If there’s anyone out there living with diabetes who does NOT find it frustrating, send me an email. I’d like to hear your secret. For the rest of us, living with it just got that much harder through a yet another “standardized guideline” announced by the IDF (International Diabetes Foundation) last week.
“The new IDF Guideline recommends that people with diabetes try to keep post-meal blood glucose levels to less than 7.8 mmol/l (140 mg/dl) two hours following a meal.”
Now I understand that postprandial (post-meal) glucose values are important, ’cause they sure can impact your A1c — that gold standard for measuring your average glucose level over the last three months. And that’s important, ’cause that helps you understand your chances of developing the nasty complications of diabetes in the long run.
So I get that the IDF feels it’s important to make some kind of statement here, given that until recently, the key recommendations for good diabetes management were only about lowering your fasting or pre-meal blood glucose levels. PWDs all around the world need to know that you don’t want to go sky-high after every meal.
By this I mean that I thumbed through the 32-page guideline document (if it’s possible to “thumb” on the Internet), and discovered that:
* most of the contents are taken up with arguing that high post-meal BG is indeed harmful, causing oxidative stress, inflammation, and other things that lead to heart disease (the same problems you get from a high A1c overall)
* the recommended “treatment strategies” are the basics: frequent SMBG (self-monitoring of blood glucose) with a traditional or continuous monitor, exercise, diet — with an emphasis on low-GI foods — and “a variety of pharmacologic therapies,” ie. insulin and a bunch of other drugs.
I guess the idea is just to get doctors and other folks treating diabetics around the world to put more emphasis on keeping post-meal numbers low. But as we all know, the details often get lost in translation. So what’s likely to come through to most patients is nothing but yet another number to stress over (!)
As a Type 1 who actually eats carbs (gasp!), I can’t remember ever hitting 140 BG after a meal when I wasn’t heading for a low. To be perfectly honest, I’m lucky to hit 180 post-meal most of the time, but most of the time, I still manage to get back in range by hour 3 or 3-1/2.
What I’m saying here is, most of us are going to look at that 140 goal, and feel like screaming: “Are you kidding me? I feel guilty enough all the time as it is!”