Type 2 Diabetes With Polyneuropathy Icd 10

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Icd-10 Diabetic Neurological Complications: May The Four Be With You

It wasnt a long time ago or in a galaxy far, far away that we started using ICD-10. And in the near future, well be dealing with another change for the code set. Starting Oct. 1, 2016, choosing the fourth ICD-10 character and beyond has added importance for your Medicare claims, as explained below. I may not be Yoda or Obi-Wan, but I can tell you to use the fourth character 4 for diabetes with neurological complications . Heres what you need to know if you dont want your claims going over to the dark side. (And, I promise, the Star Wars references stop here.) Refresh Your Knowledge of CMS Family Rules End When ICD-10-CM 2017 goes into effect on Oct. 1, 2016, well also be facing the end of Medicares grace period . The short version is that for the first 12 months of ICD-10 use, as long as the first three characters of the ICD-10 code are right, Medicare fee-for-service will process and not audit valid ICD-10 codes. That flexibility doesnt change requirements put in place by LCDs and NCDs, but the end of that flexibility on Oct. 1 still adds some extra incentive to be sure were getting all characters for diabetes ICD-10 codes correct and as specific as possible. In ICD-10 , the firs Continue reading >>

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  1. David199

    I found this article interesting on taking honey before bedtime to improve sleep.
    Does Bedtime Honey Improve Sleep? Nine Reasons to Think So
    Stuart King, an Australian musician in his thirties, recently commented:
    Most days I wake up feeling more tired than when I went to bed the night before, however I find that if I take up to a tablespoon [15 ml] of raw honey immediately before bed I almost always wake up feeling totally refreshed. I’ve suffered from low energy, brain fog, fatigue and sore muscles for years. I tried eliminating food groups (dairy, grains, nightshades, etc) but that didn’t fix the problems (although wheat has been problematic) but taking the honey did. I usually sleep without any problems that I’m aware of — even if I awaken feeling unrefreshed I will still sleep through the night and won’t awaken early or whatever, but the crucial thing is I feel rested when I wake up, if I get that right I can even eat bad food and feel good all day. I tried coconut oil and coconut oil combined with honey but they didn’t work.
    I hadn’t heard that before. I searched “health benefits of honey” but didn’t find it. A Wikipedia entry about the health benefits of honey doesn’t mention it. In China, many people think honey is a health food, yet a Chinese friend of mine, who eats honey daily, hadn’t heard this. The uses of honey in Traditional Chinese Medicine lie elsewhere. Honey as sleep aid is briefly mentioned (with a question mark: “Key to a restful night’s sleep?”) in The Honey Prescription (2010).
    Many say or assume something quite different. According to Dr. Mercola, to sleep well “avoid before-bed snacks, particularly grains and sugars”. A Huffington Post writer says, “You already know which edibles to avoid before bedtime — namely, alcohol, coffee and sugary desserts.” Honey is half fructose, which UCSF professor of pediatrics Robert Lustig calls “poison”. Lustig says fructose is “one of the most egregious [= worst] components of the western diet, directly contributing to heart disease and diabetes, and associated with cancer and dementia.” John Yudkin, a well-known nutrition professor, wrote books about the harm done by sucrose. He considered fructose even worse. Nutrition researchers rarely study time of day effects. For example, nutritional epidemiologists ask what you’ve eaten but don’t ask when.
    I found a bit of evidence supporting what Stuart found — namely, two comments here:
    Just started honey and vinegar hot drink 2 weeks ago. Am amazed at the increased quality of sleep and relief of night time pain. Thought I was imagining it so did not have my drink one night. Didn’t sleep and was racked with pain again all night. . . [my recipe:] 2 tbsp apple cider vinegar and 1 tbsp honey with 1 cup hot water.
    Honey knocks me out and I actually wake up in the morning feeling refreshed and ready for the day–amazing. I’ve been using the honey for a few months now. The difference has been “night and day!”
    In addition, a 2007 study found that honey at bedtime was slightly better than no treatment at reducing the symptoms of coughing children. A 2010 study and a 2012 study found the same thing.
    I asked Stuart how he discovered that honey improved his sleep. He replied:
    I read something that Tim Ferriss said about having a small snack before bed [Ferriss advises protein and fat, not honey — Seth], I think he mentioned that unrefreshed sleep was due to low blood sugar. At the time I was doing carb back loading (I’ve since stopped that as carb restriction gave me problems). I would have a snack before bed but it didn’t always work. I think the small fructose amount in honey was what helped, starches didn’t always help. I did some research and came across your blog and Dave Asprey’s blogs on sleep, Dave mentioned raw honey. He encouraged people to take MCT oil with the honey to stay ketogenic, I tried coconut oil with the honey instead but it didn’t work. If anything it made my sleep worse with stomach cramps. I think there is an amount where benefits end, I think anywhere between a teaspoon or a tablespoon is about right. . . . The first time I did it I couldn’t believe it, I felt so good the next day.
    He added later:
