won't on Any T2 on diet only that I know about. it might STILL be high at four hours, but it WON'T look fine at two. Maybe if you're using insulin it might, I wouldn't know, but the OP isn't.

 

[xyzzy]

In the world of xyzzy +4 hours is the point after eating that any reading then taken (or later) will be counted as fasting or pre-prandial. Nowadays I find very few readings are significantly more than 0.5 higher at +2 hours than the reading I took before eating. Of course that statement depends on what has been eaten so a high(er) carb or is you prefer high(er) GI meal may well show an increased BG at +2 hours but if its still raised at +4 then I would probably think twice about eating the same thing or quantity of thing again.

... and yes I would never dream of eating much more than 50g (2oz) dried weight of either low GI brown basmati rice or low GI brown or tri-colour pasta - half that for white! The spike implications for diet only or even diet + Met at some point over the ensuing 4 hours would normally spike me to double figures. I realise those amounts are low but I would suggest even the "toughest" diet only T2 would have great difficultly not spiking dangerously within the 4 hour period on quantities even as low as 100g.

 

[jopar]

Pneu

Is the thought pattern wrong?

High fats slow down adsorption of carbs that have been eating (as any level) most T2's will lower carb intake and increase Protein breaks down, both to replenish and repair the body, but the excess from this breaks down into carbs to fuel the body... Now due to the slowness T2's hope to be able to burn this of naturally with physical activity..

But often there's a rise in the morning/fasting level.. Now yes if the rise is consistent every day then it's probably a reaction to the increase of hormone activity first thing in the morning... But if this rise is intermittent then could it not be that because of the length of time meals the previous days taking time to adsorb and impact on the blood glucose overlapping with each other rather than the assumed liver dump! More so when the increase isn't particularly high

 

[Pneu]

Grazer to be honest I had skimmed the thread and missed that.. I would imagine that you are correct

All I was trying to get at is that in the same way you may want to check for spikes at +1 hour, with high fat or protein content meals you may want to check at + 3 or +4 hours as well to ensure you don't miss a spike later.

 

[xyzzy]

High fats slow down adsorption of carbs that have been eating (as any level) most T2's will lower carb intake and increase Protein breaks down, both to replenish and repair the body, but the excess from this breaks down into carbs to fuel the body... Now due to the slowness T2's hope to be able to burn this of naturally with physical activity..

I don't think any informed T2 would have much of a problem with that statement BUT it's the QUANTITY of carbs you assume we can eat safely which is the issue. Without an adequate insulin response to cover the carbs, effectively the same kind of response you get from injecting insulin, then the same thing will happen as if you miscalculated and didn't inject enough insulin. You would spike horribly as would a T2.

 

[Grazer]

Jopar, sorry, but that post is completely irrelevant to the question. And if I may say somewhat tough to understand the point of. The basic issue is that a T2 on diet only will NOT look "fine" testing two hours after eating rice or a pizza! So as the OP clearly stated they were advised to test at four hours INSTEAD of two, then the correct answer is that the advice was rubbish. Sometimes it's better to say a mistake was made than to try covering it with technicalities which confuse the poor OP even more.

 

[borofergie]

High fats slow down adsorption of carbs that have been eating (as any level) most T2's will lower carb intake and increase Protein breaks down, both to replenish and repair the body, but the excess from this breaks down into carbs to fuel the body... Now due to the slowness T2's hope to be able to burn this of naturally with physical activity..

But often there's a rise in the morning/fasting level.. Now yes if the rise is consistent every day then it's probably a reaction to the increase of hormone activity first thing in the morning... But if this rise is intermittent then could it not be that because of the length of time meals the previous days taking time to adsorb and impact on the blood glucose overlapping with each other rather than the assumed liver dump! More so when the increase isn't particularly high

Again, this is a false assumption. Low-carbing T2s don't necessarily eat more protein than anyone else. If we do, it's to fuel gluconeogenesis and provide the minimal levels of glucose that our brains require (about 25g in ketosis), which doesn't leave much to raise BG levels.

Doesn't have anything to do with the OPs question. Good job on derailing the thread though.

 

[Pneu]

Ladies & Gents... Back to the OP please before this one fly's off on a tangent..

As I said some posts ago... I can see no valid reason why a +4 hour reading in isolation would be required for a diet controlled only Type II. OP I would suggest you continue to test at +2 hours; unless for instance you situation re medication had changed etc...