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Blood Sugar Pp Means

Why Checking Postprandial Glucose Is Important

Why Checking Postprandial Glucose Is Important

Checking your blood sugar (glucose) levels at home is part of your type 2 diabetes management plan. You can use the results of these tests to help improve your blood sugar control. But if you’re only testing first thing in the morning, you might be missing the full picture. “I like to tell my patients that the first morning glucose level check is usually the lowest of the day, and checking only in the morning is akin to purposefully ‘blindfolding’ yourself to only see the best-case scenario,” says endocrinologist Ildiko Lingvay, MD, MPH, an associate professor in the department of internal medicine/endocrinology at the University of Texas Southwestern Medical Center in Dallas. “If you want to see a more complete picture, I recommend patients mix it up and check their glucose level at various times during the day — and, most importantly, when they know they might have not followed the best advice — to see the full effect of their choices.” The American Diabetes Association (ADA) recommends checking blood sugar levels before eating (fasting blood sugar) and then again one to two hours after the beginning of a meal — particularly if target A1C goals aren’t being met. The test after the meal is called the postprandial glucose (PPG) test. You might also need to test your blood sugar at other times during the day, or after certain activities, depending on the information you and your medical team are trying to gather about your type 2 diabetes. PPG 101 The term “postprandial glucose” might sound like jargon, but it literally means “sugar after the meal.” “Glucose levels begin to rise about 10 minutes after the start of a meal and peak two hours after a meal… and they return to pre-meal levels within two to three hours,” explains endocrinolo Continue reading >>

Healthy Blood Sugar Targets

Healthy Blood Sugar Targets

If you have been told your blood sugar is higher than normal, you may wonder what blood sugar levels you should be aiming for to ensure ongoing health. Doctors and organizations like the American Diabetes Association suggest various blood sugar targets, but before you adopt any such target, it is worth remembering that the point of setting and adhering to any blood sugar target is to avoid diabetic complications. "Complications" is a euphemism for some very ugly outcomes that include blindness, amputation, kidney failure and death. So the obvious question to ask about any blood sugar target is "What evidence suggests that this blood sugar level is low enough to prevent complications." Research conducted with human patients, mice, and pancreas beta cell cultures all point to a single threshold at which elevated blood sugars cause permanent damage to your body. What is that level? 140 mg/dl (7.8 mmol/L) after meals You can read in detail about the research that establishes this as the highest level you should allow your blood sugars to rise after meals here: Research Connecting Blood Sugar Level with Organ Damage The AACE Recommends A Post-Meal Blood Sugar Target Below 140 mg/dl In 2007, The American Association of Clinical Endocrinologists, an organization of specialists who treat diabetes, published a White Paper recommending that blood sugar should not be allowed to rise above 140 mg/dl two hours after a meal. The white paper explained this stating: . .a large number of highly robust cross-sectional and prospective epidemiologic studies have clearly implicated a close association between postchallenge or postprandial hyperglycemia and cardiovascular risk. These studies encompass diverse populations and disparate geographic regions, from Honolulu to Chicago to Islington Continue reading >>

How To Manage Blood Sugar Spikes After Meals

How To Manage Blood Sugar Spikes After Meals

If you're trying to manage diabetes, you already know it's important to keep track of your blood sugar levels. But how do you handle a spike that comes after you eat? It's called "postprandial" blood glucose, and if you take some simple steps, you can get it under control and help avoid health problems. When your blood sugar is high, you can get symptoms like a foggy-headed feeling that makes it hard to focus or think clearly. Your energy may also take a dive, and you may feel nervous or moody. If your levels go too low, you could even pass out. In the long run, if your blood sugar stays up, you could be at risk for heart disease, stroke, kidney disease, or other problems. The American Diabetes Association (ADA) recommends you check your blood sugar levels right before mealtime with a blood sample from a finger stick. Then do it again 1 to 2 hours after that first bite of food. Keep this up for a week or so. Write down the time and the blood sugar number. Make a note about anything you think might affect your levels, like medicine or exercise. And don't forget to log exactly what you ate, along with portion sizes and the amount of carbs. What levels are too high after a meal? Experts vary on what the number should be, but the ADA says a general goal is a blood sugar level under 180 mg/dL, 1 to 2 hours after a meal. Talk to your doctor about what you should aim for, and don't adjust your medicine without speaking to him first. Get medicine that works for you. The right insulin or medication program can make a big difference. In general, to cover after-meal spikes, those that kick in quickly and for a short time are a better choice than ones that work slowly over a long period. Your doctor can explain your options. Keep blood sugar in check before meals. That way, even if Continue reading >>