    I have noticed that if I eat a lot of sugar during the day (soft drinks, desserts and so forth) then I don’t feel refreshed [when I wake up] regardless of the honey. Perhaps there’s something about honey that helps regulate blood sugar. I think it works better on an empty stomach/lightly fasted. So if you had dinner at 7 pm you might not eat anything after and take the honey at 9 or 10. In the past I’ve had a late dinner then maybe some dessert or fruit in the following hours, then added the honey just after and I don’t think it worked as well. When I first tried it I used commercially available heated honey and it worked great. I’ve tried 2 tablespoons, but I don’t think that worked any better than one and sometimes as little as 1 teaspoon is enough.
    In summary, three people reported great improvement in sleep from honey at bedtime. Stuart found several other things: 1. If he ate a lot of sugar during the day, the effect went away. 2. Other carbs didn’t work. 3. An empty stomach was important. 4. Effective doses ranged from 1 teaspoon to 1 tablespoon.
    I believe Stuart has discovered something very important. My belief rests on several things:
    1. Repetition. I started eating honey (1 tablespoon) at bedtime. My sleep (much better than Stuart’s to begin with) clearly improved, even with 1 teaspoon. I felt more rested when I awoke and more rested throughout the day. The improvement happened night after night. One evening I didn’t eat the honey on an empty stomach. The improvement didn’t happen, just as Stuart would have predicted. I told a friend about it. He took 1 tablespoon at bedtime. His sleep immediately improved by a large amount. He stopped waking up in the middle of the night and stopped needing a nap in the afternoon. Another friend has tried it once (so far). “When I woke up the next morning,” she wrote, “I’d realised I’d slept all the way through the night without waking up in the early morning (a nice change) but had a terrible case of the jitters (a not-so-nice change).” A third friend tried it twice. She slept better the first night but not the second. Maybe she failed to eat it on an empty stomach or had too many sweets during the day.
    2. Strength increase. As soon as I started the honey, I got stronger — a complete surprise. For years I have done one-legged standing to exhaustion several times per day because it improves my sleep. To reach exhaustion sooner, I stand on one bent leg. Recently I’ve been doing it four times per day (right leg twice, left leg twice). For a year, I’ve averaged about 3 minutes to exhaustion. After I started the honey, the length of time until exhaustion quickly increased. Here are the measurements:
    Each point is a different day; each is the average of the two durations for the first right and first left leg standing of the day. The 2013 tick marks the start of 2013. Nothing changed except the honey. The strength increase was also clear in other ways. In Beijing, I live on the sixth floor of a walk up. It became noticeably easier to climb the six flights of stairs.
    The strength increase astonished me. The dietary change was tiny, did not happen before exercise, and involved a safe widely-available food (in contrast to the drugs athletes use, such as steroids). I believe better sleep increased muscle growth. I predict that taking the honey at other times, such as in the morning, would not have the same effect. My earlier observations that lots of standing and one-legged standing improve sleep make more plausible causality in the opposite direction: something that improves sleep will increase muscle growth.
    When I described my strength increase to Stuart, he replied:
    I have noticed that when I do the honey, my weight goes up over the next week or two, perhaps by 400-500 grams [yet] my waist doesn’t increase (I measure it with a tape measure) even after a few weeks. I also have been sure that I noticed rapid muscular growth around my chest, shoulders and arms, similar to what I have noticed when going hard at the gym after a few months off. I kind of assumed that maybe I had more stored muscle glycogen from the honey, but had also considered that improved sleep as you said was the reason.
    3. Evolutionary explanation. It has been a mystery why evolution shaped us to like sweetness so much. Israel Ramirez (whose research led to the Shangri-La Diet) pointed out that the usual explanation (sugar is a source of energy) makes no sense. If it’s because sugars provide energy, why don’t potatoes and rice taste just as good? They don’t. Nutritionists lump sugars with other carbohydrates, thereby ignoring the puzzle. No anti-sugar advocate — not Yudkin, Lustig or anyone else — has provided a good explanation of why evolution shaped us to like the taste of a “poison”.
    There are several related puzzles. Why are meals divided into main course and dessert? In other words, why do we eat the sweet part separate and later? If we like sugars because they provide energy, this makes no sense. If sugars are simply carbs, this makes no sense — we eat plenty of carbs during the main course. The separation of dessert and main course, if it reflects brain mechanisms, must mean that sugars are quite different than other carbs. Somehow we benefit from this division. A few people, in particular Elizabeth Capaldi, an experimental psychologist, have figured out that sweet food tastes worse if we are hungry (enough). This is why dessert comes after the rest of the meal. Yet other carbohydrates do not taste worse. Stuart pointed out something else along these lines, which I had not heard before but which is clearly true: We eat dessert much more after dinner than after lunch.
    Stuart’s observations explain these mysteries. All four observations (liking for sweetness, separation of main course and dessert, sweet things taste bad when hungry, dessert after dinner but not lunch) make sense if we have evolved mechanisms to push us to eat sweet foods near bedtime. Long ago, these foods would have mainly been fruit. Because sleep is so important for health, there would be powerful selection for anything that improved sleep.
