Dear Dr. E,
I‘m fairly newly diagnosed with diabetes, and I was wondering what a good/normal blood sugar number is to have after eating a meal? Mine often spikes to 250 or more, and stays that way for a few hours.
Dr. Edelman: Preventing your blood sugar level from rising too high after eating is one of the biggest challenges in diabetes. For folks who have a continuous glucose monitoring (CGM) device, they now know how high they get after each meal and snack. For those of you still pricking your finger, you may or may not know how high you really go after eating unless you get lucky and time the peak glucose level just right.
The American Diabetes Association, who sets most of the standards, states that your post-meal (or postprandial) glucose level should be less than 180mg/dL two hours after the start of your meal. I guess you have to start somewhere with guidelines, but we here at TCOYD have things to add to that fairly rigid goal. What if you are Italian and have a typical two-hour, five-course meal? Of course the composition of the types of food you eat has a tremendous influence on when to test, i.e. vegetarian, vegan, meat and potatoes person…etc.
One of the most important things to look at is the change from baseline. In other words, the difference in glucose value between the start of the meal and the two-hour mark, or peak postprandial rise. What if you start a meal with a BG of 155 mg/dL, which is not too bad. It would be impossible to stay under the recommended goal of 180mg/dL, only 25 points higher. I like to speak about the “Delta 50” which refers to keeping your glucose from going up more than 50 points no matter where you start from. Even that is a tough goal for many folks whose diet contains a lot of carbs.
No matter what type of diabetes you have, trying to keep your blood glucose levels from rising excessively after eating is tough, but something you can work toward with pharmacological and non-pharmacological tips and tricks, which we explain in more detail in our recent Dose of Drs. E + P: Post-Meal High-Blood Sugars: How to “Strike the Spike”. Go easy on yourself and do the best you can.