Carbohydrate-last Meal Pattern Lowers Postprandial Glucose And Insulin Excursions In Type 2 Diabetes

Carbohydrate-last Meal Pattern Lowers Postprandial Glucose And Insulin Excursions In Type 2 Diabetes

Background There are limited data regarding the timing of carbohydrate ingestion during a meal and postprandial glucose regulation. Methods Sixteen subjects with type 2 diabetes mellitus (T2DM) consumed the same meal on 3 days in random order: carbohydrate first, followed 10 min later by protein and vegetables; protein and vegetables first, followed 10 min later by carbohydrate; or all components together. Blood was sampled for glucose, insulin, glucagon-like peptide-1 (GLP-1), and glucagon measurements at baseline (just before meal ingestion) and subsequently at 30 min intervals up to 180 min. Results The incremental areas under the curve for glucose (iAUC0–180) and incremental glucose peaks were 53% and 54% lower, respectively, when carbohydrate was consumed last compared with carbohydrate consumed first (3124.7±501.2 vs 6703.5±904.6 mg/dL×180min, p<0.001; 34.7±4.1 vs 75.0±6.5 mg/dL, p<0.001) and 44% and 40% lower, respectively, compared with the all components together condition (3124.7±501.2 vs 5587.1±828.7 mg/dL×180min, p=0.003; 34.7±4.1 vs 58.2±5.9 mg/dL, p<0.001). Postprandial insulin excursions were lower (iAUC0–180: 7354.1±897.3 vs 9769.7±1002.1 µU/mL×min, p=0.003) and GLP-1 excursions higher (iAUC0–180: 3487.56±327.7 vs 2519.11±494.8 pg/mL×min, p=0.019) following the carbohydrate-last meal order compared with carbohydrate first. Conclusion The carbohydrate-last meal pattern may be an effective behavioral strategy to improve postprandial glycemia. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the origi Continue reading >>

Diabetes: Blood Sugar Readings

Diabetes: Blood Sugar Readings

www.CardioSmart.org What is a blood sugar reading? A blood sugar reading shows how much sugar, or glucose, is in your blood. A test of your blood sugar may be done to: • Check for diabetes. • See how well diabetes treatment is working. • Check for diabetes that occurs during pregnancy (gestational diabetes). • Check for low or high blood sugar levels (hypoglycemia or hyperglycemia). What are normal blood sugar readings? There are several types of blood sugar tests. Normal results can vary from lab to lab. Talk with your doctor about what any abnormal results might mean, and about any symptoms and other health problems you have. Normal values for adults who do NOT have prediabetes or diabetes Less than or equal to 100 When you have not eaten (fasting blood sugar): Less than 140 if you are age 50 or younger; less than 150 if you are age 50 to 60; less than 160 if you are age 60 and older 2 hours after eating (postprandial): Levels vary depending on when and how much you ate at your last meal. In general: 80 to 120 beforemeals or when waking up; 100 to 140 at bedtime. Random (casual): Target values for nonpregnant adults who have prediabetes or diabetes 80 to 130When you have not eaten (fasting blood sugar): Less than 1802 hours after eating (postprandial): What causes abnormal blood sugar? High blood sugar can be caused by: • Diabetes or prediabetes. • Certain medicines, such as corticosteroids. Low blood sugar can be caused by: • Certain medicines, especially those used to treat diabetes. • Liver disease, such as cirrhosis. Rarely, high or low blood sugar can be caused by other medical problems that affect hormone levels. Prediabetes and diabetes Blood sugar helps fuel your body. Normally, your blood sugar rises slightly af Continue reading >>

Understanding Diabetes

Understanding Diabetes

This information describes diabetes, the complications related to the disease, and how you can prevent these complications. Blood Sugar Control Diabetes is a disease where the blood sugar runs too high, usually due to not enough insulin. It can cause terrible long-term complications if it is not treated properly. The most common serious complications are blindness ("retinopathy"), kidney failure requiring dependence on a dialysis machine to stay alive ("nephropathy"), and foot and leg amputations. The good news is that these complications can almost always be prevented if you keep your blood sugar near the normal range. The best way to keep blood sugar low is to eat a healthy diet and do regular exercise. Just 20 minutes of walking 4 or 5 times a week can do wonders for lowering blood sugar. Eating a healthy diet is also very important. Do your best to limit the number of calories you eat each day. Put smaller portions of food on your plate and eat more slowly so that your body has a chance to let you know when it's had enough to eat. It is also very important to limit saturated fats in your diet. Read food labels carefully to see which foods are high in saturated fats. Particular foods to cut down on are: whole milk and 2% milk, cheese, ice cream, fast foods, butter, bacon, sausage, beef, chicken with the skin on (skinless chicken is fine), doughnuts, cookies, chocolate, and nuts. Often, diet and exercise alone are not enough to control blood sugar. In this case, medicine is needed to bring the blood sugar down further. Often pills are enough, but sometimes insulin injections are needed. If medicines to lower blood sugar are started, it is still very important to keep doing regular exercise and eating a healthy diet. Keeping Track of Blood Sugar Checking blood sugar wi Continue reading >>

