Is it optimal to check fingertip blood a) 2 hours?... or b)2 1/2 hours?... c) after the first bite?... or d) after the last bite of a meal?... e) Source(s)?

a) What are authoritative source(s) for the following information?...

Diabetes MDs, Internal Medicine MDs, diabetes nurses and diabetes educators have been inconsistent, what is more optimal for checking fingertip blood?...
Example b) 2 hours after the first bite of a meal?...

Example c) 2 1/2 hours after the first bite of a meal?...

Example d) 2 hours after the last bite of a meal?...

Example e) 2 1/2 hours after the last bite of a meal?...

...for the Bayer Contour USB glucometer

I check two hours after I begin my meal. I think this is the most common checking time. The reasons for the time is that is when most people have their peak, so you want to see how high you spike. Some people spike sooner, I haven't heard too many people saying they spike after that. Start testing at 1 1/2 hours, 1 3/4 hours and 2 hours for awhile and see when you most commonly spike, then make that your testing point. After you find it stay consistent as much as possible. I found that I spiked around 1 3/4, but when I was on MDI I decided to use 2 hours just for the convenience of the math in computing IOB. I've just stayed with it.

You best authoritative source is *you* after you have checked your BG frequently and logged the results. The quality of the meal food composition will affect your body's absorption as will many other factors, including stress, and the presence of other hormones. The amount and quality of the carbohydrate content of your meal will have a large affect on your post-meal BGs. Simple processed carbs generally cause a faster and larger rise in post meal BGs. These include bread, cereal, rice, and potatos. Carbs that you drink, such as fruit juice act very fast on BGs. Your body's relative sensitivity or resistance to insulin will also affect your post meal BGs.

My highest post meal BGs occur about 2 hours after I eat. If I exercise in the first hour or two after eating, my BGs will not rise as much.

I'm sorry I can't just give you pat answers but unfortunately, it's more complicated. You are your own best expert! I would never put much weight in any doctor, endocrinologist, certified diabetes educator advice that gave you specific answers to your questions. The only way you can arrive at answers that are even close to reality is for you to check and log your BGs on a regular basis.

f) Do you believe that optimally you try testing for your highest accurate test results whatever the number of minutes after eating?... g) Or do you believe testing always the same number of minutes after eating would make a more optimal representation over weeks of testings of this metabolism, for example in a line graph?...

h) Any authoritative citations?... professional literature?...

Authoritive citations aren't all that important, teszak, as we are all different. What I suggest is a combination of your "f" and "g": Determine what is your most common spike point and once you've established that time, do it consistently. The second is the more important part because you don't want to compare apples and oranges. Long term you want to be able to see patterns of, for example, always being high 2 hours after eating a certain food, or being over target a significant percentage of time at breakfast (which informs you that you need to increase your breakfast I:C ratio. If you tested sometimes at 1 hour, sometimes at 2, sometimes at 3 you wouldn't get a clear picture. You only want to do that initially to determine when your spike point commonly comes.

theszak - After rereading your original post and subsequent comments, I wonder if your interest in "authoritative sources" is driven by some academic goal that you might have.

If that's the case, please say so up front. I do a lot of reading about diabetes and have continuously monitored (as have many others here) a wide variety of published studies about diabetes. I feel like you might not not be plain about what drives your questions.

Why do you seem to resist the notion that "you are your own best expert"? I don't mean to challenge you to stir up controversy or conflict. People ask questions here for many different reasons. Your motivation seems obscure to me.

I have watched this many years and on cgms adn note the following:

I usually test 2 hours after first byte and on average that seems a good point. Depending on the gastric load as noted by others; I can see that vary a bit earlier as well as an hour later. In addition for me and reported by many others using cgms, I routinely see a smaller varying peak at 5 to 6 hours after eating is when the complex carbs/proteins crack off. this peak will vary based upon the amounst of those complex carbs and proteins.

Two sources for detailed diabetes related recommendations that I have found to be reliable are the websites of the Joslin Diabetes Clinic at Harvard University, and the American Association of Clinical Endocrinologists.

Also, in particular I would draw attention to that organizations guidelines for creating a personal management plan for diabetes type II:

Another interesting source of data is the blog blood sugar 101

A different spin and outlook.

Thanks, the information there is a good supplement to mainstream sources.
I particularily appreciate that they, unlike many mainstream sites, don't appear to promote the inevitability of progression of diabetes type II, leading to insulin injections. (Based on my experience progression is largely a state of mind, if you accept it and let your guard down, it will happen.)

Reply by jims
...crack off

What's the meaning of the expression?... "crack off"

I meant as in distallation term and in this case after digestive process, sugars come off. My apology for taking short cut.

Good luck with your health.

i check 2 1/2 hours after i finish my last bite. unless of course i dont feel right (low BS) then i check immediately

While the remark made has some interesting response; I do not except the state of mind issue completely.

My read and experiece is:

a) on liver excess gluscose release - I see no improvement, it appears to be there permently. Stop the pills and schedule and immediately the higher glucose in blood reappears. Taking the met pills has stopped problem but no overall medical impropement on liver yet pill control keeps under control. - - ie drop metformin not option.

b) Insulin side has been far better in that keeping liver under control on metformin and watching diet and exercise and foods eaten has seen improvement and reduction of insulin needed as boost. In past there had been a ton of 75/25 a day - gone and lantus - now gone after working down from 17units a day and down to zero.
I am on the humalog lispro and that started as 10 units per meal and dropped now to 1.5 or less units and sometimes not needed.

So in summary, liver is controlled but no improvement while insulin use has come down indicating improvement.

This is on body that almost rotted out on excess insulin, actos, starlix et all. If your intention is that discipline and hard work correcting mess is state of mind. Possibly.

My answer is WHENEVER and no sources to note. I usually try to check at 2 hours, but if busy I ignore it. I check randomly anymore, and am enjoying life better and have a 5.6 A1C.

Before bite, last bite---what is it? 30 minutes? How long is only an issue if you are a little OCD about it. Take it easy.