Why Your “Normal” Blood Sugar Isn’t Normal (Part 2) | Chris Kresser
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Why Your “Normal” Blood Sugar Isn’t Normal (Part 2)

by Chris Kresser

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In the last article I explained the three primary markers we use to track blood sugar: fasting blood glucose (FBG), oral glucose tolerance test (OGTT) and hemoglobin A1c (A1c). We also looked at what the medical establishment considers as “normal” for these markers. The table below summarizes those values.

Marker Normal Pre-diabetes Diabetes
Fasting blood glucose (mg/dL) <99 100-125 >126
OGGT / post-meal (mg/dL after 2 hours) <140 140-199 >200
Hemoglobin A1c (%) <6 6-6.4 >6.4

In this article, we’re going to look at just how “normal” those normal levels are – according to the scientific literature. We’ll also consider which of these three markers is most important in preventing diabesity, diabetes, and cardiovascular disease. But before we do that, I’d like to make an important point: context is everything.

In my work with patients, I never use any single marker alone to determine whether someone has a blood sugar issue. I run a full blood panel that includes fasting glucose, A1c, fructosamine, uric acid and triglycerides (along with other lipids), and I also have them do post-meal testing at home over a period of 3 days with a range of foods.

If they have a few post-meal spikes and all other markers or normal, I’m not concerned. If their fasting BG, A1c and fructosamine are all elevated, and they’re having spikes, then I’m concerned and I will investigate further.

On a similar note, I’ve written that A1c is not a reliable marker for individuals because of context: there are many non-blood sugar-related conditions that can make A1c appear high or low. So if someone is normal on all of the other blood sugar markers, but has high A1c, I’m usually not concerned.

With all of that said, let’s take a look at some of the research.

Fasting Blood Sugar

According to continuous glucose monitoring studies of healthy people, a normal fasting blood sugar is 83 mg/dL or less. Many normal people have fasting blood sugar in the mid-to-high 70s.

While most doctors will tell you that anything under 100 mg/dL is normal, it may not be. In this study, people with FBG levels above 95 had more than 3x the risk of developing future diabetes than people with FBG levels below 90. This study showed progressively increasing risk of heart disease in men with FBG levels above 85 mg/dL, as compared to those with FBG levels of 81 mg/dL or lower.

What’s even more important to understand about FBG is that it’s the least sensitive marker for predicting future diabetes and heart disease. Several studies show that a “normal” FBG level in the mid-90s predicts diabetes diagnosed a decade later.

Far more important than a single fasting blood glucose reading is the number of hours a day our blood sugar spends elevated over the level known to cause complications, which is roughly 140 mg/dl (7.7 mmol/L). I’ll discuss this in more detail in the OGGT section.

One caveat here is that very low-carb diets will produce elevated fasting blood glucose levels. Why? Because low-carb diets induce insulin resistance. Restricting carbohydrates produces a natural drop in insulin levels, which in turn activates hormone sensitive lipase. Fat tissue is then broken down, and non-esterified fatty acids (a.k.a. “free fatty acids” or NEFA) are released into the bloodstream. These NEFA are taken up by the muscles, which use them as fuel. And since the muscle’s needs for fuel has been met, it decreases sensitivity to insulin. You can read more about this at Hyperlipid.

So, if you eat a low-carb diet and have borderline high FBG (i.e. 90-105), it may not be cause for concern. Your post-meal blood sugars and A1c levels are more important.

Hemoglobin A1c

In spite of what the American Diabetes Association (ADA) tells us, a truly normal A1c is between 4.6% and 5.3%.

But while A1c is a good way to measure blood sugar in large population studies, it’s not as accurate for individuals. An A1c of 5.1% maps to an average blood sugar of about 100 mg/dL. But some people’s A1c results are always a little higher than their FBG and OGTT numbers would predict, and other people’s are always a little lower.

This is probably due to the fact that several factors can influence red blood cells.