Blood Glucose

Blood Glucose

Test Overview A blood glucose test measures the amount of a type of sugar, called glucose, in your blood. Glucose comes from carbohydrate foods. It is the main source of energy used by the body. Insulin is a hormone that helps your body's cells use the glucose. Insulin is produced in the pancreas and released into the blood when the amount of glucose in the blood rises. Normally, your blood glucose levels increase slightly after you eat. This increase causes your pancreas to release insulin so that your blood glucose levels do not get too high. Blood glucose levels that remain high over time can damage your eyes, kidneys, nerves, and blood vessels. There are several different types of blood glucose tests. 2-hour postprandial blood sugar. This test measures blood glucose exactly 2 hours after you start eating a meal. This is not a test used to diagnose diabetes. This test is used to see if someone with diabetes is taking the right amount of insulin with meals. Random blood sugar (RBS). It measures blood glucose regardless of when you last ate. Several random measurements may be taken throughout the day. Random testing is useful because glucose levels in healthy people do not vary widely throughout the day. Blood glucose levels that vary widely may mean a problem. This test is also called a casual blood glucose test. Oral glucose tolerance test. This test is used to diagnose prediabetes and diabetes. An oral glucose tolerance test is a series of blood glucose measurements taken after you drink a sweet liquid that contains glucose. This test is commonly used to diagnose diabetes that occurs during pregnancy (gestational diabetes). Women who had high blood sugar levels during pregnancy may have oral glucose tolerance tests after pregnancy. Hemoglobin A1c. This test is also Continue reading >>

Blood Glucose

Blood Glucose

Test Overview A blood glucose test measures the amount of a type of sugar, called glucose, in your blood. Glucose comes from carbohydrate foods. It is the main source of energy used by the body. Insulin is a hormone that helps your body's cells use the glucose. Insulin is produced in the pancreas and released into the blood when the amount of glucose in the blood rises. Normally, your blood glucose levels increase slightly after you eat. This increase causes your pancreas to release insulin so that your blood glucose levels do not get too high. Blood glucose levels that remain high over time can damage your eyes, kidneys, nerves, and blood vessels. There are several different types of blood glucose tests. Fasting blood sugar (FBS). This test measures blood glucose after you have not eaten for at least 8 hours. It is often the first test done to check for prediabetes and diabetes. 2-hour postprandial blood sugar. This test measures blood glucose exactly 2 hours after you start eating a meal. This is not a test used to diagnose diabetes. This test is used to see if someone with diabetes is taking the right amount of insulin with meals. Random blood sugar (RBS). It measures blood glucose regardless of when you last ate. Several random measurements may be taken throughout the day. Random testing is useful because glucose levels in healthy people do not vary widely throughout the day. Blood glucose levels that vary widely may mean a problem. This test is also called a casual blood glucose test. Oral glucose tolerance test. This test is used to diagnose prediabetes and diabetes. An oral glucose tolerance test is a series of blood glucose measurements taken after you drink a sweet liquid that contains glucose. This test is commonly used to diagnose diabetes that occurs during Continue reading >>

Blood Glucose

Blood Glucose

Test Overview A blood glucose test measures the amount of a type of sugar, called glucose, in your blood. Glucose comes from carbohydrate foods. It is the main source of energy used by the body. Insulin is a hormone that helps your body's cells use the glucose. Insulin is produced in the pancreas and released into the blood when the amount of glucose in the blood rises. Normally, your blood glucose levels increase slightly after you eat. This increase causes your pancreas to release insulin so that your blood glucose levels do not get too high. Blood glucose levels that remain high over time can damage your eyes, kidneys, nerves, and blood vessels. There are several different types of blood glucose tests. Fasting blood sugar (FBS). This test measures blood glucose after you have not eaten for at least 8 hours. It is often the first test done to check for prediabetes and diabetes. 2-hour postprandial blood sugar. This test measures blood glucose exactly 2 hours after you start eating a meal. This is not a test used to diagnose diabetes. This test is used to see if someone with diabetes is taking the right amount of insulin with meals. Random blood sugar (RBS). It measures blood glucose regardless of when you last ate. Several random measurements may be taken throughout the day. Random testing is useful because glucose levels in healthy people do not vary widely throughout the day. Blood glucose levels that vary widely may mean a problem. This test is also called a casual blood glucose test. Oral glucose tolerance test. This test is used to diagnose prediabetes and diabetes. An oral glucose tolerance test is a series of blood glucose measurements taken after you drink a sweet liquid that contains glucose. This test is commonly used to diagnose diabetes that occurs during Continue reading >>

