What Causes Sharp Fall In Glucose Levels After Meals In A Diabetic?

Posted on Wed, 12 Aug 2015

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Wed, 12 Aug 2015 Answered on

Tue, 1 Sep 2015 Last reviewed on

Question : Was diagnosed two weeks ago as Diabetic with a finger prick of 344. Put on metoformin 500 mg once daily. Blood sugar has not gone over 191 and as low as 91 since. It is highest in the am )170-185) and tapers during the day. I ate grilled chicen and a salad for lunch and it went from 131 pre meal to 108 2 hours later. It drops when I eat and I feel like crap for some reason. I have not had an ac1 or tolerance test just the finger prick. I have changed my diet , tapering off of the bourbon, and have eaten only fruits veggies and some fish and chicken since. I have dropped over 9 pournd already. How long for metformin to take full effect/should I have kidney and pancreas test/are the doctors missing something ?? The dropping is mysterious to me. Thanks so much in advance. XXXXXXX

Answered by Dr. Shehzad Topiwala (5 hours later)

Brief Answer:
Diabetes

Detailed Answer:
I follow what you are saying.

What you are describing is fairly common. This typically occurs in early type 2 diabetes. There is a tendency to have a sharp fall in the blood glucose levels after meals due to a robust insulin response of the body after a meal.

So do not worry about it. It is complex scientific phenomenon to understand.

I see you are making significant lifestyle changes and it appears to be effective in lowering your glucose levels in addition to the metformin. This is good.

However, you need a comprehensive diabetes care program preferably under the guidance of an endocrinologist who will help you potentially reverse this condition to normal.

When I see someone like you in my practice, I order the following tests in addition to a thorough physical examination:

1 CBC
2 CMP
3 HbA1c
4 Urine Albumin to creatinine ratio
5 TSH
6 Lipid panel

I have the individual see a dietitian to learn about healthy eating, and encourage increased physical activity. Weight loss of 5 to 7 % is aimed for if the person is overweight/obese.
It is important to see an eye doctor to get the back of the eye checked (retina) for the effects of diabetes.

Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.

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