    4. Basic physiology. The brain runs on glucose. In my brain tests, sugar drinks, cupcakes, and other sugar-rich foods make an obvious difference 30 minutes to 2 hours later. (I get faster.) And the brain controls sleep, an enormously complicated and time-sensitive process. Too little blood sugar during sleep could easily disrupt sleep.
    5. Basic nutrition. Honey is half glucose, half fructose. When you eat it, the glucose enters the blood quickly and would supply glucose to the brain in the first half of the night. In contrast, the fructose turns into glucose and enters the blood slowly (fructose has a low glycemic index). This would supply glucose to the brain in the second half of the night. Many fruits, such as bananas, figs, and grapes, have a similar composition (similar amounts of fructose and glucose). Most fruits have plenty of fructose and glucose. A 50/50 glucose/fructose mixture makes honey near the start of sleep a good source of blood glucose over an extended period without food. Notice that you need both — glucose and fructose — in roughly equal amounts to get a roughly steady supply over six or seven hours.
    6. Basic engineering. When you are asleep, there can be no “course correction”. You must subsist for the next six or so hours without any behavioral help, such as drinking water when thirsty. So it makes design sense to do something shortly before sleep that will provide a relatively steady supply of glucose throughout the night (“time-release”). That won’t be a lot of glucose at once. You need a food that is a mix of sugars.
    7. Support for general idea. A few weeks ago a woman told me that when she ate very low-carb her sleep suffered, so she ate more carbs and her sleep got better. This supports the general idea behind what Stuart found — that the brain needs a certain amount of glucose to work well during sleep and it is best if it gets at least some of it from carbohydrate.
    8. Explanation of correlation of sugar and bad health. Why is sugar consumption often correlated with poor health? This is easy to explain: sugar at the wrong time is the problem. Too much sugar during the day interferes with the bedtime benefit (and may also interfere with sleep in general). Stuart found exactly this: Eating lots of sugary foods during the day disturbed his sleep and eliminated the honey effect (“if I eat a lot of sugar during the day . . . then I don’t feel refreshed [when I wake up] regardless of the honey”). Too much sugar during the day could make it harder to get optimal glucose levels during the night. For example, too much sugar during the day might raise insulin levels, causing too-low blood sugar at night and/or causing a fructose/glucose mixture eaten at bedtime to be digested too quickly. Anything that harms sleep will increase disease. Good health, good sleep and good immune function are closely connected. An example of the evidence is that shift workers get more cancer than non-shift workers.
    9. Reichenbach’s Common Cause Principle, in my paraphrase, is lightning doesn’t strike twice in one place for different reasons. If two rare events might have the same cause, they probably do. In this case, lightning has struck three times in one place. 1. Huge sleep improvement from tiny dietary change. 2. Huge strength improvement from tiny dietary change far from time of exercise. 3. Evolutionary explanation of why sugars taste good, why dessert exists and follows the main course, and so on. Before this, no one has come close to a plausible evolutionary explanation. The absence of an explanation is remarkable because two of the phenomena — sweetness tastes good, sweets are eaten separately after the rest of the meal — are so obvious.
    I believe Stuart’s discovery is important for two other reasons that might not impress anyone else. One is similarities with my earlier work. First, I’ve found other “cross-over” interactions with time of day, where something helpful at one time is harmful at another time. Vitamin D in the morning improves sleep, Vitamin D at night harms sleep. Morning faces improve mood, evening faces harm mood. Second, wondering why we like sour, umami and complex flavors was the first thing to suggest to me that we need to eat plenty of fermented food to be healthy. Many facts later, I’m sure this is true. Finally, evolutionary reasoning has helped me find several new experimental effects (morning faces, Shangri-La Diet, flaxseed oil, standing and sleep).
    Finally, Stuart’s discovery explains something puzzling I’d noticed repeatedly for years. Now and then I slept unusually well. I’d wonder why — how was yesterday different from usual? — and see that the only unusual thing was that I’d had dinner at a friend’s house. At the times, I guessed that seeing faces in the evening was somehow improving my sleep. This did not make sense in terms of my morning faces work, but a connection between social contact and sleep was well-established. Now I realize that dinner at a friend’s house is one of the few times I eat dessert. A friend told me that when his partner has dinner parties, she serves dessert long after the main course.
    This report suggests that different honeys may differ in important ways.
    I told a Dutch friend about this. She said it was common in Holland to have milk and honey at bedtime, although she herself didn’t do this. I asked why. No clear reason, she said. An excuse to have something sweet? Could this be why the Dutch are so tall? Children grow when asleep. Better sleep, more growth. My strength increase suggests what a big effect this could be.