Postprandial Blood Glucose

Postprandial Blood Glucose

Individuals with diabetes are at increased risk of developing microvascular complications (retinopathy, nephropathy, and neuropathy) and cardiovascular disease (CVD). The Diabetes Control and Complications Trial (DCCT) (1) and U.K. Prospective Diabetes Study (UKPDS) (2) showed that treatment programs resulting in improved glycemic control, as measured by HbA1c, reduced the microvascular complications of diabetes. The effect of these treatment programs on reducing CVD was less clear. However, some epidemiological studies suggest that there may be a relationship between glycemic levels and CVD. In the management of diabetes, health care providers usually assess glycemic control with fasting plasma glucose (FPG) and premeal glucose measurements, as well as by measuring HbA1c. Therapeutic goals for HbA1c and preprandial glucose levels have been established based on the results of controlled clinical trials. Unfortunately, the majority of patients with diabetes fail to achieve their glycemic goals. Elevated postprandial glucose (PPG) concentrations may contribute to suboptimal glycemic control. Postprandial hyperglycemia is also one of the earliest abnormalities of glucose homeostasis associated with type 2 diabetes and is markedly exaggerated in diabetic patients with fasting hyperglycemia. Several therapies targeted toward lowering PPG excursions are now available and have been shown to improve glycemic control as measured by HbA1c. However, many questions remain unanswered regarding the definition of PPG and, perhaps most importantly, whether postprandial hyperglycemia has a unique role in the pathogenesis of diabetic complications and should be a specific target of therapy. To address these issues and to provide guidance to health care providers, the American Diabetes As Continue reading >>

Blood Glucose

Blood Glucose

A A A Blood Glucose Test Overview A blood glucose test measures the amount of a type of sugar, called glucose, in your blood. Glucose comes from carbohydrate foods. It is the main source of energy used by the body. Insulin is a hormone that helps your body's cells use the glucose. Insulin is produced in the pancreas and released into the blood when the amount of glucose in the blood rises. Normally, your blood glucose levels increase slightly after you eat. This increase causes your pancreas to release insulin so that your blood glucose levels do not get too high. Blood glucose levels that remain high over time can damage your eyes, kidneys, nerves, and blood vessels. There are several different types of blood glucose tests. Fasting blood sugar (FBS) measures blood glucose after you have not eaten for at least 8 hours. It is often the first test done to check for prediabetes and diabetes. 2-hour postprandial blood sugar measures blood glucose exactly 2 hours after you start eating a meal. This is not a test used to diagnose diabetes. Random blood sugar (RBS) measures blood glucose regardless of when you last ate. Several random measurements may be taken throughout the day. Random testing is useful because glucose levels in healthy people do not vary widely throughout the day. Blood glucose levels that vary widely may mean a problem. This test is also called a casual blood glucose test. Oral glucose tolerance test is used to diagnose prediabetes and diabetes. An oral glucose tolerance test is a series of blood glucose measurements taken after you drink a sweet liquid that contains glucose. This test is commonly used to diagnose diabetes that occurs during pregnancy (gestational diabetes). This test is not commonly used to diagnose diabetes in a person who is not pregnant Continue reading >>

