title: Understanding Post-Prandial Hyperglycemia in Patients with Type 1 and Type 2 Diabetes: A Web-based Survey in Germany, the UK, and USA.
abstract: BACKGROUND
  To explore how patients with diabetes experience post-prandial hyperglycemia (PPH) or elevated blood glucose (BG) following a meal.
  
  
  METHODS
  A web-based survey of patients with type 1 or type 2 diabetes using bolus insulin in Germany, the USA, and the UK was conducted.
  
  
  RESULTS
  A total of 906 respondents completed the survey. PPH was a frequent occurrence among patients with type 1 and type 2 diabetes; 61.9% of respondents had experienced PPH in the past week, and differences by diabetes type were not significant. More than half of the respondents reported that they knew they were experiencing PPH because they had measured their BG (64.8%) and/or because they "just didn't feel right" (51.9%). The most frequently reported reasons given for PPH were eating more fat/sugar than estimated (31.2%) and over-eating in terms of their calculated bolus insulin dose (30.4%). The most common situations/factors contributing to PPH were stress (27.4%), eating at a restaurant (24.9%), being busy (21.1%), and/or feeling tired (19.2%). The most frequent corrective actions respondents took following PPH were testing BG and taking bolus insulin based on the reading (62.0%), and/or eating less/more carefully at their next meal or snack (18.8%). Additionally, significant differences in the reasons and contributing factors given for PPH and corrective actions following PPH, as well as emotions experienced when taking bolus insulin, were found by diabetes type.
  
  
  CONCLUSIONS
  These findings shed light on how patients with diabetes experience and manage PPH on a day-to-day basis and have implications for improving diabetes self-management. Clinicians and diabetes educators should help patients address eating habits and lifestyle issues that may contribute to PPH.
  
  
  BACKGROUND
  This study was sponsored by Novo Nordisk.
authors.affiliation: The Brod Group, 219 Julia Avenue, Mill Valley, CA, 94941, USA. mbrod@thebrodgroup.net.
authors.forename: Meryl
authors.initials: M
authors.lastname: Brod
authors.affiliation: Market Access, Payer Engagement, Novo Nordisk A/S, Vandtårnsvej 114, 2860, Søborg, Denmark.
authors.forename: Annie
authors.initials: A
authors.lastname: Nikolajsen
authors.affiliation: Health Economic Outcomes Research, Novo Nordisk, Inc., 800 Scudders Mill Road, Plainsboro, NJ, USA.
authors.forename: James
authors.initials: J
authors.lastname: Weatherall
authors.affiliation: Health Outcomes Research, The Brod Group, 219 Julia Avenue, Mill Valley, CA, USA.
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Pfeiffer
keywords: Disease management; Health survey; Patient outcome assessment; Post-prandial hyperglycemia; Type 1 diabetes; Type 2 diabetes