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.
Comments
Metformin and Glipizide
My type 2 diabetes is much like the conditions of Jeff Matt. Except I have some reading of glucose levels of at or near 180 mg/dl. down to 76 mg/dl 1 to 2 hours after a meal, since starting the new medications Metformin and Glipizide. Since March 2009.
I had done very well on Advania. EXCEPT after 4 years, I started experiencing tachycardia, wieght gain, and swollen ankles. Advandia was removed from my diabetic medications and Metformin and Glipizide was added. I lost some weight and the tachycardia has deminished.
I have been given perscriptions of Metformin 500mg twice a day. Also, I take Glipizde 5mg once a day. I have been instructed to take the Metformin 30 minutes before a meal. The Glipizide is to be taken once a day, in the morining.
In doing so, I found that before eating my breakfast, I feel weak, shakey, light headed and nauseated. I called the doctor and the nurse told me that I should be taking the Metformin 30 minutes before meals, breakfast and dinner, with no exceptions to the 30 minute directive.
I have read on the internet at various sites concerning diabetic medications that Metformin is to be taken with the meals, and the Glipizide should be taken 30 minutes before the meal.
I don't want to feel so bad before I eat breakfast and the ill effects continue through out the day. At times, I do not take the Metformin 30 minutes before the evening meal, so as to not make my side effects of the medication even worse. I take Metformin with the meal or I do not take Metformin before the evening meal. My glucose test levels have been as low as 46 mg/dl prior to the morning meal.
My question is: Shouldn't I be taking the Metformin with meals and not 30 minutes before the meal? Also, should I take the one dose of Glipizide 30 minutes before a meal?
I am 60 years old.
Sue Englehart
New Mexico, USA
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