Type 2 on Insulin

Monnier’s study

When you have diabetes, your sugars are high.  They are high after meals, in between meals, before meals, during the night.  They are high ALL the time.

You take the average of all of those sugars and you get an A1c.

But, what is the contribution to the A1c from these times?  Does the ‘during the night time’ contribute more to the A1c than after meals? Or is it the opposite?  Does it really matter?

Well, there is a pattern that we can learn and it starts with an A1c of 8.5. 

If your A1c is under 8.5, the majority of the contribution is from after meals.

If your A1c is over 8.5, the majority of the contribution is from in between meals and during the night.

Does this really matter?  Well, yes, if your A1c is 8.2, you and your doctor need to focus on lifestyle changes or medication changes that will lower the sugars after your meals.  If the focus of the medication is during the night time, then it won’t make that much of a difference. 

This is where GLP-1s , SGLT-2s, and meal time insulin come in handy if the A1c is under 8.5 as these medications lower sugars after the meals. 

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