The physical examination results for our residents came out a few days ago. While interpreting the reports at the outpatient clinic, Dr. Wu noticed a particularly important, widespread, and seriously mistaken issue. Moreover, I was shocked to hear from patients that some doctors claim it’s sufficient to manage fasting blood glucose alone. What exactly is going on?

As many of you may know, I focus on diabetes management and treatment. So, the first thing I did after reviewing the reports was to check everyone’s blood biochemistry results. To my astonishment, at least 4 to 5 out of 10 individuals were diabetic, and among them, at least 1 to 2 had already developed complications—such as myocardial infarction requiring cardiac stents or cerebral infarction leading to hemiplegia. In short, blood glucose control was far from adequate.

But that’s not the key issue. The critical point is that when I asked these diabetic patients about their postprandial blood glucose levels, over 95% of the residents said they didn’t know, had never measured it, and only checked their fasting levels. Their doctors had never advised them to monitor postprandial glucose, so they were completely unaware of its importance. Dr. Wu was truly taken aback.

Friends, for most Chinese individuals, abnormal blood glucose typically manifests first as elevated postprandial levels, with fasting levels rising gradually only after several years. Moreover, postprandial blood glucose is closely linked to cardiovascular health. How can we overlook its monitoring?

It might be forgivable if the general public is unaware, but it’s unacceptable for some doctors to remain uninformed. To say they are endangering lives for profit would not be an exaggeration.

For individuals with prediabetes, timely detection of abnormal postprandial blood glucose and proactive adjustments could completely prevent progression to full-blown diabetes. Unfortunately, due to a lack of knowledge and inadequate education from local doctors, many miss the optimal window for intervention. By the time elevated fasting blood glucose is detected, postprandial levels may have been high for years, pushing them firmly into the diabetic category.

For those already diagnosed with diabetes, neglecting postprandial blood glucose monitoring can lead to severe complications without understanding the cause. Some may even believe their blood glucose is well-controlled, resulting in irreversible harm to their health—a situation none of us want to see.

Let me share a story about a resident in our community. He was a senior engineer with a high pension and a comfortable family situation. After retirement, he often traveled with friends to relax and enjoy life. As he put it, he wanted to make the most of his golden years and live a high-quality life.

He took his health seriously, regularly monitoring his blood pressure, lipids, and blood glucose. One evening after dinner, while out for a walk, he suddenly felt dizzy, unsteady on his feet, and began leaning uncontrollably to one side. He quickly suspected a cerebral infarction and, with his family’s help, rushed to the hospital. Fortunately, timely treatment saved his life, but he was left with sequelae—paralysis on the entire right side of his body, largely losing the ability to care for himself. His children, busy with work, had to hire a full-time caregiver. Thankfully, his financial situation allowed for this. For an average family, children would have to take leave to care for their elderly parent, placing a significant burden on them.

Some might say, "If that were me, I’d rather not be treated or live on." Dr. Wu believes such statements are meaningless and unhelpful, changing nothing. It’s far more meaningful to focus on learning about health and how to minimize the risk of major illnesses.

After being discharged, the patient was deeply troubled, unable to understand how he could have suffered a cerebral infarction when all his indicators seemed normal. I advised him to monitor his postprandial blood glucose, and each reading was above 12 mmol/L, fluctuating unpredictably and posing significant risks to his blood vessels and nerves. It had never occurred to him that abnormal postprandial blood glucose could trigger a cerebral infarction, yet this was a major factor behind his complication.

Through this patient’s story, I hope our residents will remember two key points. What I’m about to say is crucial—take note!

1. Blood glucose monitoring must be comprehensive. It’s not enough for fasting levels to be normal; postprandial blood glucose is equally important and should not be overlooked. This includes monitoring after breakfast, lunch, and dinner—at least four times a day.

2. Postprandial blood glucose refers to the measurement taken two hours after the first bite of a meal. For example, if you eat at 12 PM, measure at 2 PM.