Diabetes India

3rd Post on "When to test the PPBS?"

3rd Post on "When to test the PPBS?"


Some responses on the previous two posts on the topic ("When to test the PPBS?") made me repeat the sequence PPBS test on May 29, 2014.

My first OGTT (September 2009) indicated that BS peak occurred between 30 & 45 minutes after intake of Glucose for the test ( appropedia.org/File:GTT_Gra... ).

To confirm this I tested BS at 30, 45 & 60 minutes after intake of Glucose for the third OGTT (March 2012, appropedia.org/Diabetes_mel... ). [Second OGTT was done with 100 gm Glucose & Blood tests were done at 1 Hr, 2 Hr & 3 Hrs only by that lab.]

Based on these results only, I was telling about the time of blood sugar peaking & testing PPBS.

Then came up (rather somebody brought up) the issue of T-zero, the point from which time count is to begin for blood extraction & test. Some experts are of the opinion that time count for PPBS test must begin with the start of food intake. It was Only to clarify this SPECIFIC point the sequence PPBS test was done early this month (May 20, 2014), noting the beginning & end times of food intake. This sequence test also showed that Blood Sugar peak occurs at 45 minutes after completion of food intake, IN MY CASE.

The results from Home-glucometer on May 20, 2014 are:

| Time | Time-| BS-----|Test----|

| (min) |(min)-|(mg/dl)-|......--....|

| from--| from-|............|.....--.....|

| first---| meal-|............|......--....|

| bite---| end---|............|......--....|


| 00.0 |-15.0 | 097-----|FBS-----|

| 15.0 | 00.0 |NotDone|N A------|

| 45.0 | 30.0 | 153------|PPBS 1|

| 60.0 | 45.0 | 170------|PPBS 2|

| 90.0 | 75.0 | 154------|PPBS 3|

|120.0 |105.0| 147------|PPBS 4|

|150.0 |135.0| 117------|PPBS 5|

This has reconfirmed that for ME Blood Sugar peak occures at 45 minutes after end of meal. But then came the argument that different patients take different duration to complete food intake; more over Glucose entry into blood keeps happening during intake also and hence to eleminate the uncertain effect of intake duration on PPBS value, time count MUST start with the first bite/sip of food.

In order to throw more light on the effect of food intake duration on the PPBS value, one more sequence PPBS test was carried out on May 29, 2014. This time Blood Sugar at end-of-meal also is tested for more clarity.

The results from Home-glucometer on May 29, 2014 are:

| Time | Time| BS-----| Test----|

| (min)|(min)-|(mg/dl)|-----------|

| from | from-|---------|----------|

| first| meal---|---------|-----------|

| bite | end----|---------|-----------|


| 00.0 |-10.0 | 089------|FBS----|

| 10.0 | 00.0 | 112------|PPBS 1|

| 55.0 | 45.0 | 178------|PPBS 2|

|120.0 |110.0 | 143-----|PPBS 3|

|130.0 |120.0 | 131-----|PPBS 4|

|150.0 |140.0 | 107-----|PPBS 5|

This time also PEAK blood sugar value has occured at 45 minutes from END OF INTAKE in spite of difference in intake duration and type & quantity of food. {In previous case intake duration was 15 minutes where as this time it is 10 minutes. In previous case food was 4 Idlis, 4 spoons each of Saambaar & Cocont chutney and a Coffee with sugar, where as this time it is three Idiyappams & onion roast}.

Past experience:

Starchy food when chewed for some time gives sweetness.

Picture in my mind:

Starchy food gets partly digested by the physical action of chewing & biochemical action of saliva and the Glucose thus formed from breaking Starch enters blood stream at mouth itself.

Glucose entering blood from food path triggers Pancreas into action & Insulin begin entering blood stream.

As Glucose entry is the former event & Insulin entry the latter, latter one lags behind the former for some time. More over since (like any other physical entity) Pancreas has a capacity limit, Insulin level keeps lagging behind Glucose for a considerable duration - presumably 45 minutes (+/- delta) after completion of food intake IN MY CASE.

