IF ONE IS LOOKING FOR HIGHEST VALUE OF BLOOD SUGAR, ONE MUST TEST BLOOD AT 45 MINUTES AFTER COMPLETION OF A FOOD INTAKE.
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.