What is Postprandial Glucose

A postprandial glucose test is a blood glucose test that determines the amount of glucose, in the plasma after a meal. The diagnosis is typically restricted to postprandial hyperglycemia due to lack of strong evidence of co-relation with a diagnosis of diabetes.

Dr. Dina Prus

Dr. Dina Prus

Endocrinologist
Belleville, NJ
Dr. Roshney Jacob-Issac

Dr. Roshney Jacob-Issac

Endocrinologist
Belleville, NJ
Dr. Swaminathan Giridharan

Dr. Swaminathan Giridharan

Endocrinologist
Brooklyn, NY

Dr. Amish Parikh, MD, FRCPC, Endocrinologist, discusses how to control post prandial glucose levels with meal time insulin.

Quiz: Do You Understand Postprandial Glucose?

Test your knowledge by answering the following questions:

Questions
True
False
1

Mealtime insulin lasts anywhere from 40 to 120 minutes.

Explanation:
Mealtime insulin is designed to help control the blood sugars after a person eats. They try to mimic the body’s natural response to sugar surges and last anywhere from 40 to 120 minutes.
2

High postprandial sugars can make you feel unwell, but they won't contribute to diabetes-related complications.

Explanation:
High postprandial sugars can make you feel unwell, and over time, if the blood sugars are high on a consistent basis, you can develop diabetes-related complications involving your eyes, heart and kidneys.
3

Diabetics need to coordinate the insulin rise with the food that’s entering the system.

Explanation:
Diabetics need to coordinate the insulin rise with the food that’s entering the system. Usually, that’s done by giving rapid-acting insulin, which tries to reproduce this action of our normal insulin to control the glucose levels.
4

A1C levels in the blood are affected by fasting glucose.

Explanation:
Postprandial glucose can influence A1C levels. A1C levels in the blood are affected by glucose levels throughout the day, so it includes the effects of fasting glucose, but also the glucose levels after eating (the postprandial glucose levels).
5

All types of insulin need to be taken before a meal to work effectively.

Explanation:
The newer insulins that are available tend to be faster acting, so they can be given closer to the meal, right at the beginning of the meal or even right after the meal to control postprandial glucose.
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Controlling Post Prandial Glucose With Meal Time Insulin

PPG is postprandial glucose, it’s a measurement of what the blood sugars are after a meal. Typically after you eat, the body makes insulin, and that helps to control the sugars after the food has been digested. In people that have diabetes, oftentimes the insulin made is not enough, and the blood sugars can go high after a meal, which is also called postprandial hyperglycemia.

PPG can influence the A1C levels. The A1C is a measurement of the average blood sugar for the past three months or so. For people that have diabetes, we usually target an A1C of less than or equal to seven percent.

High postprandial sugars can make you feel unwell, such as being tired, and over time, if the blood sugars are high on a consistent basis, this can lead to diabetes-related complications such as problems with your eyes, heart attack, and problems with your kidneys.

Mealtime insulin is designed to help control the blood sugars after you eat. They try to mimic the body’s natural response to sugar surges. They last anywhere from 40 to 120 minutes. However, they do not completely match the body’s natural response to insulin, and therefore there is still a chance postprandial hyperglycemia can occur.

If patients take their insulin as prescribed, before they eat, they have the best chance of keeping their sugars under good control and avoid postprandial hyperglycemia. If insulin is missed, then the blood sugars after meals can go very high.

Mealtime insulin helps to control sugars after meals, and should ideally be taken 30 to two minutes before a meal, depending on the type of insulin. Some insulins now, however, allow you take them 20 minutes after a meal, and still achieve good postprandial sugar control. In summary, postprandial hyperglycemia can influence A1C levels.

If you would like more information about this topic, feel free to speak to your family doctor, your diabetes team, such as the nurse practitioner or dietitian, or your endocrinologist. Local Endocrinologist 

Presenter: Dr. Amish Parikh, Endocrinologist, Toronto, ON

Local Practitioners: Endocrinologist

Post prandial blood glucose is a measure of your blood glucose after you have eaten.  In healthy individuals when a meal is consumed, insulin that is produced by the pancreas keeps glucose levels within a normal range.  In Diabetes, the pancreas does not make enough insulin to process mealtime sugars.  This means that glucose in the blood goes above the normal range, which is also called post prandial hyperglycemia

Post prandial hyperglycemia can contribute to a persons overall blood glucose control.  One marker of overall control is the A1C blood test.  The A1C test shows an average blood glucose level over a span of a few months.  It’s used to screen and monitor a patients overall blood glucose control.  For most patients, the target for A1C is greater or equal to 7%.  Post prandial hyperglycemia can impact a patients A1C level.

Having high post prandial glucose levels can make a person feel unwell and experience symptoms such as tiredness and feeling thirsty on a daily basis.  If they are high over time, this can put a person at risk of developing diabetes complications such as worsening eye sight, heart attacks, and kidney disease.

High post prandial glucose levels are managed with Bolus or ‘meal time’ insulins.  These insulins are formulated to try and replicate the body’s natural physiological response to mealtime sugar surges.  They are designed to have a rapid onset and last anywhere from 40 to 120 minutes.  If patients take their meal time insulin exactly as prescribed, they have the best chance of being protected from post prandial hyperglycemia.  If they do not take their meal time insulin as prescribed, the body will have a harder time bringing down post-meal sugar spikes.  Depending on the insulin, mealtime insulins should ideally be taken 2 to 30 minutes prior to a meal. Some insulins now even allow the patient to take the insulin up to 20 minutes after the meal and still achieve good post prandial glucose control.  </p>

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