Tips for Improving Post Meal Blood Sugars
A post meal blood sugar spike is an elevation in blood glucose that occurs one to two hours after eating a meal. It is normal for the blood sugar to rise a little after eating a meal, even in a person without diabetes; however, the rise is usually not more than 40 mg/dL.
High blood sugars following a meal can wreak havoc on your diabetes control and put you at greater risk for cardiovascular problems. The American Diabetes Association (ADA) recommends blood glucose be less than 180 mg/dL one to two hours after a meal. When blood sugar is persistently above this target, it can make reaching a target A1c (marker of blood sugar control over last 2-3 months) of less than 7% very challenging.
Most people with type 2 diabetes do not self-monitor blood glucose (SMBG) routinely after eating a meal. However, recently, it has been recommended that if A1c targets are not being reached (<7% according to the ADA) that blood glucose be monitored one to two hours after meals.
The following article will review variables that affect post meal blood glucose and practical tips for improving your post meal blood glucose and well as medications to discuss with your doctor.
First things first: Learn what foods have carbohydrates and how to read a nutrition label:
- Carbohydrates have the greatest impact on blood sugar
- Check out the following articles to learn more: Meal planning and controlling carbohydrate consumption and Making sense of the nutrition label
Next ask your dietitian or diabetes educator how much carbohydrate you should have at each meal:
- Most people do well with 45 to 60 grams of carbohydrate at each meal
Don’t forget to measure or weigh your food:
- Using measuring cups or a food scale will help you get an accurate carbohydrate count for your meal.
Have a basic understanding of the glycemic index:
- The glycemic index refers to the speed at which a carbohydrate food will raise the blood sugar.
- In general, the more refined and processed a food is, the higher the glycemic index will be.
- Foods that are high in fiber such as whole grains, fresh fruit and vegetables, as well as beans/legumes are typically lower in the glycemic index.
- Adding protein and some fat will also help lower the overall glycemic index of your meal.
Are you eating a high fat meal (i.e. fried food, pizza, or pasta in a cream sauce)?
- Having some fat (in particular heart healthy monounsaturated fats such as olive oil and canola oil) is healthy and will help fill you up at a meal; however a high fat meal (greater than 20 grams) can cause insulin resistance. With insulin resistance, your liver releases a larger amount of glucose (sugar) into the blood stream.
Does your meal contain an acidic food or ingredient?
- Acidity slows digestion
- Try using vinegar and oil on salad instead of a cream based dressing. Instead of white dinner rolls, try sourdough rolls.
- Caffeine stimulates the liver to breakdown glycogen (storage form of sugar).
- Consider swapping out your regular coffee for decaf or switching to tea.
How much sleep are you getting?
- People who get less than 6 hours of sleep each night tend to have an increased appetite and are more insulin resistant.
Low blood sugar before meal:
- Having a low blood sugar before a meal results in food rapidly digesting which, in turn, can result in greater post meal blood sugar spikes.
- There is also a tendency to over treat low blood sugars, which can result in significant blood sugar spikes.
Do you take mealtime insulin?
- Mealtime insulin (rapid acting insulin: Humalog, Novolog, Apidra) typically works best at improving post meal blood sugars when given 15-20 minutes before eating.
Medications that may help:
Consider discussing any of the following medications with your diabetes doctor (for a more comprehensive list of diabetes medications please refer to: Drug Treatment Options)
- Symlin: Is a synthetic form of the hormone amylin. Symlin works by slowing the movement of food from the stomach to small intestine and inhibits the release of glucagon (a hormone that counteracts insulin action).
- Byetta, Bydureon and Victoza: These medications are in a class of drugs called incretin mimetics. They work by enhancing insulin secretion in response to a high blood sugar following a meal as well as slow down movement of food from the stomach to small intestine.
- Precose and Glyset: These medications are in class of drugs called alpha-glucosidase inhibitors. They work by blocking an enzyme that aids in carbohydrate digestion. Thus, some of the carbohydrate from the meal is not absorbed.
Sitting around after a meal?
- Try exercising or doing chores around the house instead
- Just 10-15 minutes of mild activity can make a big difference!