This is why blood sugar level keeps increasing till that time (45 mins from end of meal) & starts decreasing afterwards.

By two hours from completion of food intake, the Blood Sugar level decrease to normal level & becomes SHALLOW afterwards; this may be indicative of the temporary shutting down of Insulin production by Beta cell of Pancreas, till next food intake.

The problem of Blood Sugar level escalation in Diabetic patients may be due to the inability of Pancreas to produce sufficient Insulin in this two + delta hours to handle the Glucose input to blood from food. This information might be the basis for the stop-gap advice of splitting food intakes.

18 Replies

45 min after the end of meal if meals start-to-finish time is 15 minutes. For hard pasta the spikes will come later. Spikes can also come later for pizza with crust. To eliminate the variable of "time taken to finish the meal" it is always fist bite or start of meal, because some may finish in 10 minutes while others can take 30 minutes. The cephalic phase of digestion starts right from the moment food is smelt or tasted.




Following article gives clear picture about blood glucose variations in normal people.



Following is an elaborate interpretation of OGTT for a wide variety of cases.


Non diabetics return to around premeal levels at 120 minutes.

1 like

Hi shrisamarth,

Thank you for the link to a good paper. After reading it came up some doubts next day dawn.

In which country was this study done?

What is the general diet pattern of the volunteers?

What is the work/life style of the volunteers? (The three formulae for calculating eAG from HbA1c give three different values to eAG because the group of people from whom data was collected for developing those formulae had different characteristics!)


Since it mentions CDC, it's US. As for population breakup -- from the paper --

The 74 subjects ranged in age from 9 to 65 years old. Of them, 51 (69%) were female; 55 (74%) were non-Hispanic, Caucasian; 13 (18%) were Hispanic; 1 (1%) was African American; and 5 (7%) were other race/ethnicity. Mean A1C was 5.3 +/- 0.3

The findings were similar on Chinese population as per the paper --

Our mean sensor data were similar to those reported in healthy Chinese subjects using Medtronic's Continuous Glucose Monitoring System.

The emphasis is on the word "healthy subjects" being used and the results reported therein.

Of 148 subjects screened for the study, 39 were excluded because of low fasting glucose (n = 3), elevated fasting glucose (n = 16), elevated 2-h glucose (n = 5), positive antibodies (n = 8), ineligible BMI (n = 3), ineligible A1C (n = 1), or insufficient sensor data (n = 3).

I don't think there's any computation of eAG from A1C as it is a study with CGM and they did their own relational analysis following least square method to study relation between A1C, FBS, PPBS.

Point to note:

Sensor glucose concentrations were 71–120 mg/dl for 91% of the day. Sensor values were ≤60 or >140 mg/dl for only 0.2% and 0.4% of the day, respectively. So, they spiked above 140 only for 5.76 minutes during the entire day.


Dear Sir,

After taking LMWDR for 15 days my readings are as below:

FBS: 113


I check on accu-check meter. Before starting LMWDR my are FBS:125-135. PPBS: 165-180

Also I used to suffer from constipation. Now the bowel movement is very free. I am not taking any coffee or tea, not taking any sweet containing food or starch food in between. For me it sees there is lot of improvement. Yesterday I checked BS after 30 min of mt first bite of lunch. My lunch was rice(Single polish, semi brown) along with Spinach dal (red gram) and veg curry and curd in rice finally. After 30 min my meter shows 181 and after 1 hour it was 145.

I am taking more quantity of LMWDR. I consumed 5 kilos for 17 days. It comes to approximately 150 grams per serve. My weight is 54 KGS and height is 5.4. My energy levels are good with this quantity. I feel so hungry in between if I take lesser quantityy of LMWDR.

Please let me know in case I need to reduce the quantity of LMWDR. In between I am not eating or drinking anything as you advised except water.

I have been walking regularly briskly for 1 hour. ( I do exercise for the past 15 year). I am now 39 years old, vegetarian.

Please advise.




