Several factors contribute to post-meal hyperglycemia, including what you eat, how much, and the timing of insulin injections. According to the American Diabetes Association, your blood sugar should be less than 180 milligrams per deciliter of blood within one to two hours after eating, but your doctor may set different blood sugar goals specific to you. Tami Ross, RD, LD, a certified diabetes educator based in Lexington, Ky. and current president of the American Association of Diabetes Educators answers some frequently asked questions about blood sugars spikes, what they mean, and when they may be cause for concern. Women who are pregnant or trying to get pregnant should be very focused on keeping their blood sugar as close to normal as possible. This will help get the best possible outcome for your pregnancy. Women with uncontrolled blood sugar are at risk for birth defects, miscarriage, and your baby growing too large. If you are taking insulin, your needs for insulin will also increase, particularly in the last months of pregnancy. Those looking to improve their A1C blood glucose levels [average blood glucose over the last couple of months] should pay more attention to their post-meal blood sugar. What are the negative consequences of an after-meal spike? There are short-term and long-term effects of a post-meal blood sugar spike. In the short-term, you’ll feel tired after eating, so tired that you could just sit down in a chair and fall asleep. You might have blurry vision and just overall not feel well. In the long-term, if you consistently have these spikes after eating, it’s going to raise your A1C level. We know individuals who have an elevated A1C over time have a greater risk of complications such as heart disease. How can you prevent these spikes from recurring? If your blood sugar is out of range, it can be an opportunity to learn by doing post-meal checks and guiding your decisions about eating and meal planning moving forward. It’s a scenario I see often with my patients. People go out to an Asian buffet or get Mexican food or whatever it may be, and two hours after the meal their blood sugar is out of target. People should look at these incidents and ask themselves a few questions: Did I get my carbohydrate count correct? Do I need to adjust my portions? If they take insulin, do they need to take a different dose? It’s a great opportunity for problem solving. Are there particular foods that cause spikes? Diabetes is very individualized. How people respond to different foods and how their bodies manage different foods is unique to each person. There probably aren’t any foods we’ll tell you to never eat again. You might instead eat a different portion size. If you choose to eat cheesecake, one or two bites can fit in your meal plan; but a whole piece would be excessive. Activity plays into what foods you can choose too. If you’re going to be more active, that can impact your blood sugar. Exercising on a consistent basis lowers your blood glucose and can help keep your A1C stable. You hear a lot about the glycemic index [which measures how a carbohydrate-containing food raises blood sugar]. But you’re probably not ever going to stop eating foods with a high glycemic index, and you don’t really need to as long as you’re watching portions and counting carbs. How can caregivers help someone with diabetes manage their blood sugar? Support and encouragement are huge things that all diabetes patients need. Some individuals need help evaluating their portion size and figuring out the carb content of the foods they eat. Some people might need help making healthy food decisions when they’re out shopping or cooking at home. In terms of keeping their blood sugar steady, sometimes it’s good to hold a person accountable to getting out and walking or going to the gym and doing some kind of physical activity. Are there preferred ways of tracking blood sugar levels? There’s no recommended way to track. As long as you’re doing it, that’s all we care about. You can use an old-fashioned pen and paper, an app on your phone, an Excel spreadsheet, or an online support website. A diabetes educator once told me, “Going to the doctor without your glucose numbers is like going to the vet without your pet.” Diabetes can be very unpredictable, and in the case of keeping track of blood sugar levels, knowledge is power.
