Question about Blood glucose test

Keister · Mar 30, 2015

Hi, I asked my nurse for a blood glucose meter so that i could self test but i'm confused about some of the results.

Now i know some of you will say this is to many carbs and i'm aware that it is but bear with me.

Today before breakfast my reading was 7.5 and after eating two wholemeal rolls with Bacon and brown sauce my reading after 2 hours went up to 15.2
Now before luch my reading was 8.2 and i had 2 wholemeal rolls with German Salami and mayonaisse 2 hours later my reading went up to 8.9

How can eating the same wholemeals rolls give me two totally different jumps in glucose levels?

Spiker · Mar 30, 2015

how much brown sauce? it's pretty much liquid sugar.

NoCrbs4Me · Mar 30, 2015

Did you wash and dry your hands well before testing every time?

Keister · Mar 30, 2015

Always wash my hands before the test and was probably about a tea spoon of brown sauce in the rolls.

NoCrbs4Me · Mar 30, 2015

For the same food/carbs, I found my blood glucose goes up much higher after eating in the morning compared to lunch or dinner.

phoenix · Mar 30, 2015

NoCrbs4Me said:
For the same food/carbs, I found my blood glucose goes up much higher after eating in the morning compared to lunch or dinner.

That's called the second meal effect.

The effect of a prior meal in decreasing the rise in blood glucose after a subsequent meal was first recognized almost a century ago (1). It has repeatedly been confirmed in healthy subjects, but tests with intravenous or oral glucose suggested that the second-meal effect does not occur in type 2 diabetes (2–4). We observed incidentally that a second meal in subjects with type 2 diabetes brought about a 70% lesser rise in blood glucose (5).

http://care.diabetesjournals.org/content/32/7/1199.full
It's one reason why it isn't a good idea to miss breakfast.

Spiker · Mar 30, 2015

phoenix said:
That's called the second meal effect.

http://care.diabetesjournals.org/content/32/7/1199.full
It's one reason why it isn't a good idea to miss breakfast.

I guess this is why DAFNE suggests testing for different carb ratios at different meals?

noblehead · Mar 30, 2015

Spiker said:
I guess this is why DAFNE suggests testing for different carb ratios at different meals?

That's correct, plus some people are more insulin resistant first thing in a morning and less so as the day goes on.

Pasha · Mar 30, 2015

Well Dr Bernstein does or did. ex breakfast 6gms, lunch 12 gms, tea 12 gms carbs. carbs

Spiker · Mar 30, 2015

phoenix said:
That's called the second meal effect.

http://care.diabetesjournals.org/content/32/7/1199.full

The indispensable Prof Taylor!

The second-meal phenomenon is not mediated by an acute effect on insulin secretion, and FFA suppression must be considered. Increased FFA induces insulin resistance in humans (10,11). Conversely, suppression of plasma FFA by acipimox acutely improves insulin action in type 2 diabetes by increasing glucose storage as muscle glycogen and decreasing hepatic glucose production (9,12,13). An increase in FFAs leads to an inhibition of net hepatic glycogen breakdown and increases gluconeogenesis (14). We recently observed that, in normal subjects, the second-meal phenomenon was associated with increased rates of storage of lunchtime carbohydrate in muscle glycogen (7).

The present data demonstrate that under everyday conditions, postprandial glucose metabolism in type 2 diabetes is facilitated by suppression of plasma FFA concentrations after a previous meal.

If I read this right it's the combination of two known phenomena: plasma free fatty acids rising during fasting (along with increased gluconeogenesis), and plasma free fatty acids inhibiting glucose storage in muscle. Very interesting. Breakfast, of course, "breaks the fast". So we move out of fasting conditions (eg nutritional ketosis).

I wonder what would have happened if the breakfast had been a low carb breakfast. I'm guessing there would not have been a "second meal" effect.

phoenix · Mar 30, 2015

I wonder what effect a small breakfast of protein would have in a T2 or non diabetic since that can also stimulate insulin.
In those with little or none then the only answer is to eat breakfast and dose some insulin or not eat breakfast but also give a small insulin dose.

Lamont D · Mar 30, 2015

phoenix said:
I wonder what effect a small breakfast of protein would have in a T2 or non diabetic since that can also stimulate insulin.
In those with little or none then the only answer is to eat breakfast and dose some insulin or not eat breakfast but also give a small insulin dose.

I've often had just protein for breakfast.
As a non diabetic, it did nothing, in fact because I always dog walk/work after breakfast, my readings are always down at 2 hours.
Even though I flush insulin, it's only medium to high carbs and sugar that do it, maybe if the insulin produced would not be enough to spike you from protein only.

Question about Blood glucose test

Keister

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Question about Blood glucose test

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