Peak-time determination of post-meal glucose excursions in insulin-treated diabetic patients.
OBJECTIVE
This study aimed to determine the optimal time to measure peak blood glucose values to find the best approach for self-monitoring blood glucose after a meal.


METHODS
For this retrospective analysis, 69 ambulatory continuous glucose-monitoring system (CGMS) profiles were obtained from 75 consecutive insulin-treated patients with diabetes. The parameters measured were the peak post-meal blood glucose values, peak time, and rates of increase and decrease to and from the zenith of the resulting curves.


RESULTS
The mean peak time after breakfast was 72+/-23 min, which was reached in less than 90 min in 80% of the patients. The apparent glucose rate of increase from pre-meal to the maximum postprandial value was 1.23+/-0.76 mg/dL/min, while the glucose rate of decrease was 0.82+/-0.70 mg/dL/min. Peak time correlated with the amplitude of postprandial excursions, but not with the peak glucose value. Also, peak times were similar after breakfast, lunch and dinner, and in type 1 and type 2 diabetic patients.


CONCLUSIONS
To best assess peak postprandial glucose levels, the optimal time for blood glucose monitoring is about 1h and 15 min after the start of the meal, albeit with wide interpatient variability. Nevertheless, 80% of post-meal blood glucose peaks were observed at less than 90 min after the start of the meal.
Daenen
S
S
Université Paris 5 René-Descartes, service de diabétologie, Hôtel-Dieu, AP-HP, 1, place du Parvis-de-Notre-Dame, 75004 Paris, France.
Sola-Gazagnes
A
A
M'Bemba
J
J
Dorange-Breillard
C
C
Defer
F
F
Elgrably
F
F
Larger
E
E
Slama
G
G
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D015190:Blood Glucose Self-Monitoring / Q000379:methods* / Q000592:standards; D003920:Diabetes Mellitus / Q000097:blood* / Q000188:drug therapy*; D006801:Humans; D007328:Insulin / Q000627:therapeutic use*; D008875:Middle Aged; D019518:Postprandial Period / Q000187:drug effects / Q000502:physiology*; D015203:Reproducibility of Results; D012189:Retrospective Studies
D001786:Blood Glucose; D007328:Insulin