"Doctor, my fasting blood glucose is normal—so why did I still develop diabetic complications?"

In the clinic, many diabetes patients have this confusion. They strictly monitor their morning fasting blood glucose but neglect another potentially more dangerous indicator—postprandial blood glucose.

Today, we'll uncover this mystery: which type of blood glucose is more likely to cause complications? And how should we effectively control it?

Fasting blood glucose vs. postprandial blood glucose: which is more dangerous?

Fasting blood glucose—like a calm lake surface, reflecting basal metabolic state

Fasting blood glucose refers to the blood glucose value after 8–10 hours of fasting, with a normal range of 3.9–6.1 mmol/L. It mainly reflects hepatic glucose output and basal insulin secretion capacity, and is an important indicator for diagnosing diabetes.

Postprandial blood glucose — fluctuating like tides, concealing health risks

Postprandial blood glucose usually refers to the blood glucose value 2 hours after eating and should normally be below 7.8 mmol/L. It directly reflects the body’s ability to handle a glucose load and is a key indicator for assessing the quality of glycemic control.

Medical research indicates that abnormal elevations in postprandial blood glucose are more closely associated with the risk of diabetic complications. The reasons include:

Large amplitude of glucose fluctuations: the rapid rises and falls in postprandial blood glucose cause repeated damage to vascular endothelial cells

Long duration: during the day, we are in a postprandial state for about 16 hours, so postprandial glucose affects us for a longer time

“Invisible” harm: many people have normal fasting glucose but neglect postprandial hyperglycemia, delaying the timing of intervention

Why is postprandial blood glucose the “silent killer”?

Imagine your blood vessels are like the bed of a river. When fasting glucose is normal, the river flows gently; when postprandial glucose soars, it is like a sudden surge of waves continuously striking and eroding the riverbanks.

This “wave effect” can lead to:

Microvascular complications: retinopathy, nephropathy, neuropathy

Macrovascular complications: coronary heart disease, stroke, peripheral vascular disease

Accelerated atherosclerosis: glycemic variability promotes inflammatory responses and damages the vascular wall

The International Diabetes Federation states that controlling postprandial glucose can significantly reduce cardiovascular disease risk and is crucial for preventing complications.

A twofold defense: how to scientifically control both types of blood glucose?

1. Fundamental strategies for controlling fasting blood glucose

Regular daily routine: Maintain consistent sleeping and waking times; avoid staying up late

Appropriate dinner: Dinner should not be too late or overly heavy; avoid high-fat and high-protein meals

Moderate morning exercise: Moderate morning exercise helps lower fasting blood glucose

Medication adjustment: Under physician guidance, it may be necessary to adjust nighttime or long-acting insulin doses

2. Key measures to tame postprandial blood glucose

Dietary wisdom

Choose low glycemic index foods: oats, brown rice, legumes

Control total carbohydrates: keep staple food at each meal no larger than the size of your fist

Adjust eating order: eat vegetables first, then protein, and staple foods last

Chew slowly and eat slowly: lengthen meal time, slow down sugar absorption

Postprandial exercise

Engage in light activity 30–60 minutes after meals, such as walking for 15–20 minutes

Avoid sitting or lying down immediately after a meal

Separate meals

Divide three meals into five to six small meals to reduce the glucose load per occasion

Medication selection

Discuss with your physician about using medications that specifically target postprandial glucose control, such as α-glucosidase inhibitors, rapid-acting insulin, etc.

3. Monitoring and management: your personal blood glucose profile

Comprehensive monitoring: Do not only measure fasting glucose; regularly check 2-hour postprandial glucose.

Dynamic observation: Use continuous glucose monitoring (if available) to understand blood glucose fluctuations throughout the day.

Record and analyze: Log diet, exercise, and glucose values to identify individual patterns

Regular follow-up: check glycated hemoglobin every 3–6 months to assess long-term control

Special reminder: these populations need to pay more attention to postprandial blood glucose

Those with normal fasting glucose but elevated glycated hemoglobin

Diabetic patients with existing cardiovascular disease risk

Elderly patients with diabetes

Patients with gestational diabetes

Conclusion

Fasting blood glucose and postprandial blood glucose are like a person's two legs; a problem with either will affect healthy walking. And postprandial blood glucose, this "silent killer," requires us to be especially vigilant.

Diabetes management is not a fight against a single number, but an overall optimization of lifestyle. Through scientific diet, appropriate exercise, regular monitoring, and taking medications as prescribed, we can fully build a solid defense to delay or even prevent the onset of complications.

Remember, controlling blood glucose is not to please the glucose meter, but to take good care of every blood vessel and every organ in your body. From today onward, pay attention to your postprandial blood glucose to win a higher quality of life for yourself.