Lowering 2 hr Post Prandial Glucose Tests

As a diabetes educator I've seen the trends for managing diabetes change over the years. When self-blood-glucose monitoring first arrived, post prandial blood sugar tests were not considered important. However, it would be careless now to ignore the significant research on 2 hr post prandial glucose tests. Slightly elevated sugars after eating are associated with increased eye damage, heart disease and other diabetes complications. This also applies to people with pre-diabetes.

Disclaimer:Please do not consider the information on this site to be specific medical advice for you. Be sure to follow with your doctor and diabetes team. Reading beyond this notice implies you've read and agree with the Disclaimer. Thanks for keeping yourselves safe folks!

Should you do 2 hr post prandial glucose levels after meals?

Yes. Most likely you will benefit from it. After all, high blood sugars could do damage in your body regardless of when they happen. If you're unsure if you should do 2 hr post prandial glucose testing after meals, ask your diabetes educator.

Definitely consider doing glucose tests 2 hr after eating if:

1. If your A1c blood test comes back above the A1c target but your blood sugars before meals have mostly been in target . You might very well be having high blood sugars after eating. (You should also check your blood glucose monitor and diabetes test strips for accuracy).
2. If you experience excessive tiredness after eating, or are sleepy after eating. These are both diabetes symptoms or more commonly put, symptoms of high blood sugars. You would not expect to feel this way if you had diabetes with well-controlled blood sugars. You should investigate your 2 hr post prandial glucose levels.
3. You want to know what specific foods or meals are doing to your blood sugar.
4. You are interested in fine-tuning your blood sugar control. Checking blood sugars after eating at least once or twice a week is part of a regular glucose testing schedule for many people with diabetes. Some people may need to do it more often. Check with your diabetes educator.
5. You want to check to see how well your diabetes medications are working. Some diabetes medications are designed specifically to lower blood sugars after eating. See here for a list of these diabetes medications that can help 2 hr post prandial sugars.

What is a normal blood glucose level after eating?

A normal range blood sugar level 2 hr after eating is less than 7.8 mmol/L in Canada and less than 140 mg/dL in the U.S.

If you have diabetes, you can find the targets for healthy blood sugars before and after eating here.

If you are questioning if you have diabetes or pre-diabetes, please review the guidelines for diagnosing these conditions in the U.S. or in Canada.

How to lower blood glucose levels after meals.

TAKE NOTE: If your blood sugars BEFORE MEALS are higher than suggested targets or guidelines blood sugar levels , you might put your efforts into how to lower blood sugars before meals first. Once you've succeeded there, then you can address blood glucose levels 2 hr after eating. Also, check out the 4 steps to guide you towards lowering bloods sugars - or "U-ACT". Important stuff if you hope to put all the pieces together.

Wait! Check that your meter and diabetes test strips are accurate. You'd hate to waste time, money and emotions on inaccurate blood sugar numbers.

If you have diabetes, be sure to pinpoint which meal you are highest after. Don't assume that all your 2 hr post prandial tests are high! You might be putting forth more effort than you need to. .

Solutions to Lower Blood Glucose Levels after Eating.

