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Why My Fasting Blood Sugar Is More Than Postprandial Blood Sugar?

Posted on Sat, 4 Jan 2014

Question: After one month of medication: 25 tab of Glycomet 500 SR and 25 Tab of Tonac TG. I did recheck up of blood Fasting blood sugar: 132.2, Postprandial blood sugar: 119.6; Lipid profile: Total Cholesterol: 185 Tryglycerides: 109 HDL Cholesterol: 116.2 VLDL: 21.8 CHOL:HDL ratio: 3.9 Looks like Lipid profile normal now. Not sure about sugar 1. Could you please suggest me should i need to continue medicine any more?? 2. Why my fasting sugar is more than postprandial blood sugar? How this is can happen? Is this a mistake of test?? Please give you guidance??

Answered by Dr. Dr. Prasad J (21 hours later)

Brief Answer: Yes, you might need treatment alteration... Detailed Answer: Hi, Fasting blood sugar (FBS) in most cases is lower than post prandial sugar (PPBS). But there are certain set of events associated with diabetes that explains FBS lower than PPBS. Briefly, there are a group of hormones that raise blood sugar of body. These hormones are actively secreted early morning or when a person develops low blood sugar. The release stops as one takes food. A normal individual with normal insulin activity is able to balance the effects of opposing hormones. In your case, the fasting blood sugar is high either due to low blood sugar during the night and / or unopposed action of early morning sugar release hormones. As you take food, these counter regularly hormones secretion is reduced and sugar level falls. Off course, I recommend that you test again to rule out laboratory errors before confirming this theory. This problem can be corrected by modifying your treatment. You are on slow release once a day medication which are mostly unable to control early morning sugar rise and may be over correcting sugar later during the day. This off-course is a presumption. I would recommend you check your sugar before dinner and 2 hours after dinner. Consult a diabetologist / endocrinologist for appropriate medications. Hope this helps. You are free to ask for clarifications. Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Prasad J (1 hour later)

Hello, What to do with cholesterol? Should i stop medicine?? As looks like the report is normal. As you have mentioned "I would recommend you check your sugar before dinner and 2 hours after dinner. Consult a diabetologist / endocrinologist for appropriate medications." But this would not be with full fasting if i do the test on this kind of timing. Don't you think the FBS and PPBS would not be correct. Or do i need to do same test again with same timing as i did earlier. Thanks, XXXX

Answered by Dr. Dr. Prasad J (1 hour later)

Brief Answer: Continue tonact tg... Detailed Answer: Dear XXXX, Your cholesterol numbers look better than what it was earlier. I would continue tonact tg and encourage you to be active with exercise and weight management. Lipid lowering drug need to be stopped if you experience muscle pains, nausea, abdominal pain or any other unusual symptoms. As you have not reported those, it is better that you continue with Tonact TG. As far as blood sugar is concerned, if you do not have a blood glucose meter (glucometer) at home, you need not get the sugar checked at night. Visit a diabetologist / endocrinologist and get your medications altered. I feel you will benefit with twice a day tablets instead of slow release tablets (as the one you are now). Hope this helps. Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Prasad J (2 days later)

Dear Dr, I am wondering as my cholesterol level is normal but why do i need to continue the tonact tg again? I don't have buy a glucometer if you want to do the night checkup as you had mentioned earlier. Just wanted to know exactly do i need to change the checkup order. As i do the test before dinner how this would be fasting testing. Or do i need to maintain any gap? Could you please suggest me good glucometer to buy? Are you meaning two tab per day is needed for me? What will be the power of the tab? For your information health wise currently i am not feeling any issue. But still do it really needed any medicine? Thanks, XXXX

Answered by Dr. Dr. Prasad J (9 hours later)

Brief Answer: Consult a diabetologist... Detailed Answer: Dear XXXX, As you see your fasting blood sugar is still high, it seems your once a day sustained release tablet isn't able to control early morning blood sugar. Therefore I opined you will be better off with twice a day medication. Please consult a diabetologist who will start a new treatment regime. If you do not have a glucometer at home, you need not buy one. We recommend glucose monitoring at home when blood sugars are not in control. Testing blood sugar before dinner and after dinner (without previous fasting) will allow us know how your blood sugar is behaving at night. At this instance you might skip night sugar monitoring; but consult a diabetologist for change of medications. As far as Tonact Tg is concerned, your cholesterol level are in check because of medication. Odds are not in favour to stop the drug. Continue with it. Practice a healthy life style and keep your cholesterol levels checked every 6 months. I would consider reducing/stopping Tonact if cholesterol number remain stable for 2-3 years. Hope this helps. Regards

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar