Does this sound familiar? You’re in the physician’s office awaiting the results of your latest lab measures. Lately, you’ve worked hard to achieve better blood sugar control, and you sit in anticipation of your A1C test results. A1C is a blood test that indicates overall blood sugar control over the previous two to three months. In other words, it’s a single test that reflects your average blood sugar levels over time. In walks your physician with the news: Your A1C is high at 8%. (The American Diabetes Association® recommends an A1C of 7% or less.)
The contrast between your efforts and test results is confusing. You exercise more and eat better, yet you don’t receive the results you want. If you exercise and your meter readings are usually where they should be, what is the problem?
Understanding Postprandial Blood Sugar
Postprandial hyperglycemia refers to high blood sugar levels that occur shortly after eating meals or snacks. Post means “after,” and prandial means “eating”; put the words together and you get “after eating.” It is normal for blood sugar to rise a little after meals, but high blood sugar increases can result in a higher A1C, even if your pre-meal blood sugar reading was normal. Blood sugar usually peaks about an hour after eating. The goal is for blood sugar to be below 180 mg/dL one to two hours after your first bite.
Clinical research has found that elevated postprandial blood sugar levels are the leading contributors to elevated A1C. As you may know, elevated A1C is directly linked to an increase of diabetes complications. Read the table below to see how A1C levels compare to average blood sugar levels. A1C percentages 6 and 7, highlighted in blue, correspond to optimal glucose levels.
|
A1C (%)`
|
Glucose Level (mg/dL)
|
|
6
|
135
|
|
7
|
170
|
|
8
|
205
|
|
9
|
240
|
|
10
|
275
|
American Diabetes Association. Diabetes Care 2008:31 Suppl 1:S12-S54.
Checking blood sugar before and after meals (including snacks) will help you determine if postprandial spikes are a problem, and at which specific meals the problem occurs. It will be important to share these results with your physician. Not only is it important to know your after-meal blood sugar, but it also is important to know how high your blood sugar rises based on your food intake. For example, an after-meal reading of 190 mg/dL following a pre-meal reading of 160 mg/dL indicates a rise of 30 points, whereas a post-meal reading of 230 mg/dL following a 110 mg/dL pre-meal reading represents a rise of 120 points.
How Do I Manage These Peaks?
- Check more often. Give your best effort toward testing more often (as described above). Think of your blood sugar meter as a compass: Without knowing your readings, you won’t know which direction to go.
- Get some exercise. Muscles use up glucose from the blood.
- Select the right carbs. Carbohydrates impact blood sugar directly, so the amount and type of carbohydrates make a difference. For example, Glucerna products contain blends of slowly digested carbohydrates that are specially designed to help minimize postprandial glucose response. As you’ve learned, managing this response can help lower your A1C.
- Follow your medication plan. Whether you take oral medication or insulin, the right program can be the key to your success in managing those after-meal peaks.
- Share your results. Be sure to share your blood sugar results with your physician so he or she can fine-tune your medication plan.