What should I do if my blood sugar is higher than 7.8 after a meal?

Long-term postprandial hyperglycemia will continuously aggravate insulin resistance and pancreatic B cell secretion defects, damage large blood vessels and microvessels, and is a major independent risk factor leading to cardiovascular and cerebrovascular complications of diabetes. So how should people with diabetes manage postprandial blood sugar?

Postprandial hyperglycemia is common among Chinese people

Patients with type 2 diabetes and abnormal glucose tolerance often have postprandial endogenous glucose and food impairment due to reduced early-phase insulin release, weakened inhibition of postprandial glucagon secretion, increased hepatic glycogenolysis and hepatic and renal gluconeogenesis. The release of medium sugar is increased, which is manifested by excessive elevation of blood sugar after meals and lasting for a long time.

Countermeasures for high blood sugar after meals

First make lifestyle adjustments: Controlling postprandial hyperglycemia first requires lifestyle adjustments, including dietary intervention, physical activity and weight control, which are still the cornerstones of diabetes control.

Add drug treatment when necessary: After non-drug treatment, patients who are still unsatisfied with postprandial blood sugar control should add drug treatment in a timely manner. Commonly used drugs to lower postprandial blood sugar include the following:

Alpha-glycosidase inhibitors, including acarbose and voglibose. This type of drug lowers postprandial blood sugar by inhibiting the absorption of carbohydrates in the small intestine. It is suitable for patients with carbohydrates as the main food component and patients with elevated blood sugar after meals. Common adverse reactions of α-glycosidase inhibitors are gastrointestinal reactions, such as flatulence and occasionally diarrhea. This drug has no systemic toxic or adverse reactions, but it should be used with caution in patients with severe liver and kidney dysfunction. It should not be used in patients with chronic gastrointestinal dysfunction who have obvious digestive and absorption disorders. Use of this type of drug alone will not cause hypoglycemia, but if used in combination with sulfonylureas, metformin or insulin, hypoglycemia may still occur. Once this occurs, glucose, milk or honey needs to be directly applied, and the effect of eating sucrose or starchy foods is Poor.

Among the meglinide drugs currently on the market in China are repaglinide and nateglinide. It is a non-sulfonylurea insulin secretagogue. It can effectively reduce postprandial blood sugar by stimulating the early secretion of insulin. It has the characteristics of rapid absorption, rapid onset of action and short action time. This type of drug can be used alone or in combination with other hypoglycemic drugs (except sulfonylureas). The main adverse reaction is hypoglycemia, but it is generally mild and is easier to correct after giving carbohydrates. This type of medicine is contraindicated in patients with obvious liver and kidney damage.

Insulin and insulin therapy are important means of controlling hyperglycemia. Patients with type 2 diabetes should initiate insulin treatment in a timely manner when oral medications are ineffective or there are contraindications to the use of oral medications. Rapid-acting insulin analogs have the characteristics of rapid absorption, rapid peaking, and rapid return to basal state, and can better control postprandial hyperglycemia.

Other new drugs, such as amylin analogs, glucagon-like peptide-1 (GLP-1) derivatives, etc.

During the physical examination, we only measured fasting blood sugar and not postprandial blood sugar, resulting in many impaired glucose tolerance being undiagnosed. For diabetic patients, postprandial blood sugar is also more difficult to control. If postprandial blood sugar fluctuates greatly, , you can seek medical advice.