  2. Dutchie

    @david199 Apparently theres something called the hibernation diet which talks about eating a spoon of honey&its benefits and have some similarities to your article. I don’t know what’s true of it though.

  3. David199

    Thanks Dutchie. I spent much of last night reading about the Hibernation Diet and i have bought the book. I have insomnia where i wake up in the middle of the night around 4am and can’t get back to sleep. Ironically, i first bought Robb Wolfs book on Paleo because he asked: “Do you wake up in the middle of the night?” but Paelo didn’t help and then i found Matt and his Paleo myths which asked: “Do you wake up in the middle of the night?” but Diet Recovery has not helped my sleep. I am seeing a sleep doctor and working on sleep restriction therapy but i still wake up every night and have for the last decade. So i was a total sucker for an idea that i should fuel my liver/brain to sleep better since that is a very specific problem that i have. I found this website that has a good Q&A from the author of the book (you have to click on the comments for each question) http://www.hibernationdiet.blogspot.com
    The basic premise is that during sleep, the brain is burning a large percentage of your energy requirements and it needs a steady stream of glucose which it gets from the liver – and you need fructose to nurish the liver. Honey, being roughly half glucose/fructose is perfect as it provides a little initial insulin spike to get sleep moving forward and then the melotnin secreted during sleep keeps the insulin in check and the fructose through a variety of reasons provides fuel for the liver to supply the brain with glucose. If the brain is happy, it will keep the stress hormones to a minimum which provides deeper rest, if the brain is not getting anough glucose from the liver, its going to secret stress hormones to get it from other tissues or produce ketones. Matt has recommended sugar and salt under the tongue in the middle of the night if you wake up but 1) why not use it before bed to sleep all night and 2) the author of the Hibernation Diet does not like sucrose and prefers the sugar in fruit and honey. While sucrose is also 50/50 glucose/fructose, the author believes (for reasons that i hope are explained in the book) that refined sugar has a much different effect than fruit or honey. We’ll see. Anything that can improve my sleep (I fall asleep fast but awake every night at ~4am) is worth investigating. Worst case scenario i eat some honey. Not a bad trade-off. As a side note, there was a very interesting series of posts on the Crossfit blog years ago where all those paelo and zone dieters found that eating ice cream at night made them leaner and none of them could figure it out. Sounds like it might coincide with the advice in Hibernation Diet as well as opposing the conventional wisdom mantra of not eating late a night. As Matt says in Food Ninja: The key to vitality is play hard, eat hard and sleep hard.