1. Check to be sure you aren't starting the meal with a high sugar. If you are, then very likely it will be even higher after the meal. Check for solutions for how to lower sugar before breakfast, lunch or supper.
2. Eat less carbohydrate foods at the meal or snack before the high blood glucose. This is the obvious fix. But if you are already eating reasonable portions it does not pay to eliminate all the carbohydrate (fruit, milk or starch) from your meal. It's easier to make healthy meal choices if you have healthy recipes from which to choose. You'll find links to many great diabetes recipes here
3. Swap a sweet treat for a starch or two. In other words, have the piece of dessert but don't have the potatoes/rice etc that meal and see how this works. You wouldn't want to do this all the time. Err, let me rephrase that. You might want to do this all the time but really, you don't want to suffer the weight gain.
4. Eat lower glycemic index meals/snacks. You might keep the same portion of rice but switch from a sticky rice to a long grain rice which is slower to raise the blood sugars. Or, switch from branflakes which are fast to rise glucose levels to Bran Buds which are very slow. Other "slow sugars" are milk, yogurt, whole grains, kashi, barley, pasta (watch the portions and don't overcook it); long grain rice; oatmeal, bran buds with psyllium, All Bran. I do recall a woman lowering her 2 hr post prandial blood sugars just by giving up cornflakes and switching to All Bran.
5. Do 10-20 minutes activity after eating. By far this is the most successful method to lower 2 hr post prandial glucose levels, but be sure to check with your physician first. Make sure this is a safe time for you to exercise. (We typically tell cardiac patients not to exercise right after eating). Walks after the meal can be so effective that people on fast insulin may need to decrease their insulin by 1/2 if exercising after the meal, particularly if on Novorapid/Novolog or Humalog. .
6. Remember to take medication on time as prescribed. If diabetes pills are to be taken before the meal but you're constantly taking them after eating, then your 2 hr post prandial blood sugars may suffer. Read here if you're interested in research on the effect of missed diabetes pills.(However, some pills may be taken after eating if not tolerated before eating - like metformin.)
7. Manage stress or reduce the effects of stress on the body.
8. Check your blood sugar records . . . the answer might already be there! Maybe you just haven't looked. People frequently keep great data but do not take the time to review or analyze that data (remember "A" in "U-ACT" means "Analyze"). Maybe the high is happening only after you have certain type of meals like pizza, or chinese or bagels (which are often equal to 4 bread!) or sub sandwiches (the footlong is 6 bread!). Maybe it only happens on days you never leave your desk. Check it out.
9. Ignore it. Yes, you read right. If the high blood sugar after eating does not happen frequently, then ignoring it is a fine option. Remember the 80/20 rule. You want blood sugars "in target" at least 80% of the time. Of course, if you have high glucose levels after eating on a regular basis and ignore it, then your A1c blood test and risk for complications will likely go up.
10. See your doctor for medication changes or additions. If you are doing all you can or all you want to and those blood sugars after eating are still high, then you might need an adjustment or addition of diabetes medication that targets 2 hr post prandial glucose levels. See immediately below.

    Medications to lower blood sugars after meals are:

    • Prandase or Acarbose - pill
    • Repaglinide (Gluconorm)-pill
    • Natiglinide (Starlix)-pill
    • Humalog insulin-injection
    • Novorapid/Novolog insulin -injection
    • and now the recently approved Byetta -injection
    • metformin/glucophage may even help prevent diabetes** (we are awaiting research from the DREAM study to see if Avandia or Altace help to prevent diabetes too).

Remember, taking medications is not a sign of defeat. Your pancreas is growing older faster than you. If your hair turns prematurely grey, you color it. If your pancreas grows prematurely old, think of the diabetes medications as hair dye. And do remember that it is typically the high blood sugars that do the damage, not usually the diabetes medications. Indeed, some medicine may actually prevent diabetes.

**A special note: The Diabetes Prevention Program showed that people at risk for diabetes who had higher than normal 2 hr post prandial glucose tests were able to reduce their risk of getting diabetes by 31% if they took a diabetes pill called metformin/glucophage. Special, Special note: those at risk for diabetes who made lifestyle changes reduced the risk by up to 58%! They did not have a group who made lifestlye changes and also took metformin. It would be interesting to see those results. Don't let the news of high 2 hr post prandial sugars get you down. You might have immense control things!

Ready to move on? Find another "high chunk" of your day that you'd like to get into normal range blood sugar levels. If you're unsure where to start, review the "U-ACT" 4 steps. If you know where you want to work next, Click on:

The best blood sugar monitors
How to lower blood sugars before meals.

Good Luck and Good Health --- Bev

Didn't find what you want? Try searching the web or searching this site. Best of health.

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