What is postprandial hyperglycemia?

Postprandial hyperglycemia is a condition where a person has extremely high blood glucose after eating a meal. Typically, blood glucose levels rise slightly after eating food. Glucose is a form of sugar which is one of the main sources of energy for the body. We get glucose from carbohydrate-rich foods, such as rice, bread, milk and potatoes. When we eat these foods, our body breaks it down into glucose that is then transported to various body tissues via the bloodstream. However, for glucose to enter the cells of the body to be used for energy, it requires insulin. Insulin is a natural hormone which is produced by the beta cells in the pancreas. This naturally occurring hormone is responsible for transporting glucose into body’s tissues such as fat and muscle cells. People who do not have diabetes are able to naturally produce insulin. On the other hand, people with type 2 diabetes cannot produce enough insulin after meals. Because of this, they may experience postprandial hyperglycemia (post-meal).

You are considered to have postprandial hyperglycemia when your blood glucose levels go above 180 mg/dL. For non-diabetics, blood glucose levels rarely go beyond 140 mg/dL after eating. However, if you eat a large meal that contains a high amount of carbohydrates, your postprandial glucose levels can go up to 180 mg/DL. Post-prandial hyperglycemia is a challenge for people with diabetes who are aiming to achieve a stable blood sugar level. High blood glucose levels can lead to serious health complications including damage to nerves, kidneys and blood vessels. People with diabetes may take insulin injections to help them stabilize their blood glucose levels.

Signs and Symptoms

Various factors can contribute to symptoms of post-meal. People who are experiencing physiological stress are likely to experience postprandial hyperglycemia. This is because when your body is under stress, it releases various hormones, which may increase your blood glucose levels. Some certain types of drugs such as epinephrine, corticosteroids and niacin can contribute to the risk of post-meal. Diabetes mellitus is one of the main causes of post-meal. This is because patients who have diabetes mellitus do not produce enough insulin to absorb and process sugar (glucose) in the blood. When your blood sugar is high, you may feel foggy headed which may make it difficult to concentrate and focus. You may also get moody or feel nervous. If you experience any of these symptoms, it is important you seek medical attention immediately. If left untreated, high blood sugar can lead to health complications such as heart disease and stroke.

The following are signs and symptoms of postprandial hyperglycemia:

  • Blurred vision
  • Fatigue
  • Weight loss
  • Drowsiness
  • Increased thirst
  • Dry mouth
  • Frequent urination

Treatment

The main goal of post-prandial hyperglycemia treatment is to bring blood glucose close to normal levels as much as possible in three components of glycemic control, i.e. post-meal glucose peak, HbA1 and fasting glucose. For you to effectively treat post-meal, you need to work towards preventing it. If you are using insulin medication, your doctor may need to adjust your dosage so as to prevent the risk of postprandial hyperglycemia occurring in the future. Whether you are diabetic or not, it is recommended that you exercise regularly so that you can maintain a healthy blood glucose level. Your doctor may advise you to adopt a healthy diet plan so that you can avoid the risk of post-meal. Your diet plan may involve reducing alcohol consumption, watching your carbohydrate intake, and including whole grains, fruits and vegetables into your diet. Because postprandial hyperglycemia occurs after meals, it is important you consume the right types and quantity of carbohydrates. In case you have problems with your eating plans, you can consult with your dietitian on the best diet plan that works for you. Managing your stress levels can also help you prevent post-meal.

Drugs for postprandial hyperglycemia

For patients who have type 2 diabetes, there are various drugs designed for postprandial hyperglycemia. Short-acting insulins are preferred to long-acting insulin because of their ability to start working within a short time. You can take regular insulin at least half an hour to one hour before your meals so that the glucose rise and insulin peak coincide. You can also choose to use rapid acting insulin such as insulin lispro, insulin aspart or insulin glulisine 15 minutes before you eat. Other than insulin, type 2 diabetic patients can use oral drugs that help them manage post-meal. For example, miglitol and acarbose block the small intestine enzymes that break down carbohydrates into sugar. Hence, sugar slowly enters the blood which gives insulin enough time to manage it. Nateglinide and repaglinide drugs work by stimulating the pancreas to secrete insulin based on the number of glucose available in the blood. Therefore, in case there is too much glucose in the bloodstream, more insulin will be released. Hence they are able to control post-meal.


Disclaimer: Please note that the contents of this community article are strictly for informational purposes and should not be considered as medical advice. This article, and other community articles, are not written or reviewed for medical validity by Canadian Insulin or its staff. All views and opinions expressed by the contributing authors are not endorsed by Canadian Insulin. Always consult a medical professional for medical advice, diagnosis, and treatment.