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FULL VERSION: https://goo.gl/APNPrA?42034

2007 Icd-9-cm Diagnosis Code 357.2 : Polyneuropathy In Diabetes

Short description: NEUROPATHY IN DIABETES. ICD-9-CM 357.2 is a billable medical code that can be used to indicate a diagnosis on a reimbursement claim, however, 357.2 should only be used for claims with a date of service on or before September 30, 2015. For claims with a date of service on or after October 1, 2015, use an equivalent ICD-10-CM code (or codes). You are viewing the 2007 version of ICD-9-CM 357.2. Convert to ICD-10-CM : 357.2 converts approximately to: 2015/16 ICD-10-CM E08.42 Diabetes mellitus due to underlying condition with diabetic polyneuropathy 2015/16 ICD-10-CM E09.42 Drug or chemical induced diabetes mellitus with neurological complications with diabetic polyneuropathy 2015/16 ICD-10-CM E10.42 Type 1 diabetes mellitus with diabetic polyneuropathy 2015/16 ICD-10-CM E11.42 Type 2 diabetes mellitus with diabetic polyneuropathy 2015/16 ICD-10-CM E13.42 Other specified diabetes mellitus with diabetic polyneuropathy Diabetes type 1 with peripheral neuropathy Diabetes type 1 with peripheral sensory neuropathy Diabetes type 2 with diabetic polyneuropathy Diabetes type 2 with peripheral neuropathy Diabetes type 2 with peripheral sensory neuropathy Diabetic peripheral n Continue reading >>

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  1. Equinox

    Hello, I am on day 17 of the Whole30, which I started in an attempt to get my rosacea under control. I am also interested in weight loss. Anyway, I can say that my pants are fitting a little looser since I started and my rosacea is better than it has been in a long time. So far I have tried to be as compliant as possible and my only two slips were accidental. I ate a sausage that had red wine on the ingredient list (I forgot that wine isn't allowed as I don't drink alcohol at all so I didn't register that part of the book as applying to me and just skimmed over it!). I also accidentally grabbed my daughter's glass instead of mine and got a small sip of lime-ade before I could spit it out. Those were in the first week though. I didn't bother starting again on Day 1 with these as I plan to be on the Whole30 for more than 30 days and counting things annoys me.
    On the other hand, my menstrual cycle (which arrived about 10 days in) was both heavier and longer than normal and I had terrible insomnia for a week beforehand. After my cycle began this eased off somewhat but I still have trouble falling asleep, staying a sleep and also with waking up too early. I feel like a zombie and I'm averaging about 5 hours of poor quality sleep a night. I've had to stop my regular exercise routine as I'm just too tired. I should mention that I'm usually a good sleeper, except when my daughter wakes me up in the night, which unfortunately happens a couple of times a week these days. And that happened more than the usual number of times in the past two weeks so my sudden insomnia has been all the worse. This is seriously the worst quality sleep I have ever gotten in my life that was not caused by some external factor (like having a newborn). I just toss and turn and feel really anxious over nothing at all.
    It seems that some other people have experienced this with the Whole30 as well. I'm wondering if I've entered into ketosis, which I read was associated with insomnia in some people, especially women. I just weighed myself to see if I had any sort of profound weight loss that might explain it and it seems I've lost 4 lbs, which is more than usual for me but certainly not beyond the pale. So, assuming that I have not been eating enough starch (I've been trying to eat a starchy vegetable once a day and eating a banana once a day also), how long will it take to get out of ketosis if I start adding a starchy vegetable to each of my three meals? I should add that even though I maybe haven't been getting enough starch, I haven't been hungry at all and I didn't experience any cravings at all until the sleep deprivation started to kick in. Also, has anyone had success with melatonin?
    I just really want to get a good night's sleep.

  2. missmary

    I would not recommend melatonin as a long-term solution because it interferes with your bodies ability to produce melatonin on it's own. Magnesium is a great supplement that can help with sleep.
    If you already have included starchy veggies and bananas every day, ketosis is very unlikely. Regardless, starchy veggies can certainly help with sleep and anxiety issues, especially when consumed at meal #3. How is your fat intake? Make sure you keep that at least to the minimum recommended 1-2 thumbs per meal (don't rely on cooking fat alone, since much of that stays in the pan).
    Eating within an hour of waking and also getting sunlight right away in the morning (go outdoors for 15 minutes) can really help with getting cortisol in the right rhythm which will help with sleep. In the same vein, avoiding bright light and screens at night will also help keep circadian rhythms in proper order. Some people use amber glasses or software like f.lux to reduce blue light at night for a similar effect.
    Good luck. I hope you get some better sleep soon!

