Highs After Meals
I am 35 years old and have had type 2 diabetes for 2 years. I take 500 mg of metformin once a day. My A1C is always between 6.3 and 6.7. I have read that blood glucose levels should be 180 or less one hour after a meal and 140 or less two hours after a meal. Is it okay to have a blood glucose of 200 an hour or two after a meal, as long as it does come back down within a reasonable amount of time and my A1C tests keep coming in at a good range? I like to eat, and I find it hard to stay below 180 after meals, but I must be doing something right according to my A1C tests. Jeff Matt, Fremont, Ohio
Christy Parkin, MSN, RN, CDE, responds: Based on your A1C levels, it sounds like you are doing everything right. Congratulations on your good diabetes control. However, you are right to be concerned about blood glucose levels above 200 mg/dl after meals. Research shows that high blood glucose after meals may have damaging effects on your vascular system. This damage occurs even if your A1C is relatively low. So it is very important that you pay attention to your after-meal blood glucose levels. One thing you might consider is eating more frequent meals, but with smaller portions of food at each meal. This will spread out your carbohydrate intake and help reduce glucose "spikes" after meals. I suggest that you talk with your health care team about lifestyle changes or medications to help you get better control over your post-meal glucose levels. Considering your current level of self-care, any additional changes should not be difficult for you to implement.