Normal 3 Hour Postprandial Blood Sugar – In this post we will discuss blood glucose level, testing time, purpose, blood glucose level and peak testing; Many find it helpful in managing gestational diabetes and gestational diabetes.
Blood sugar levels are constantly changing. A blood sugar spike is the highest peak your blood sugar level reaches after eating or drinking. A good way to visually show how blood sugar levels change is with an image of the Freestyle Libre Continuous Blood Glucose Monitoring System:
When blood sugar levels rise, it sends a signal to our body to process the glucose, using insulin to break it down in our cells and turn it into energy. However, with gestational diabetes, we cannot do as usual. This means that we can have higher blood sugar levels than we should, which in turn can cause complications during pregnancy.
In gestational diabetes, when there is too much sugar in the mother’s blood, it is passed to or fed to the baby. The baby then has to increase its own insulin production to help process the extra sugars. Insulin is a growth hormone and as a result the baby grows too much and for many the AC [abdominal circumference] increases. It is the adipose tissue (subcutaneous fat) caused by the overproduction of insulin that causes the baby to ‘put on weight’.
By controlling blood sugar with diet, exercise, and some will even need medication/insulin, this helps the child control insulin production to a normal level and slows the growth rate of the child’s AS while the growth of the rest of the child stops. This means that the child returns to a “normal” or average growth size.
There is uncertainty as to whether overall glucose control or elevated blood glucose levels affect fetal development, but the HAPO (Hyperglycemia and Adverse Pregnancy Outcomes) Study-1 found that both fasting and postprandial glucose levels nutrition affect fetal development and therefore most women will be advised to test both fasting and postprandial [post-meal] levels.
Optimal glucose control before pregnancy reduces congenital malformations and miscarriages, while during pregnancy it reduces macrosomia, stillbirth, neonatal hypoglycemia, and respiratory distress syndrome. 2 Timings and purposes of the blood glucose monitoring test
Although there are national guidelines with research-backed recommendations on what blood sugar targets should be used for best outcomes in gestational diabetes, hospitals and trusts are not required to follow them.
This means that women in the UK and Ireland may receive different blood glucose monitoring targets and testing times. Some may be very strict, others may be very lenient. You can literally walk into one hospital and get a set of goals and testing times, and the next hospital a few miles away can be dramatically different.
There are many different testing methods offered to women diagnosed with gestational diabetes, from multiple daily tests before and after meals and at bedtime, to only testing at the Breakfast Club after a certain carb-rich breakfast!
Here’s what we found out from 1,222 women with gestational diabetes about the blood test regimen they were advised to follow:
“Will testing times and goals help you manage your gestational diabetes as well as possible?”
If you were told to check your blood sugar levels only before and after each meal for a day, does that give you enough information to know how and where you can adjust your diet to be as optimal as possible? sugar can be achieved. ?
Similarly, if you are told to monitor your blood sugar levels only once a week, will that be enough to see what happens and your tolerance to different foods? Or does it encourage you to follow a strict diet on the day you know you’re testing and be less strict when you know you’re not?
1.3.5 Advise pregnant women with any form of diabetes to maintain their capillary plasma glucose below the following target levels if this can be achieved without causing problematic hypoglycaemia: Fasting: 5.3 mmol/litre and 1 hour after meal: 7.8 mmol/liter or after 2 hours : 6.4 mmol/l.[New 2015] 1.3.6 Advise pregnant women with diabetes taking insulin or glibenclamide to maintain their capillary plasma glucose above 4 mmol/l.[New 2015]NICE Guidelines NG3 during pregnancy.Diabetes
Postprandial glucose should be monitored in pregnant women with gestational diabetes and considered in pregnant women with type 1 or 2 diabetes. …target blood glucose to achieve: between 4 and 6 mmol/l before a meal and <8 mmol/l one an hour later or 6 mmol/l at bedtime. Sign Guidelines 116 7.5 Optimizing glycemic control
5.3.6 Blood glucose target levels during pregnancy The following target values are recommended for optimal maternal and fetal outcome: – Fasting capillary glucose level: 3.5-5.0 mmol/L – 1 hour capillary glucose level postprandial: <7.0 mmol/L HSE Guidelines for the management of GDM
It is worth noting that none of the national guidelines recommend only pre-meal testing or alternating pre-meal and post-meal testing days. They all recommend fasting and postprandial testing, with additional preprandial testing recommended for those using insulin therapy.
One-hour vs. two-hour postprandial examination Several studies have shown that postprandial hyperglycemia is a predictor of fetal macrosomia and may contribute to neonatal hypoglycemia. Current recommendations state that tests should be performed within an hour or two after a meal. However, studies show that a 1-hour post-meal test can detect abnormal values that may require treatment and help understand the relationship between food and blood sugar levels – 3, 5 NICE guideline NG3 Diabetes in pregnancy
To show the difference between a one hour and a two hour postprandial test, here is an image of the mother’s test results. This mother with GD was concerned that the 2-hour postprandial testing she was doing was missing the rise in her blood sugar levels, so she decided to start testing at both 1 and 2 hours.
According to NICE guidelines (1 hour after level <7.8 mmol/L), she missed 7 spikes in blood glucose levels over 2 weeks, but her levels by the 2nd hour were below the guideline of <6.4 mmol/L L for all of them. cases. Imagine how many spikes she would have missed for the rest of her pregnancy if she had only continued testing at the 2nd hour!
We should note that any blood glucose monitoring is better than no monitoring at all. Capillary blood glucose monitoring is only a guide, but it will help you get a better idea of what’s going on in your body and help you understand how different foods and drinks affect you.
However, when you test and the targets used can also have a big impact on how your gestational diabetes is managed and controlled.
The more you test, the more you can see and build a much bigger picture. You can learn which foods you struggle with and change meals accordingly. Taking this approach may mean you stay on a controlled diet for longer or need less medication or insulin.
If you think that testing more often or at a different time than what your diabetes team recommends may be beneficial in managing your gestational diabetes, discuss this with your team and explain the reasons with guidance and research. Which shows which time is best. The test is the peak test What is the peak test?
A spike test is more common testing after consuming a food/beverage to see the effect on blood sugar levels in order to make dietary changes to better control blood sugar levels.
The Peak Test was developed after we saw some women in our Facebook group getting away with eating very highly processed carbohydrate meals washed down with full sugar fizzy drinks or pure fruit juice etc.
We’ve noticed in the Facebook group that often women admit or admit to eating some very questionable things (a large piece of chocolate cake, Krispy Kreme donuts, Chinese sweet and sour chicken with rice and chips, etc.) and then get really low . Then, assuming they tolerated that treat/suspiciously high carb meal really well.
Many times they would not even admit to their professionals that they were eating these things and “getting away with it” even though they would come to the group and ask why they could tolerate these things – the question was if they really .?
Once they see that good levels can be achieved with these things, they continue to eat them – why wouldn’t they if their blood sugar levels look good?
We regularly see posts like this one in our Facebook group: “I can’t touch a piece of bread but I’m fine with Krispy Kreme donuts?!”, “I can get better at eating junk than eating healthy. Doesn’t that make sense?”
Despite levels of 100 and above and/or the baby was born puffy, bloated and sick
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