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From Wichita Falls, Texas, USA:

I am 34 year old who has type 2 diabetes, and I have noticed that if my pre-meal sugars are low (around 90 mg/dl [5 mmol/L]) and I the same amount of food I usually eat, my post-meal sugars are going higher (around 190 mg/dl [10.6 mmol/L]) than if I eat the same food with my pre-meal sugars around 120 mg/dl [6.6mmol/L]. I was thinking it should be the other way because my sugars are already high, and I am adding more food. Is this normal?


One of the variables that we cannot readily "see" in type 2 diabetes is the amount of insulin that your own pancreas is producing, nor can we "see" the state of insulin resistance that you might be in. Some people with type 2 diabetes are actually "hyperinsulinemic", meaning that they are producing higher than normal levels of insulin in an attempt to control glucose level. All of this is occurring in the presence of insulin resistance, the hallmark of type 2 diabetes.

Although it is only an educated guess, it might be that when your pre-meal sugars are higher 120 mg/dl [6.6mmol/L], the amount of insulin that is already circulating is slightly higher as well, and therefore you are not observing as great a rise in your blood sugar levels despite equivalent carbohydrate intake. Not all people with type 2 diabetes will notice this. In fact, most will probably notice the opposite; the higher the pre-meal sugars, the greater the rise after meals and the greater the loss of control.


Original posting 21 May 2002
Posted to Daily Care and Type 2


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