NEW YORK (Reuters Health) - For people with type 1 or type 2 diabetes, pre-meal blood glucose (sugar) levels are generally more closely associated with long-term blood sugar levels than post-meal blood sugar levels, according to a study reported at the European Association for the Study of Diabetes annual conference in Rome.
Before-meal glucose values have a larger impact on hemoglobin A1C — a standard indicator of blood sugar control — “presumably because they resemble the 24-hour, and thus the long-term, glucose levels more closely,” Dr. Rikke Borg from the Steno Diabetes Center, Gentofte, Denmark, told the conference.
Borg and colleagues used intensive blood sugar monitoring data to figure out which self-monitoring, meal-related blood glucose values of the day provide the best prediction of average blood sugar.
Blood glucose measurements were obtained pre- and post-meal for approximately 10 full days during 3 months for each of 273 type 1 diabetics and 168 type 2 diabetics, yielding an average of 66 meal-related blood glucose measurements per study subject.
In general, the combined pre-meal blood sugar values predicted hemoglobin A1C and therefore long-term blood sugar levels, better than combined post-meal values for both type 1 and type 2 diabetes, and particularly for type 2 diabetes, Borg and colleagues found.
For type 1 diabetes, pre-breakfast, pre-lunch, and post-lunch values predicted A1C the best, and for type 2 diabetes (both non-insulin- and insulin-treated), the pre-breakfast and post-lunch, and pre-dinner values provided the best prediction.
“These findings provide insight for the patient and clinician who seek the optimal blood glucose monitoring at minimal expense and discomfort,” Borg and colleagues conclude in their meeting abstract.