The medication for diabetes should be taken before what time of dinner or lunch and how does the same work? Is the idea to control the diabetes during the peaking time after food? For how long is the peaking time after which it blood sugar level comes down? Kindly answer this for my clarity.

Dr. Prabhakar Laxman JatharEndocrinologist46yrs exp

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Drugs like glimepiride, gliclazide, glinides etc are given before food about 30 to 40 minute earlier. Because they stimulate insulin secretion. So when food reached the gut, adequate insulin should be available. Metformin is usually given after food as in some taking it before food may cause gastrointestinal symptoms. But in combination mostly it is given before food. Voglibose and acarbose are given with food as they inhibit enzymes which convert disaccharides to glucose and delay the absorption. This dosing time is not related anything else. Usually after food it takes about 2 to 3 hours for glucose levels to come down. After about 8 to 10 hours glucose level is lowest. 

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