What do you think - the absolute or the difference matters more?
What do you think is more important - the absolute BG readings or the difference between pre-prandial and post prandial readings? This question came up in my mind after reading some posts in the different diabetes related e-forums.
Here is an example:
Case 1: Pre-prandial 4.2 mmol/L (75 mg/dL) and post prandial 6.9 (125). Difference is 2.7 (50)
Case 2: Pre-prandial 6.1 (110) and post prandial 7.5 (135). Difference is only 1.4 (25)
Let us say the post meal readings noted above are the the peak readings after food and BG goes back to around pre-meal reading by 3 hours after food . Note that in both cases the BG levels remain below what is widely believed to be harmless levels.
My question is, which is better - Case 1 or Case 2?
Reading some of the posts in the various e-forums, I get the impression that the posters believe case 2 to be better. They seem to emphasize the difference between pre and post meal readings much more than the absolute BG readings. In a couple of posts it appeared to me that the posters were trying to relate A1c to the difference rather than the absolute levels.
My humble opinion in this matter is as follows:
1. Case 1 is better in spite of the difference between pre-and post meal readings being double of that in case 2. I believe the absolute BG levels are what matters and as long as the absolute level is within safe limits, we are safe.
2. A1c is determined by the absolute BG levels and not by the difference between pre and post prandial readings.
As I consume what I believe to be a reasonable amount of carbohydrates, I might see a difference of typically 2.7 (49) — my highest post prandial readings after a major meal are normally less than 7.4 (133) and pre-prandial readings are around 4.7 (84).
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