Remember, A1c is a measure of how much hemoglobin in red blood cells is bonded (glycated) to glucose. Anything that affects red blood cells and hemoglobin – such as anemia, dehydration and genetic disorders – will skew A1c results.

A number of studies show that A1c levels below the diabetic range are associated with cardiovascular disease. This study showed that A1c levels lower than 5% had the lowest rates of cardiovascular disease (CVD) and that a 1% increase (to 6%) significantly increased CVD risk. Another study showed an even tighter correlation between A1c and CVD, indicating a linear increase in CVD as A1c rose above 4.6% – a level that corresponds to a fasting blood glucose of just 86 mg/dL. Finally, this study showed that the risk of heart disease in people without diabetes doubles for every percentage point increase above 4.6%.

Studies also consistently show that A1c levels considered “normal” by the ADA fail to predict future diabetes. This study found that using the ADA criteria of an A1c of 6% as normal missed 70% of individuals with diabetes, 71-84% with dysglycemia, and 82-94% with pre-diabetes. How’s that for accuracy?

What we’ve learned so far, then, is that the fasting blood glucose and A1c levels recommended by the ADA are not reliable cut-offs for predicting or preventing future diabetes and heart disease. This is problematic, to say the least, because the A1c and FBG are the only glucose tests the vast majority of people get from their doctors.

OGTT / Post-Meal Blood Sugars

If you recall, the oral glucose tolerance test (OGTT) measures how our blood sugar responds to drinking a challenge solution of 75 grams of glucose. I don’t recommend this test, because A) it’s not realistic (no one ever drinks 75 grams of pure glucose), and B) it can produce horrible side effects for people with poor glucose control.

However, there’s another more realistic and convenient way to achieve a similar measurement, and that is simply using a glucometer to test your blood sugar one and two hours after you eat a meal. This is called post-prandial (post-meal) blood sugar testing. As we go through this section, the numbers I use apply to both OGTT and post-meal testing.

As the table at the beginning of this article indicates, the ADA considers OGTT of between 140 – 199 two hours after the challenge to be pre-diabetic, and levels above 200 to be diabetic.

But once again, continuous glucose monitoring studies suggest that the ADA levels are far too high. Most people’s blood sugar drops below 120 mg/dL two hours after a meal, and many healthy people drop below 100 mg/dL or return to baseline.

This study showed that even after a high-carb meal, normal people’s blood sugar rises to about 125 mg/dL for a brief period, with the peak blood sugar being measured at 45 minutes after eating, and then drops back under 100 mg/dL by the two hour mark.

Another continuous glucose monitoring study confirmed these results. Sensor glucose concentrations were between 71 – 120 mg/dL for 91% of the day. Sensor values were less than or equal to 60 or 140 mg/dL for only 0.2% and 0.4% of the day, respectively.

On the other hand, some studies suggest that even healthy people with no known blood sugar problems can experience post-meal spikes above 140 mg/dL at one hour. As I said in the beginning of the article, context is everything and all of the markers for blood sugar must be interpreted together.

If post-meal blood sugars do rise above 140 mg/dL and stay there for a significant period of time, the consequences are severe. Prolonged exposure to blood sugars above 140 mg/dL causes irreversible beta cell loss (the beta cells produce insulin) and nerve damage. 1 in 2 “pre-diabetics” get retinopathy, a serious diabetic complication. Cancer rates increase as post-meal blood sugars rise above 160 mg/dL. This study showed stroke risk increased by 25% for every 18 mg/dL rise in post-meal blood sugars. Finally, 1-hour OGTT readings above 155 mg/dL correlate strongly with increased CVD risk.

What does it all mean?

Let’s take a look again at what the ADA thinks is “normal” blood sugar:

Marker Normal Pre-diabetes Diabetes
Fasting blood glucose (mg/dL) <99 100-125 >126
OGGT / post-meal (mg/dL after 2 hours) <140 140-199 >200
Hemoglobin A1c (%) <6 6-6.4 >6.4

But as we’ve seen in this article, these levels depend highly on context and whether all markers are elevated, or just a few of them.

