Fasting blood sugar and postprandial blood sugar, which indicator is more important? The doctor's detailed analysis will tell you the answer
Whether it is diabetes diagnosis or diabetes treatment, it is necessary to look at the two indicators of fasting blood sugar and postprandial blood sugar. Fasting blood sugar refers to the blood sugar level measured without calorie intake for at least 8 hours, usually refers to the blood sugar before breakfast after getting up in the morning, and postprandial blood sugar refers to the blood sugar measured 1-2 hours after eating.
Fasting blood sugar or postprandial blood sugar, which is more important?
The importance of the two in the diagnosis and treatment of diabetes has its own merits and can be said to be comparable.
- Importance in Diabetes Diagnosis
According to the Chinese diagnostic criteria for type 2 diabetes, fasting blood glucose ≥ 7.0, random blood glucose ≥ 11.1 and typical diabetic symptoms, or two glucose tolerance tests at different times showed fasting blood glucose ≥ 7.0, postprandial blood glucose ≥ 11.1 without typical symptoms Diabetes symptoms can be diagnosed as diabetes.
However, in the actual blood sugar measurement, fasting blood sugar is more likely to fluctuate due to the interference of external factors, such as whether you had a late-night snack the night before or whether you got enough rest, etc., while postprandial blood sugar is relatively less affected and more able to Reflects the patient's true blood sugar level.
Therefore, in the diagnosis of diabetes, postprandial blood glucose should be more important.
- Importance in diabetes treatment
In the treatment of diabetes, fasting blood glucose and postprandial blood glucose also need to be monitored. Although both fasting and postprandial blood glucose can guide the adjustment of antidiabetic drugs, fasting blood glucose may be more useful in detecting nocturnal hypoglycemia in patients. Some diabetic patients are not mainly due to insufficient insulin secretion or insulin resistance leading to increased postprandial blood sugar, but because islet cells are unresponsive and delayed postprandial insulin secretion peak.
If the patient eats too little at dinner, or the insulin injection dose is too large, the postprandial blood glucose is likely to be within the normal range, but due to the delay in the peak insulin secretion, the patient is likely to experience nocturnal symptoms under the action of subsequent insulin. Hypoglycemia, at this time, the fasting blood sugar measured in the morning may be lower than normal, or the reaction may increase, so it will be found that hypoglycemia occurs at night, you can increase the monitoring of blood sugar at 0:00, 3:00 and 5:00 at night, or reduce dinner Measures of pre-insulin dosage. In this regard, fasting blood glucose is even more important in preventing hypoglycemia in patients.
From the perspective of patient compliance, because the patient's meal time is not fixed, and the postprandial blood glucose needs to be measured every time in the morning, noon and evening, the postprandial blood glucose is more likely to be missed by the patient or the value caused by the inaccurate measurement time. error, while fasting blood glucose only needs to be measured once, so it is easier for patients to perform and relatively more accurate.
However, in guiding the diet adjustment of diabetic patients, postprandial blood sugar is more important, because postprandial blood sugar can directly reflect the patient's eating situation, if eating too much or the structure is unbalanced, the postprandial blood sugar will rise, then the patient needs to be Adjust your diet.
Finally, having said so much, it is not advocating that people with diabetes should ignore one of them. In fact, fasting blood sugar and postprandial blood sugar are both very important. If one of them is not well controlled, it will affect the overall situation of comprehensive diabetes treatment, and even lead to treatment failure. The most serious consequence is the appearance of complications. Therefore, diabetic patients can not ignore this and the other, and need to pay equal attention to fasting and postprandial blood sugar.
references:
"Guidelines for the Prevention and Treatment of Type 2 Diabetes in China" (2017 Edition)
Pharmacist Fang Jian