  3. Tom Denham

    I am one of those people who needs starchy veggies every day to keep me sleeping good. I've also had a great experience with taking magnesium. I used to take Natural Calm, but it provoked diarrhea for me. I switched to magnesium aspartate supplements - 200 to 300 mgs per night. It is working very well. Actually, when I first saw a functional medicine doctor, she gave me an injection of magnesium and I enjoyed great sleep that night and for the next several nights.

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Today I introduce you to ICD-10-CM and ICD-10-PCS. I also give you a website, www.cms.hhs.gov, where you can download the ICD-10-CM Official Coding Guidelines. My e-mail address is: [email protected] https://www.cms.gov/

Draft Icd-10-cm/pcs Ms-drgv28 Definitions Manual

Draft ICD-10-CM/PCS MS-DRGv28 Definitions Manual Appendix C: Principal diagnoses which convert CC/MCC to non-CC Disorders of other specified cranial nerves Cranial nerve disorders in diseases classified elsewhere Cervical root disorders, not elsewhere classified Thoracic root disorders, not elsewhere classified Lumbosacral root disorders, not elsewhere classified Nerve root and plexus disorder, unspecified Nerve root and plexus compressions in diseases classified elsewhere Carpal tunnel syndrome, unspecified upper limb Other lesions of median nerve, unspecified upper limb Other lesions of median nerve, right upper limb Other lesions of median nerve, left upper limb Lesion of ulnar nerve, unspecified upper limb Lesion of radial nerve, unspecified upper limb Other specified mononeuropathies of unspecified upper limb Other specified mononeuropathies of right upper limb Other specified mononeuropathies of left upper limb Unspecified mononeuropathy of unspecified upper limb Unspecified mononeuropathy of right upper limb Unspecified mononeuropathy of left upper limb Lesion of sciatic nerve, unspecified lower limb Lesion of sciatic nerve, right lower limb Meralgia paresthetica, unspecifi Continue reading >>

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  1. mindhunter88

    Just received a blood glucose meter! What are the proper protocols for testing fasted blood sugar and what range is considered to be healthy? Additonally, what is the best method for using this meter to test my reaction to artificial sweeteners, which may be the culprits of my current 7 week stall?

  2. richard

    In general a fasting value of 3.9 - 5.5 mmol/l (70-100 mg/dl) is a normal result.
    Officially the ADA recommends for someone with diabetes: 4.5–7.2 mmol/L (80–130 mg/dl )
    2 hours after a meal a normal result is less than 7.8 mmol/L (140 mg/dl).
    For a diabetic managed with drugs by the ADA the expected values are less than 10.0 mmol/L (180 mg/dl).
    I vehemently disagree with the ADA on both the fasting and the pp numbers. We have a right to normal glucose and on a keto diet we can have just that.
    So glucose jumps around like a cat on a hot tin roof and is affected by a lot of things. But there are specific times to test that are less subject to external influence.
    You can test first thing in the morning. That will not be affected by food, and that value day to day will tell you how your overall glucose control is going. If you do that and then try an intervention and your numbers start going a little lower, then the intervention is improving your glucose control. However it's worth noting that that morning fasted test is still subject to influence - for example @tdseest found that whenever he had a nightmare that his glucose was significantly elevated ... so you really need to smooth other the day to day changes and look at the long term trend.
    Another common place to test is 2 hours AFTER eating. That post-prandial (after digesting) measurement should return to normal ranges 90-100 mg/dl in normal people within 2 hours of eating a meal, in a type 2 diabetic it could stay high for 4-5 hours.
    I wrote an article on my blog on how to chart a glucose curve to test foods
    Charting a glucose curve - Easy Lo-Carb
    How to use a diabetic glucose meter to test how your body will respond to specific foods by plotting a Glucose Curve in response to a food challenge.

  3. mindhunter88

    Exactly and succinctly what I was searching for. Thank you!

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