If you’re interested in health and longevity – instead of just slowing the onset of serious disease by a few years – you might consider shooting for these targets. But remember to interpret the numbers together, and also remember that blood sugar is highly variable. If you wake up one morning and have a fasting blood sugar of 95, but your A1c and post-meal numbers are still normal, that’s usually no cause for concern. Likewise, if you see a one-hour post-meal spike of 145 mg/dL, but all of your other numbers are normal, that is also usually no cause for concern.

Marker Ideal
Fasting blood glucose (mg/dL) <86*
OGGT / post-meal (mg/dL after 2 hours) <120
Hemoglobin A1c (%) <5.3

*If you’re following a low-carb diet, fasting blood sugars in the 90s and even low 100s may not be a problem, provided your A1c and post-meal blood sugars are within the normal range.

Another key takeaway from this article is that fasting blood glucose and A1 are not often reliable for predicting diabetes or CVD risk. Post-meal blood sugars are a more accurate marker for this purpose.

And the good news is that this can be done cheaply, safely and conveniently at home, without a doctor’s order and without subjecting yourself to the brutality of an OGTT.

I’ll describe exactly how to do this in the next article.


Join the conversation

  1. I’m a 62 year old woman who’s always been healthy and active. 5’7″ 150#. I have always eaten a lot of sugar and had no obvious adverse effects though i know that’s a bad idea. i could also go nearly all day without eating, even exercise vigorously, and feel fine.

    however in the past year, and especially in the past few months I’ve had episodes of what i call “the wobblies.” legs and arms feel like they’re trembling and/or vibrating, and feel weak. sometimes i feel clammy and sweaty and overheated, but not always. that’s pretty much it for symptoms.

    my doctor suspects hypoglycemia and gave me a glucometer.

    since i began testing at home, my blood glucose has never been below 81.

    one time when i ate did sugar jellies it spiked to 155 But was down to 112 less than an hour later. it’s usually 120 (ish) after a meal and is between 80 to 110 throughout the day.

    i seem to have the wobblies almost all the time, though sometimes they’re gone, or very mild. they ate usually worst in the morning.

    i don’t know that they’re correlated with blood sugar at all! i feel them more when I’m standing or exerting myself. and yes, two times when my blood glucose was 81 and 82, the episodes were acute.

    is it possible that i am someone whose “normal” is higher than usual?

    my doctor said she’d send me to a neurologist if I’m not hypoglycemic.

    my recent blood work is completely normal including thyroid. however past bloodwork had shown me to be slightly anemic.

    I’m wondering if it’s neurological, hormonal, psychosomatic, or tested to my blood sugar, even with what appear to be normal readings.

    • Simple reliance on a fasting blood sugar or even an A1C test may not be the most reliable diagnostic tool considering your symptoms. A1C tests are skewed when a person is even slightly anemic. Fasting blood sugar tests didn’t work to discover my hypoglycemia; but a 4 or 6 hour glucose tolerance test did because it actually charted or graphed a measured glucose solution by the hour and how my body specifically responded to the insulin produced. Mild hypoglycemics most always fail the test. Severe hypoglycemics usually “crash” before the test is completed.
      I’m no doctor, but this actually happened to me.
      Good luck!

    • What’s this business about going without eating all day? Your symptoms could have NOTHING to do with glucose. For example, sodium/potassium ratio.

      What are you eating? Super low carb? That’s the first symptom you’ll see on KETO dieting.

      Download Cronometer and enter and track every single thing you injest. You’ll see what’s going on nutritionally. Your doctor should be taking this more seriously.

        • Here’s the link, I use it on my desktop. My autocorrect misspelled the word. It’s CRONometer not CHronometer LOL.


          There’s a free version, and a (inexpensive) Gold version which gives additional functions.

          It allows you to enter your biometrics all day then generate a report. IE BG reading. Waist size etc.

          It also allows you to make a “note” any time any place. So you can note the times you took your BG. Or one big note with all your comments.

