I spoke with a cardiologist at a diabetes expo. I showed him my A1c's and my lipid test results. I then asked him about the saying that the risk of heart attack for A T2 is about the same as for someone who has had one heart attack.
I think that spending a few hours > 140 isn't a big deal however I don't aim for 140 ever. I like having lower targets because it seems to me to make it easier to run flatter. I think that it's harder for me to run in the 140s as the bigger numbers seem to, because of the exigencies like needing to eat, lead to wider variation in numbers which includes more and more exciting lows.
Running in the 80-100 range seems that I mostly run in the 80-100 range and run up to say 120 after I eat. Still a 40 point spike but I seem to have ok results. But I still, after 30 years now, have some microvascular complications. Hair falling out on my legs and things like that.
On digestion, yes numbers can peak up but usually do so in a controlled slow rate.
If my liver does a dump and empties its glucose buffer , I can see the blood glucose numbers rammed though the roof extremely fast in a minute or couple of minutes. The liver power drives the blood glucose to 511 on finger prick cave man machine and on cgms dexcom 7+ to 315 and slides back to 278 as heart dilutes the glucose as it pumps it around the body. That's a spike.
Today after much monitoring/work on diet and timed metformin doses; these nasty spikes have been stopped.
The best way to deal with these high numbers is to literally go out and walk 2 to 3 miles and burn off the excess glucose and I do not suffer from a serious low from over correcting on insulin.
Still pretty much where I want them. I’ve only run a handful of times since New Year’s Day, as I switched gears to do P90X3 but my BG seem to be controllable although I boosted my AM carbs a bunch. I dumped off some blood for an A1C on Saturday but the results aren’t posted yet.
Ignorable really. Ok it might "start" to become an issue from 140 upwards, but that's the starting point of a curve up, which doesn't really get something of be an issue till much higher up. So a couple of hours is not a real concern to worry about.
Sorry David, the study does not attempt to determine the threshold for organ damage. That's not at all what the study is designed to do. That is a misinterpretation of the results first presented by Blood Sugar 101 and continually perpetuated on this forum.
Here are the conclusions directly from the study you linked.
Our results suggest that IGT may cause or contribute to small-fiber neuropathy, which is similar in phenotype to the painful sensory neuropathy commonly encountered in diabetes. Two-hour OGTT is more sensitive than other measures of glucose handling in screening these patients.
That's very clearly stated without any need for interpretation. IGT may cause or contribute to small fiber neuropathy, not "a threshold of 140 mg/dl" is where organ damage begins.
The study defines IGT (Impaired Glucose Tolerance) in the Objectives:
The American Diabetes Association (ADA) revised diagnostic criteria to recognize IGT (a serum glucose between 140 and 200 mg/dl in a 2-h oral glucose tolerance test [OGTT]) as a risk factor for cardiovascular disease independent of development of diabetes.
The definition of IGT is specific to the oral glucose tolerance test which many of us have had upon diagnosis.
Basically, the study confirms that if you have problems dealing with glucose post-meal, as defined by the guidelines of the OGTT, you have a pretty good chance of coming down with diabetic complications. That's being generous because small fiber neuropathy isn't exatly the same things as diabetic neuropathy, but the point is well taken.
It has neither the intent nor the experimental design to determine with any kind of accuracy or precision where the threshhold for organ damage is.
I'm not saying not to shoot for a post-meal BG of 140 mg/dl or try to stay below 140 mg/dl. I certainly do, but that's because it's just not practical for me to control my BGs without really controlling my post-meal BGs.
