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March 21, 2006


Question from Sunnyside, Washington, USA:

I would like your opinion on this scenario. I know they want you to be under 140 mg/dl [7.8 mmol/L] two hours after a meal, but I went to Burger King and ate a whopper and a kid's fry (with a diet pop). I checked my blood sugar one hour later and it was 207 mg/dl [11.5 mmol/L]. But, two hours later, it was down to 142 mg/dl [7.9 mmol/L]. The 142 mg/dl [7.9 mmol/L] at two hours is okay, isn't it? But, how bad is it to have the 207 at the one hour mark?


It is better not to be over 200 mg/dl [11.1 mmol/L] at one hour. It you take insulin, you can adjust the insulin to the type of food you eat. If you take pills or are not on medications at all, you don’t necessarily have things to adjust. It is helpful to see what kinds of food can actually raise your blood sugars that fast and that high. In the end, it comes down to the area under the curve. Another way to say it is that control is a function of both absolute glucose level and the time you stay elevated. If you are down to 142 mg/dl [7.9 mmol/L] by two hours that is not bad. However, for women who are pregnant with diabetes, the goal is to have the post-meal blood sugar under 140 mg/dl [7.8 mmol/L] at one hour or under 120 mg/dl [6.7 mmol/L] at two hours.