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A physician-patient’s perspective on lowering glycemic variability – Part I: The role of meal timing

Elsamma Chacko* & Christine Signore

A physician with a 19-year history of type 2 diabetes and impaired awareness of hypoglycemia sought to lower the hypoglycemia risk using continuous glucose monitoring to optimize the medications-meals-exercise triad. As part of the lifestyle modification the patient found distributing daily carbohydrate consumption skewed toward the morning, when physical activity is relatively high, lowered glycemic variability. She also found that the second meal could be the biggest meal of the day.