Читать книгу Practical Carbohydrate Counting - Hope S. Warshaw - Страница 29

Checking and reviewing postprandial blood glucose levels regularly can provide healthcare providers and people with diabetes valuable insights into their glucose control. Postprandial levels often go unchecked and unanalyzed, usually because healthcare providers do not request them or because individuals already check so many fasting and mealtime levels that they don’t want to check more. Educators need to emphasize the value of postprandial monitoring, especially if A1C values are higher than expected, which could indicate people are likely missing high blood glucose levels after meals. Table I-1 on page 2 provides the goal for postprandial blood glucose and a note that postprandial levels should be checked 1–2 hours after the beginning of the meal.

If people who aren’t on MDI or CSII therapy aren’t willing to add more glucose checks, educators can encourage them to substitute a fasting or preprandial check for a postprandial check. People on MDI or CSII therapy, however, will need to add postprandial checks to their fasting and mealtime checks because they need this information for insulin dosing.

Encourage people to check postprandial blood glucose levels to accomplish the following:

• Gain more insights into blood glucose control after eating and before the next food intake

• Learn the impact of both the types of foods eaten and the amounts and make changes as needed

• Gain insights about the effectiveness of mealtime insulin dosing or other blood glucose—lowering medication and use the information to make changes in ICRs as needed

• Determine the duration of rapid-acting insulin action in order to individualize the bolus-on-board setting on insulin pumps or improve correction dosing using MDI