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Feature Article Endocrinology and metabolism
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Finding and fixing postprandial hyperglycaemia in type 2 diabetes

Pat Phillips
Postprandial blood glucose levels that are above the target range can be controlled by diet amendments, increased physical activity, oral and injectable hypoglycaemic agents and bolus insulins.
Key Points
  • Postprandial hyperglycaemia can be caused by a high preprandial value and/or a high prandial increment.
  • The preprandial value should be on target before checking postprandial values.
  • The current recommended postprandial blood glucose level targets in Australia are 6 to 10 mmol/L.
  • If glycaemia before breakfast and the evening meal is controlled by basal insulin, any high values of blood glucose (‘hypers’) are likely to be caused after breakfast (i.e. before lunch) and/or after the evening meal (i.e. before bed).
  • Strategies to control postprandial hyperglycaemia include lifestyle measures (diet and physical activity), noninsulin hypoglycaemic strategies (oral and injectable hypoglycaemic agents) and bolus insulins.
  • The guiding principle is that hypoglycaemic therapy should not require changes In lifestyle that are not achievable or acceptable for the patient.
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