High fiber and protein content in LW helps in reducing BS. 300gm carbs by way of wheat is very high carb quantity. But since your BS levels have reduced, you need to monitor BS levels regularly whether the LW is consistently giving the same results.

BTW which medications you are taking?


Sir, Thank you for your reply,

Yesterday I went for my blood test after three of using LWMDR.

My readings are as below:

Fasting-105(It was 127 before starting LWMDR)

PPBS: 117(It was 153 before starting LWMDR)- 2 hrs fromm start of my Lunch.

HBA1C: 6.0(It was 6.4 before starting LWMDR)

My lunch full of rice dal and beans curry, curd.

I am o thank youful for you for suggesting LWMDR.

It looks I am on track now and will continue LWMDR with full confidence.

For diabetes I am not suing any homeo medicine i specific, but for any health issue we use homeo medicine only.




Hi Hanu,

Thank you for the response. Glad to hear the progress. Please do not discontinue LWMDR midway like many others THINKING that you are cured. WE CAN ESTABLISH CURE BY GLOBALLY ACCEPTED & W H O APPROVED lab tests relied up on by modern science.

Wish you a speedy cure.


AxEffect: Please correct my following perception: Except fot GTT, two hour PP are used and there standards are known for that. Out here, BS has been taken at more intervals. In other words, which authority you may be citing when you wrote:Peaks of 170/180 are not non-diabetic behavior?


My GTT spiked to 229 at 1 hr and i returned to 102 at 2 hrs.

Am I cured? Or am I non diabetic? My answer to both is a BIGG NO!

I have posted mine and my wife's GTT response in other thread yesterday. Per my understanding, even my wife is on road to be a diabetic though her levels at 1 hr were lower than at 30 minutes so she has her first-stage insulin response working still though not to same level as that of a healthy individual. I have put her on same diet as me. If not, then she is a fit case to be a diabetic in around 4-5 years time.

Wife is close to curve 1b at following URL, which means that certain amount of beta cells are already dysfunctional.


She is a hypothyroid patient also so not sure if that could be one of the reasons for the GTT response that i got for her. Doctors wanted her to be on 100mcg eltroxin but i put her on 25mcg and her TSH/T3/T4/FT3/FT4 levels are normal at 1/4rth the dose recommended by so called experts. Cannot find Armour here in India else would have put her on that instead of eltroxin.


In your wife's case, I would say some beta cell dysfunction or IR is going on. I am also cautious about my wife as both her parents are diabetic.

Eight years back my levels were 92-129. These levels though not diabetic but is warning that you may have trouble in future


Yes, as i said, "Better be safe than sorry". She has beta cell dysfunction for sure. IR i doubt as post meal she is returning to near normal values. There's a problem with first-stage response for sure. If she goes by ADA standards then she will be diabetic in approximately 5 years time. I made sure that she doesn't look at ADA nonsense!


More on Peaks at 1 hour:


Those who love ADA will not like what is written there. She writes --

ADA's blood sugar targets are high enough to permit complications to develop.


AxEffect: OK let us say Shooter George has Pre-diabetic or IGT tendencies with HBA1C scores of non diabetic person. He was diabetic a few years ago. BTW you are aware that Diabetes UK suggests score of 6.5% as excellent for non hypo and 7.5% for patients inclined to hypoglycemia. MedIndia calles scores up to 8 as excellent control and early 8's as good. When I get on to my other laptop, I will inbox you a report from a US organisation that gives incidence of dreaded diabets outcomes like sight loss, organ damage and amputation at < 2.5% with average blood glucose of 205. efar52@gmail.com


AxEffect I copy paste a relevant portion: In subjects without diabetes, blood glucose levels typically peak approximately 1 hour after the start of a meal and return to preprandial levels within 2 to 3 hours; 2-hour postprandial blood glucose levels rarely exceed 140 mg/dL.


AxEffect Yes I have checked. Thanks. Though my next Lipid is due on July 15, I perhaps will get one sooner. Once earlier, about five years ago my Triglycerides were four times normal limit. Last was 151...


I have added cheese and butter..


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