Post prandial BG's

I had a doctor’s appointment on Monday, May 9th. I saw the PA rather than the doctor, which was a good thing. We had a discussion after she looked at my OneDrop BG log. I am trying to keep my BG’s in the range of 85-125. I am successful fairly often with that, but do have 140’s after eating too. The PA stated that she (medical community) like to see BG’s in the 180 range after eating, as all people, to include non-diabetics, have elevated BG’s that high 2 hours after eating. That just does seem right to me. Every time I saw the doctor previously he said the same thing. I cannot imagine that a non-diabetic, unless they ate an extremely high carbohydrate-loaded meal, would have a BG of 180+. Any thoughts on this?

If that’s what she actually said, she’s just simply wrong, full stop. “All people” don’t have readings like that. In fact, if someone habitually did, it would be enough of an eyebrow-raiser to at least warrant some further testing.

And anyway, how could she possibly know that? How many nondiabetic people test their blood sugar two hours after eating and keep records???

I agree with you and David. Maybe you should ask both your PA and doctor if they have worn a continuous glucose monitor to see what a non-diabetic’s glucose trace looks like.

I think this attitude grows out of many medical practitioners’ unreasonable hypo-phobia and legal defensive medicine posture. This attitude, unfortunately compromises their ability to fully align with your interests.

Is 180 to high?
Recently I am seeing that but with med changes it is getting back down.

It’s not excessively high, but it’s higher than non-diabetics would ever usually expect to be. I think it’s a good target for people to aim for who are having a lot of trouble after meals and are going well over 200, but it probably still causes some damage to go that high regardless of what the diabetes associations say. I correct immediately if that high and aim for much lower blood sugars than that after meals.

It seems as ridiculous to me as if your blood pressure was 115/75 and the doctor told you most people have blood pressures of 120/80, so you should work on raising it. If you are having frequent, dangerous hypoglycemia that is putting yourself/others at risk and lowering your quality of life, and lower post-meal numbers are causing that, then steps should be taken to address it. If not, I don’t see why doctors are concerned when you are working towards achieving the same (or maybe even better) numbers than people with functioning pancreases!

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That seems like really bad advice!

I think that many, if not most diabetes docs are overrun with folks who are not “managing” their BGs well, so someone who shows up with a consistent range of 85 - 125 as an anomaly. Similarly, low A1Cs are seen with the suspicion that they have been achieved with too many low BG excursions and the frequent recommendation is to have a bit higher A1C to prevent excessive lows.

On my diet (aka, NOT low carb!), a BG of 125 two hours post-prandial would surely lead to a low @ 4 hours post. I would also not be terribly concerned if I were to hit 180 if I returned to my pre-meal BG by 4-5 hours post. This is especially true if I started out a bit higher pre-meal, OR if I were hitting 180(+) after every single meal. Conversely, If I ran to 180 or higher and stayed there for hours on end, I would definitely correct.

One thing my CGM has consistently shown me is to not pay too much attention to my 2-hr PP. I frequently find the most significant drop comes well after 3 hours PP. YDMV.

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