Beyond “Eat to Your Meter” For Better Blood Sugar Control

“Eat to Your Meter” is an established method used by those with type 2 diabetes or pre-diabetes to find out how different foods affect their blood sugar.  In its common application, “eat to your meter” requires taking one’s blood sugar before a meal, and then two hours after beginning to eat the meal. Some methods also test blood sugar again 4 hours after the meal. By comparing the blood sugar result two hours after a meal to what it was before beginning to eat, we can determine how much blood sugar rose as a result of what we ate. Likewise, if we also test blood sugar again at 4 hours, we can see whether our blood sugar came back down to what it was before the meal, and if not, now much it was still elevated by. In it’s usual application, eating to our meter enables us to determine how much a particular meal affects our blood sugar.

If for example, our blood sugar was 5.0 mmol/L (90 mg/dl) before we ate and 11.0 mmol/L (198 mg/dl) afterwards, we know it went up by 6.0 mmol/L (108 mg/dl) due to what we ate.

Let’s say another time our starting blood sugar is 7.0 mmol/L (126 mg/dl) before we eat and then also goes up to 11.0 mmol/L (198 mg/dl) afterwards, we can determine that it only went up by 4.0 mmol/L (72 mg/dl) as a result of what we ate.

When we compare these two meals, it can be seen that even though both times our blood sugar went up to 11.0 mmol/L (198 mg/dl) the second meal caused a smaller rise at 2 hours. That is, blood sugar started off higher, meaning it didn’t rise as much.

“Eat to Your Meter” is a simple way for people to know how much a specific meal affects their blood sugar, but the same method can be used for individualizing people’s diet!

If you’ve been following me for a while, then you know that the order we eat components of our meal (carbohydrate-based food, protein foods and low carb vegetables) has a significant effect on how much our blood sugar will rise when eating a meal. So will how much the carbohydrate-containing food is ground (an apple compared to apple sauce, for example). Something as simple as when in the meal we eat the carbohydrate-containing can have a significant effect on blood sugar afterwards! You can read more about both of these in a previous the two-part article titled The Perils of Food Processing.

Also as briefly mentioned in an earlier article, how our body handles carbohydrate-based foods eaten in the morning is significantly different than how it is able to handle carbohydrate-based foods in the afternoon or evening [1-3]. This means that our blood sugar response to carbohydrate-containing food (not only grains but including fruit, milk or below-ground vegetables) eaten at breakfast in the morning will be different than if eaten later in the day and knowing this in theory and seeing it in real life when we “eat to our meter” can be very helpful in planning whether “breakfast for dinner” is a good idea!

Eating to Your Meter in Pre-Diabetes

A glucometer (blood sugar meter) can also be a very helpful tool for those who have been told they are “pre-diabetic”. Someone who is pre-diabetic might have higher than normal fasting blood sugar (called Dawn Phenomena) and “eating to your meter” will enable them to see which foods eaten at supper results in a morning spike, and which don’t.

Beyond the Usual – when blood sugar tests are “normal”

“Eating to your meter” also has a helpful application for those who have been told their blood sugar results are “normal”.

As I covered in detail in this previous article titled “When Normal Fasting Blood Glucose Results Aren’t Necessarily “Fine”, fasting a blood glucose test coming back “normal” doesn’t necessarily mean that blood sugar response is optimal and the reason is simple. We don’t know what happens to blood sugar between 30 minutes and 60 minutes after they eat carbohydrate-containing food.  

As discussed in the above linked article, a standard 2-hour Oral Glucose Tolerance Test (OGTT) will “miss” spikes at 30- or 60 minutes because it is not being tested for. Not testing for it does not mean there isn’t a possible reason for concern, only that we don’t know. Abnormal spikes at 30 or 60 minutes after eating a standardized carbohydrate (glucose) load indicates increased risk of developing type 2 diabetes, even when fasting blood sugar and 2 hours after a meal (called post-prandial) blood sugar is completely normal [4,5].  A simulation can be done using an established glucose load and an ordinary glucometer which enables one to see whether there are spikes occurring at 30- or 60 minutes. This can go a long way to helping people understand their risk, even when standard blood tests are still normal.

NOTE: Such a simulation is NOT a substitute for an Oral Glucose Tolerance Test, with extra glucose assessors at 30 minutes or 1 hour. A simulation can provide some indication of whether additional lab testing would be helpful.

If after a standard glucose load, people experience a blood sugar spike higher than 7.0 mmol/L (126 mg/ml) at 30 minutes or 6.5 mmol/L (117 mg/dl) at 60 minutes, or a delayed peak later than 30 minutes they can know based on current research [5] that they already have an early indication of insulin resistance and hyperinsulinemia (insulin levels being too high).  As well, current literature [4] indicates that a 1- hour post prandial blood sugar spike > 8.6 mmol/L (155 mg/dl) is a better predictor of risk of developing diabetes, cardiovascular disease or of dying than a 2 hour post prandial level of > 7.8 mmol/L (141 mg/dl).

Using an ordinary glucometer and an established glucose load can enable people to know whether their blood sugar level at 30- or 60 minutes may indicate a possible concern, enabling them to make changes in how they eat long before their blood sugar is flagged as abnormal.

Final thoughts…

“Eat to Your Meter” in it’s simplest application can be a very helpful method for those diagnosed with pre-diabetes or type 2 diabetes to determine which foods or meals spike their blood sugar. As significantly, use of a glucometer with a standard glucose load can enable those with totally normal lab results to know if they have early indications of being at risk.

More Info?

If you would like more information about how I can help you to lower your risk of developing type 2 diabetes or to help you lower your blood sugar readings, please have a look under the Services tab or in the Shop for more information on the packages I offer. If you have service-related questions, please feel free to send me a note using the Contact Me form above, and I will reply as soon as I can.

To your good health!

Joy

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References

  1. Bo S, Fadda M, Castiglione A, et al. Is the timing of caloric intake associated with variation in diet-induced thermogenesis and in the metabolic
    pattern? A randomized cross-over study. Int J Obes 2015;39:1689–1695
  2. Jakubowicz D, BarneaM, Wainstein J, Froy O. High caloric intake at breakfast vs. dinner differentially influences weight loss of overweight and obese women. Obesity (Silver Spring) 2013; 21:2504–2512
  3. Morgan LM, Shi JW, Hampton SM, Frost G. Effect of meal timing and glycaemic index on glucose control and insulin secretion in healthy volunteers. Br J Nutr 2012;108:1286–1291
  4. Manan PareekDeepak L. Bhatt, et al, Enhanced Predictive Capability of a 1-Hour Oral Glucose Tolerance Test: A Prospective Population-Based Cohort Study,
  5. Hulman A, Vistisen D, Glumer C et al, Glucose patterns during an oral glucose tolerance test and associations with future diabetes, cardiovascular disease and all-cause mortality rate, Diabetologia; 2018;61(1), pp 101-107, https://doi.org/10.1007/s00125-017-4468-z
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