Diabetes Self-Management Articles

These articles cover a wide range of subjects, from the most basic aspects of diabetes care to the nitty-gritty specifics.

Links not loading properly?

Some of our pages use Portable Document Format (PDF) files, which require Adobe Acrobat Reader. To download Acrobat Reader for free, visit www.adobe.com.

Sign up for our weekly e-mail newsletter and receive a FREE GIFT! Enter your e-mail below.

Learn more

Learn more about diabetes

Links to help you learn more about diabetes.

Ask a diabetes expert
Other diabetes resources
Browse article topics

 

Postprandial Hyperglycemia

An exaggerated rise in blood sugar following a meal. In people who don’t have diabetes, the pancreas secretes some insulin all the time. It increases its output as blood glucose rises following meals. In people with Type 2 diabetes, the pancreas can be sluggish about secreting insulin in response to a meal. This leads to postprandial hyperglycemia.

Postmeal blood glucose elevations pose a challenge to people with diabetes striving to maintain near-normal blood sugar levels. Insulin regimens of one or two injections of slow-acting insulin each day handle this challenge clumsily: The person must eat when the insulin is peaking, both to avoid hypoglycemia (low blood sugar) and to avoid postprandial hyperglycemia. Multiple injection regimens and insulin pumps provide more flexibility. A person can take Regular insulin half an hour to one hour before eating so that the insulin peak and glucose rise coincide. Using one of the two rapid-acting insulins — insulin lispro (brand name Humalog), insulin aspart (NovoLog), or insulin glulisine (Apidra) — before meals allows for even more flexibility and fine-tuning. Because they peak faster than Regular insulin, they can be taken within 15 minutes of eating. They also leave the body more quickly, losing effectiveness at the same time as blood glucose levels decline.

For people with Type 2 diabetes, there are now several oral drugs specifically designed to address postprandial hyperglycemia. Acarbose (Precose) and miglitol (Glyset) block the action of an enzyme in the small intestine that normally breaks down carbohydrate into glucose. Therefore, glucose enters the bloodstream more slowly, giving the pancreas extra time to secrete enough insulin to handle it. Repaglinide (Prandin) and nateglinide (Starlix) stimulate the pancreas to release insulin in a glucose-dependent fashion. (That is, the more glucose there is in the blood, the more insulin the pancreas secretes.) These drugs also begin acting, peak, and break down quickly, so they are well-suited to handle the brief rise in blood glucose that follows meals.

 

 

More articles on Diabetes Definitions

 

 


Statements and opinions expressed on this Web site are those of the authors and not necessarily those of the publishers or advertisers. The information provided on this Web site should not be construed as medical instruction. Consult appropriate health-care professionals before taking action based on this information.

 

 

Are There Any Good Carbs?
Refined carbs, bad; whole carbs, good. Diabetes educators and nutritionists have repeated that... Blog

The Mystery of Coffee and Diabetes
Is coffee good or bad for diabetes? Some studies show that coffee is protective, while others... Blog

Strike the Spike II
Eight years ago, I wrote an article for Diabetes Self-Management about the management of after-meal... Article

If you have Type 2 diabetes, how do you know when it's time to begin taking insulin? Get tip


Blood Glucose Self-Monitoring — Part 3: Smart Monitoring

10 Keys to Long-Term Weight Loss

Take Your Best Shot: Stay Up to Date on Vaccines

Complete table of contents
Get a FREE ISSUE
Subscription questions