How To Lower Blood Sugar Levels Naturally

How To Lower Blood Sugar Levels Naturally

I may receive a commission if you purchase something mentioned in this post. Full disclosure here. If you are an American age 40 to 70, the odds are about 40 percent that you’ve been diagnosed with diabetes or prediabetes. (source) That means nearly HALF of us aged 40-70 have blood sugar regulation issues, likely from consuming too much sugar and too many refined carbs. Has your doctor told you to monitor your blood sugar levels? Is your fasting glucose above 95 mg/dL? Most of us are aware that uncontrolled high blood sugar leads to type 2 diabetes, but it also contributes to weight gain, metabolic syndrome, heart disease, increased oxidation (read: accelerated aging), inflammation, and high blood pressure. ALL of these conditions are preventable via diet and lifestyle changes. Even if you have a family history of diabetes, you are not a slave to your genes. You can lower your blood sugar naturally to prevent disease and look and feel better. What is High Blood Sugar? Also called hyperglycemia or high blood glucose, high blood sugar means there is too much glucose circulating in your bloodstream because your cells have shut the door and will not receive any more glucose. Frequent or ongoing high blood sugar levels damage your nerves, blood vessels, and organs. Fasting high blood sugar is considered higher than 130 mg/dL after 8 hours of fasting, and postprandial (after a meal) high blood sugar is higher than 180 mg/dL two hours after you eat. Your blood glucose shouldn’t rise over 140 mg/dL after meals. Normal fasting blood glucose is between 75-95 mg/dL. Although 100 is often considered the cutoff for normal, studies have shown that fasting blood sugar levels in the mid-90s were predictive of future diabetes a decade later. Ideal fasting blood glucose is 85 mg/dL. Continue reading >>

The Management Of Post-prandial Glucose

The Management Of Post-prandial Glucose

Parkin CG, Brooks N, Is postprandial glucose control important? Is it practical in primary care settings?, Clinical Diabetes, 2002;20(2):71–6. WHO, Definition and Diagnosis of Diabetes Mellitus and Intermediate Hyperglycemia. Report of a WHO/IDF Consultation. Geneva: World Health Organization, 2006;1–46. Available at: www.who.int IDF Clinical Guidelines Task Force, Guideline for management of postmeal glucose, Brussels: International Diabetes Federation, 2007. Available at: www.idf.org/webdata/docs/Guideline_PMG_final.pdf Pratley RE, Weyer C, The role of impaired early insulin secretion in the pathogenesis of Type II diabetes mellitus, Diabetologia, 2001;44(8):929–45. Monnier L, Colette C, Dunseath GJ, Owens DR, The loss of postprandial glycemic control precedes stepwise deterioration of fasting with worsening diabetes, Diabetes Care, 2007;30:263–9. Monnier L, Lapinski H, Colette C, Contributions of fasting and postprandial plasma glucose increments to the overall diurnal hyperglycemia of Type 2 diabetic patients: variations with increasing levels of HbA1c, Diabetes Care, 2003;26:881–5. Ceriello A, Colagiuri S, Review of IDF guideline for management of postmeal glucose, Diabet Med, 2008;25:1151-6 Erlinger TP, Brancati FL, Postchallenge hyperglycemia in a national sample of US adults with Type 2 diabetes, Diabetes Care, 2001;24:1734–8. Maia FF, Araujo LR, Efficacy of continuous glucose monitoring system (CGMS) to detect postprandial hyperglycemia and unrecognized hypoglycemia in Type 1 diabetic patients, Diabetes Res Clin Pract, 2007;75:30–34. The DCCT Research Group: The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus, N Engl J Med, 1993;329:683–9 Nathan DM, Cl Continue reading >>

Overview Of Diabetes

Overview Of Diabetes

Diagnosis The biochemical hallmark of diabetes is elevated blood glucose. Therefore, diagnosis of diabetes is made by estimation of glucose concentrations in the blood. When the fasting plasma glucose is ≥ 126 mg/dl or random blood glucose ≥ 200 mg/dl on more than one occasion.1 Fasting Plasma Glucose: Elevated fasting plasma glucose is always regarded to have a high degree of specificity for the diagnosis of diabetes. It is more consistent and reproducible than postprandial plasma glucose because there are more variable in the latter, such as timing and carbohydrate load. FPG may be easier to control with medications than PPG. An overnight fasting for 8 – 12 hours is considered desirable. The ADA and WHO have recommended FPG value of ≥ 126 mg/dl as the diagnostic value for diabetes and the value of 110 – 125 mg/dl have been termed as impaired fasting glucose which is a prediabetic stage.1 Postprandial Blood Glucose: The word postprandial means after a meal and hence it refers to plasma glucose concentration after food intake. The optimal time to measure postprandial glucose concentrations is 2 hr after the start of a meal. An elevated PPG concentration is one of the earliest abnormalities of type 2 diabetes, and represents an independent risk for cardiovascular disease. Postprandial changes precipitate atherosclerosis before FPG concentrations are affected. The recommended PPG goal of treatment is a value of <160mg/dl. Oral Glucose Tolerance Test It is recommended for diagnosis/exclusion for diabetes. The Oral Glucose Tolerance Test (OGTT) is done in the morning after 8-10hrs of overnight fast (water may be taken). A fasting blood sample should be taken before giving glucose load. The person then drinks 75gm of glucose in 250-300 ml of water (the glucose load Continue reading >>

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