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After-Meal Highs: Immediate Problems

For example, research in Australia showed how post-meal glucose excursions affect childrens’ day to day performance. In this study, several hundred parents were interviewed to identify aspects of their children’s lives that changed when glucose exceeded 15 mmol/l, or 270 mg/dl. Parents reported a deleterious effect on physical, cognitive and emotional performance at these states of hyperglycemia.


Australian Study* of Children with Type 1 diabetes. Parents & children reported BG > 270 had negative impact on:


Thinking (68%)

Mood/Emotions (75%)

Coordination (53%)

J Pediatr Endocrinol Metab.  2006 Jul;19(7); 927-36


Similar research on adults in the the US and UK found a correlation between post-meal hyperglycemia and several performance-related outcomes, including the ability to think clearly, state of worry, ability to interact on a social level, energy levels, and performance at work.


1200 T1 & T2 insulin users in the US & UK surveyed.

  Frequency and severity of post-meal hyperglycemic events negatively affects:


Thinking and Concentration


Social Interactions

Energy Level

Work Activities

Heller et al. Towards a better understanding of postprandial hyperglycemic episodes in people with diabetes: impact on daily functioning.  Current Medical Research and Opinion.  ISSN: 0300-7995; 1473-4877. 2018.

Long-Term Problems

From a long-term standpoint, it has been shown that postprandial glucose levels influence A1c – particularly A1c levels below 7.5. Focusing solely on fasting and premeal glucose levels may limit a person’s ability to achieve A1c levels recommended by the American Diabetes Association. In fact, achieving an A1c of 7% or less hinges largely on one’s ability to manage post-meal glucose levels.

Long-Term Problems (cont'd.)

Research conducted years ago showed that the first signs of kidney disease begin to appear much earlier in people with postprandial hyperglycemia.  The higher the postprandial glucose, the more rapid the onset of proteinuria.


52 People with type 1 diabetes, similar BP between groups

Post-prandial glucose


Time to onset of proteinuria

Persistent <200


23 yrs

Intermittent >200


19 yrs

Persistent > 200

201 +

14 yrs

People with type 2 diabetes, starting on oral medications

For those who use oral medications to manage their glucose levels, those who use medications specifically designed to control post-meal glucose maintained healthy cognitive function, while those who used meds designed to control pre-meal glucose levels saw deterioration in cognitive function. 


             Meds to limit post-meal rise

Meds to control pre-meal BGs

          HbA1c reduction



Fasting BG



            Cognitive Function



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