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September 13, 2003

Blood Tests and Insulin Injections

Question from a physician in Colorado, USA:

In a recent reply, you advised that for postprandial blood glucose testing, the best time to test is one hour after you start eating. I have always assumed that "postprandial" implied after the end of the meal. If this is incorrect, then I will certainly change how I counsel patients.


There is no science, no data, and not much clinical difference in recommending one to two hours after meals (my usual verbiage) and whether or not the clock starts plus/minus 15 minutes or so.

Additional comments from Jane Seley, diabetes nurse specialist:

In August of 2001, AACE (American College of Endocrinologists) issued guidelines recommending that the best time for postprandial testing is two hours after you start eating. This time was chosen because for two important reasons: Everyone would be given the same advice so we would get more consistent information and because we have sufficient data to support the benefit of a two-hour postprandial of less than 140 mg/dl [7.8 mmol/L]. The only exception is in pregnancy, when the one hour post prandial of less than 130-140 mg/dl [7.2-7.8 mmol/L] seems to be more helpful.

Additional comments from Dr. Larry Deeb:

I wonder if this isn’t splitting hairs. You want to know if the glucose rises to really high levels — minutes don’t count in my mind.