Q. I am a 58-year-old woman who has had type 2 diabetes for two years. I am a vegetarian and walk regularly after meals. Last year, my doctor put me on metformin, which lowered my HbA1c (a measure of blood sugar control over the previous two to three months) from 9.4% to 6.4%. Now I have a peculiar problem: My blood sugar is normal an hour after eating but seems to rise to 130 to 140 mg/dl an hour later before coming back down. I have searched the internet for answers and remain mystified. My doctor doesn’t seem concerned, but I was hoping you could shed some light on this.
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A. First of all, congrats on getting your HbA1c into a healthy range. Exercise and a nutritious diet remain the cornerstones of diabetes management. The delayed blood sugar rise you’re seeing two hours after meals could actually be a direct result of your healthy lifestyle. Foods that are rich in fiber and slowly digesting (low-glycemic-index) carbs, such as legumes, dairy products and fresh vegetables, tend to cause a gradual/delayed rise in blood sugar. Instead of seeing a rapid spike, your blood sugar rises modestly a few hours after you eat. Exercising right after eating can also contribute to a delayed blood sugar rise. During physical activity, blood flow to the stomach and intestines is reduced. Nutrients, including sugar, absorb into the bloodstream more slowly. The combination of slowly digesting food and physical activity is likely what is pushing your post-meal blood sugar rise back to the two-hour point. As your doctor indicated, since your blood sugar is not peaking excessively high and returns to normal soon afterward, you probably don’t need to worry about it.
Want to learn more about managing after-meal blood sugar levels? Read “Strike the Spike II,” “Dealing With After-Meal Blood Sugar Spikes? Don’t Skip Breakfast,” “Managing Your Blood Glucose Ups and Downs” and “How to Lower Blood Sugar? Take a 10-Minute Walk After Meals, Study Says.”