“Why is blood glucose still predominantly measured in the morning on an empty stomach?” So asked Prof. Jaakko Tuomilehto from Finland at a major diabetes congress in Dresden. He presented a study showing that it is precisely the blood glucose values after eating that are important. They not only provide information about whether a diabetic has his diabetes well under control. They also indicate the risk of the dreaded secondary diseases, for example heart attack or stroke.
Diabetes prevention through blood glucose monitoring
Even in people who do not yet have diabetes, elevated blood glucose levels after eating suggest an increased risk of diabetes and cardiovascular disease. That’s why diabetes experts in Dresden called for more attention to after-meal blood glucose spikes.
Meal-related blood glucose spikes
In the past, little importance was attached to the phenomenon of increased blood glucose after eating – the so-called meal-related blood glucose spikes. Fasting blood glucose was considered most critical for good metabolic control in diabetics. According to new findings, however, the blood glucose value after eating is even more important with regard to the prognosis of the disease.
In contrast to fasting blood glucose, even brief spikes in blood glucose after eating cause lasting damage to the vessels, contribute to calcification of the arteries and thus lead to an increased risk of heart attack or stroke. Therefore, the new treatment strategies that enable meal-based therapy are also becoming increasingly important.
Crucial for type 2 diabetes
Meal-based therapy is essential, especially for type 2 diabetics, because in them the first, rapid phase of the body’s insulin secretion needed to eat is disrupted. Their insulin response comes too late and blood glucose rises disproportionately after a meal. To achieve the insulin response as naturally as possible, they can either take a diabetes tablet right at mealtime to stimulate insulin secretion or inject themselves with a fast-acting insulin – both of which successfully cap the harmful blood sugar spikes, acting much like a healthy person’s natural insulin response.
Good diabetes control still not achieved in many cases
Many diabetes diseases are not recognized until the disease has already developed a bit. Most diabetics are unaware of their problem and are thus at increased risk.
Experts like Prof. Tuomilehto therefore call for more attention to be paid to blood glucose levels after meals. After all, fasting blood glucose often proves to be insufficiently informative. If it is between 90 and 126 mg/dl or 5 and 7 mmol/l, diabetics are usually satisfied. But what about blood glucose after meals?
If this value is only measured from time to time, the surprise is often great: it can easily be twice as high as the regularly measured fasting value. This is actually quite logical: people are only really sober in the second half of the night. During the rest of the day, the body is almost constantly busy utilizing the food it has consumed. No wonder: we don’t eat only once a day.
Fasting blood glucose only clarifies about the early morning
As a result, this finding means that diabetes treatment should follow nature as closely as possible. In practice, this means that in order to avoid complications, which in the worst case could lead to death, blood glucose levels after a meal must be determined regularly in addition to fasting blood glucose. Only in this way is it possible to start treatment at an early stage that effectively caps the blood glucose peaks after a meal and reduces the risk of late damage – at best, even before full-blown diabetes develops.
