Diabetes Monitor - postprandial blood sugar timing during pregnancy

postprandial blood sugar timing during pregnancy

Remember that the information presented here is not intended to replace the care of your own doctor. Before making any changes in the management of your own illness, you should consult your physician or other qualified medical professionals.

Question

Concerning time to test postprandial blood glucose: I'm not sure I agree with the recommendation (1) that everyone test 90 minutes after meals. One reason that recommendation was made for pregnant women with diabetes is that digestion is somewhat slowed in pregnancy and 90 minutes is the optimal time for catching the true high after the meal.

Answer

Gastrointestinal motility is slowed with pregnancy, probably due to the increase in progesterone production. However, I am not sure that absorption from the intestine is delayed.

A recent article (2) suggested that 90 minutes postmeal was the average peak glucose value. Thus, irregardless of how digestion is affected by pregnancy, the data would suggest that between one and two hours is the time when postmeal hyperglycemia is most apparent. Therefore, that may be the most appropriate time to target in determining insulin dosing. This was just one article, and I have not changed my personal recommendation of testing at one hour after of a meal because of it.

owj

(1) Preprandial Versus Postprandial Testing at www.mendosa.com
(2) The postprandial glucose profile in the diabetic pregnancy. Am J Obstet Gynecol. 2004 Aug;191(2):576-81.

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