When to test diabetes?

Hi rebecca21265,

You should test two hours after your first taste of your meal, ma'am.

Having said that, foods such as pizza and burger have a high fat content, so testing two hours after you've finished wouldn't be so very different than if you were to test two hours after your first bite.  (A normal functioning pancreas would give a second or even third 'burst' of insulin to deal with glucose levels that remain high.)

There IS a POSSIBILITY that you could still have Impaired Glucose Tolerance (IGT), which simply means that your pancreas doesn't produce insulin efficiently to deal with a sudden influx of glucose.  (We get glucose from the breakdown of carbohydrates during the digestive process.)

In someone that doesn't have a glucose metabolism 'problem' ... someone with pre-diabetes/diabetes or hypoglycaemia [hypoglycemia, if you prefer the American spelling], which is lower than 'normal' blood glucose levels, you wouldn't expect to see a two hours post prandial (after eating) blood glucose level to be more than 7.8 mmol/l [140 mg/dL if you are American].  I say normally as there are occasions when blood glucose levels could rise higher, such as if you were suffering with some sort of infection, you were taking certain types of medication(s) which are known to raise blood glucose levels, or if you had a medical condition which could raise blood glucose levels.

If you do test and find that your two hours post prandial blood glucose level is higher than the figure quoted you need to see your doctor and explain what you've done and the result obtained.

Your doctor MAY well ask you to test a few more times, just to make sure it wasn't a 'one off', but MAY request you to undergo a Glucose Tolerance Test (GTT) ... sometimes also referred to as an Oral Glucose Tolerance Test.

For this test you would be requested to fast (not eat or drink overnight), then have a fasting blood glucose test carried out.  You would be requested to drink a sickly sweet substance, called glucola, then have blood drawn at hourly intervals.  (It depends on your doctor how many hours this test would be for.)

A comparison of the fasting blood glucose test result and the later, hourly, blood test results would indicate whether your pancreas is working sufficiently well or whether you do, in fact, have impaired glucose tolerance.

I wish you well, ma'am.

Lots of Love and Light.

 Mick

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P.S. Please don't be offended, or alarmed, at the 'x's'.  It's merely a logo, of sorts, that I've used for some 30-odd years now.

Hi rebecca21265,

Thank you for coming back with more information, ma'am.

Your post prandial blood test result of 7.1 mmol/l does look OK.

Can I ask you what makes you believe that you might be pre-diabetic?  You haven't indicated what might be causing you to believe that you're at risk.

There are several things you doctor would be looking for, such as your size and shape of body (people who carry a lot of adipose (abdominal) fat are more likely to develop insulin resistance, which is a precursor to the development of pre-diabetes and type 2 diabetes); whether you have a family history of diabetes, your ethnicity (African Caribbeans and Asians do have a higher proportion of people who MAY develop type 2 diabetes); how active you are; whether you have other medical conditions; what, if any, medications you are taking; whether you abuse alcohol or certain medications/drugs, etc.

Lots of Love and Light.

 Mick

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Dear rebecca21265,

Thank you, ma'am, for adding more information.

To be honest with you I'm not sure why your doctor is saying that you "don't need to check my glucose levels at all."  Having developed gestational diabetes yourself DOES put you at increased risk of developing type 2 diabetes yourself at some point in your life.  Having close family members that have type 2 diabetes DOES put you at increased risk of developing it yourself at some point in your life.  Being Asian DOES put you at increased risk of developing type 2 diabetes yourself at some point in your life.

The recommendation for testing your post prandial blood glucose level is two hours from the first bite that you eat.  It takes roughly one and a half to two hours for your digestive system to break down the foods that you eat and for the glucose to be absorbed through the walls of the intestines into your bloodstream, hence the advice to test two hours after eating.  You'd have PROBABLY been advised, during your pregnancy to test at one hour  after eating and MAYBE two hours after eating as well.  That is the 'normal' recommendation.

Is there another doctor in the practice/surgery that you attend that you could possibly see?  It seems that the doctor you are currently seeing isn't so au fait (familiar) wiith risk factors for the development of diabetes.

I certainly do hope that you can get someone to listen to you, ma'am, as there IS a possibility that you COULD go on to develop type 2 diabetes.  I'm really surprised that this wasn't explained to you when you developed gestational diabetes.  Normally, gestational diabetes does 'disappear' after the birth of your child, but it DOES still leave you at risk of developing type 2 at some point in your life.

Lots of Love and Light.

 Mick

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 x x x

Dear rebecca21265,

These blood glucose figures might help you:

A non-diabetic's fasting (after not eating or drinking overnight) blood glucose level should be between 3.9 and 5.5 mmol/l (millimoles per litre). (Some laboratories now accept 3.6 mmol/l as being the lower limit.)

Two hours post prandial (after eating) a non-diabetic's blood glucose level would rarely exceed 7.8 mmol/l. I say rarely as there are occasions when it could be higher, such as if the person being tested had one or more comorbid medical condition(s) that are known to cause raised blood glucose levels; if the person being tested was undergoing extreme stress at the time of being tested; or if the person being tested was taking certain types of medication which are known to cause a rise in blood glucose levels. (These medications include those that contain steroids, such as the types used in the treatment of asthma, or for the treatment of certain specific types of infection.)

Lots of Love an Light.

 Mick

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Hi rebecca21265,

I've been diabetic for almost 35 years now, and all but two of the diabetes specialist nurses that I've seen have informed me that the correct time to test a post prandial blood glucose level is two hours from the first bite of the meal.  The two diabetes specialist nurses who didn't say that it should be two hours from the first bite both said that it wouldn't really make that much difference whether it was two hours from the first bite or two hours from the end of the meal.  They added that because it takes between one and a half and two hours for food to be digested and the glucose absorbed into the bloodstream there would be a negligible difference.

Lots of Love and Light.

 Mick

x x x x

 x x x

First of all, have actually been diagnosed wih diabetes? You say you think you have pre-diabetes but then you talk about good fasting glucose results and whether you still have diabetes so it's hard to understand because if you've got diabetes you will always have diabetes, you just have to control it.  I was diagnosed with Type 2 back in 1995 but I am never and have never been overweight so it could be late onset Type 1 for all I know.  I am on four injections of insulin a day, three fast acting and one long acting but I still have many problems with my sugar levels depending on what I eat. 

What used to be called "normal" sugar levels were between 4 and 7 but the goal posts were moved several years ago and the higher one is down to about 6.5, hence the catching of more people with diabetes. My sugar level was 22 when I was diagnosed.

All sorts of things can cause blood sugar to rise, even in people without diabetes but they don't usually go above normal.  The way food is cooked can make a difference e.g. jacket potatoes send the sugar up slower than mashed potatoes, brown rice is better than white rice etc.  Regarding the testing, for say about a week, do a test before a meal and then two hours after you finish eating not two hours after you started to eat but it's not vital it's just best not to leave it too long after two hours.  By testing before and after a meal will give you an idea as to what foods cause a rise in sugar levels and by how much.  If you have a blood glucose meter was it given to you by your doctor or was it one that you bought yourself?  You get them free if you are diagnosed with diabetes and are put on medication but people who are on diet alone are told not to test which I think is stupid as all diabetics need to know what foods do to their sugar levels. You don't have to have very high sugar levels to be diagnosed as I tested my twin sister and her level was 9 and when she went to her doctor he confirmed it so as long as your levels are within the 4 - 6.5 area you should be OK but see what your pre and post meal sugar levels are and go from there.