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 after meals. In people with Type 2 diabetes, the pancreas can be sluggish about secreting insulin in response to a meal, leading to postprandial hyperglycemia. Postprandial hyperglycemia may account for high hemoglobin A1C (HbA1c) levels in people with otherwise satisfactory blood glucose control.

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Postprandial hyperglycemia presents a challenge to people with diabetes who are 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. Taking a rapid-acting insulin analog such as insulin lispro (brand name Humalog), insulin aspart (Novolog), or insulin glulisine (Apidra) can allow for even more flexibility and fine-tuning. The Food and Drug Administration approved a new faster-acting form of insulin aspart (Fiasp) in 2017.

Want to learn about additional strategies for managing blood sugar after meals? Read “Strike the Spike II: Dealing With High Blood Sugar After Meals,” “Dealing With After-Meal Blood Sugar Spikes? Don’t Skip Breakfast” and “Walking Significantly Reduces After-Meal Glucose.”

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