Case review: Uncle Li, 57 years old, has type 2 diabetes for 8 years. Currently using fast-acting insulin and oral hypoglycemic drug metformin extended-release tablets. Recent blood glucose monitoring showed that blood glucose was lower than 8 mmol/l two hours after a meal, and blood glucose was higher one hour after a meal, ranging from 10 mmol/l to 15 mmol/l.

Uncle Li’s question: If the blood sugar is high one hour after the meal, and the blood sugar will drop to the normal level rapidly two hours after the meal, this kind of Is hyperglycemia 1 hour after a meal dangerous? What needs to be done?

Postprandial glucose fluctuations

There are four goals for our blood sugar control, including fasting blood sugar, 2-hour postprandial blood sugar, glycosylated hemoglobin, and blood sugar fluctuations. Blood sugar fluctuations, that is, high and low blood sugar, on the one hand, easily lead to hypoglycemia, and another important aspect is also one of the reasons for the complications of diabetes.

Glucose fluctuations can be obtained with continuous glucose monitoring. In addition, daily monitoring of blood glucose before meals, 1 hour after meals, 2 hours after meals or even 3 hours after meals can also help us capture the signals of postprandial blood sugar fluctuations.

For diabetic patients, under normal circumstances, blood glucose before meals should be <7.0mmol/L, 1 hour postprandial blood glucose <11.1mmol/L, and 2 hours postprandial blood glucose <10mmol/L L, 3 hours postprandial blood glucose is close to fasting and preprandial blood glucose levels, less than 7.0 mmol/L.

Solution

The response to Uncle Li’s situation is mainly through two One is to change the diet structure, adopt some dietary techniques, slow down the absorption of food, and slow down the rise of blood sugar after meals, such as chewing slowly, more dry and less thin, separation of dry and wet and other small skills.

Secondly, under the guidance of doctors, make appropriate adjustments to the existing hypoglycemic treatment plans, such as the rapid-acting insulin used by Uncle Li span>, it takes effect within 10-20 minutes after injection, the maximum effect time is 1-3 hours after injection, and the duration of action is 3-5 hours, then if he eats strictly in the order of eating vegetables first, then meat and finally the staple food , Start eating after the injection, and the blood sugar will be better 1 hour after the meal. If you eat a large amount of staple food first, the blood sugar will be more stable after waiting 10-15 minutes after the injection.

In short, by monitoring blood sugar under the guidance of a doctor, you can find out your own blood sugar and eating patterns, which will help you get a more perfect postprandial blood sugar.