          Should be testing and tracking:

          Morning fasting glucose level
          Pre meals
          MINIMALLY Post meals 1 hour
          Post meals 2 hours

          You should actually start tracking every 15 minutes with BG because people peak different times. Until you see a pattern emerge. Obviously this means no snacking or your BG will be all over the place. Which is natural. But not helpful for potential or existing diabetics.

          If you happen to wake up in the middle of the night, track it also. For the Dawn Phenomenon.

          My BG can be 75 at 3 am and when it releases glucose for the day, it starts rising in the 80s by 5-6 AM peaking at 7-8 am 93 then back down in the low 80s by 9-10 am. Which is a BUMMER and I’m working on it by fasting longer not eating after dinner at 5-6.

          People with peaking higher morning BG over low 80s have a challenge when going for labwork at 8 am.

          It means my insulin resistance has not healed. Yet. Even if all my other criteria is good. I never EVER spike over around 100-105 BUT I eat a very healthy diet. Dr Fuhrman.

          Also do not drink liquids with meals or directly after. Abstain from liquids 15 minutes before.

          Some people have spiking BG when eating weird like the OP “going all day” because the body is fighting that!

          Lastly, if you have a fatty liver, you need to fix weight and be a thin person so your liver can continue to get rid of all that unhealthy stuff.

          Your waist should at LEAST be less than half your height.

          • “Your waist should at LEAST be less than half your height.” — no matter how much (or rather, how little) i weigh, my waistline does not go below 36″. i’m 66″ tall, 125 lb, waistline currently 37.5″. any thoughts on why or what i should do about this?

            i mentioned this recently to my doctor, who was shocked, but still didn’t really follow up on it, and i’m so frustrated with him. i’m concerned that i have high cortisol. no matter what i do, my waistline does not go down. and i have skinny limbs, which no matter what i do remain quite skinny.

            up until very recently i was eating keto, doing intermittent fasting, and got my weight down to 122 lb, but i was having *extreme* dawn phenomenon. waking up at 4am with heart racing at 100 bpm, dry mouth, need to pee. (and normal blood glucose — in the 80s — i would actually measure it just to be sure, at 4a when this would happen.) it was awful — nothing i did helped me get back to sleep.

            so i’ve started adding some carbs back into my diet in the evening. but i can’t go too high because i’m prediabetic. besides which, i don’t think it really helps that much anyway, because my body doesn’t process the carbs well, even slow carbs. (and really, i think i tend to swing between hyper- and hypoglycemic — years ago when i had the hyperglycemic episode that led to my pre-d dx, i swung into hypoglycemia too.)

            i’m not sure WHAT to do, and i’m incredibly frustrated with my doctor. (who wants to send me to a THERAPIST for my sleep problems. talk about treating me like a hysterical female patient.)

            anyway — any thoughts on what i can do?

    • Did your doctor explain WHY he/she suspects hypoglycemia? What you call “the wobblies” (legs and arms feel like they’re trembling and/or vibrating, and feel weak) sounds like classic symptoms of the adrenaline rush that accompanies a hypoglycemic episode. Not eating and/or vigorous exercise could cause or exacerbate a hypoglycemic episode. You say that your BG is never below 81, but is it often in the low 80s or only when you feel “wobbly?” What are your highest BG values when you feel wobbly?

      Could you be one of those people who’s normal is high? Yes. Could your wobbly feeling be unrelated to BG, or be related something else in your blood chemistry? Yes. Could it be neurological, hormonal or psychosomatic? Yes.

      But if what you’re feeling really are hypoglycemic episodes then consuming glucose should cause the wobbly feeling to go away, as well as being reflected in your BG values. I speak of episodes because if you are often hypoglycemic then you would likely lose your “feeling” for hypoglycemia as you become increasingly acclimated, and/or have less and less adrenaline rush.

      In short if your “wobblies” ARE due to BG, it should be easy to determine by manipulating/observing your glucose levels. Using a CGM might tell you a lot more than you can learn from a glucometer. If you really think it IS hormonal (because BG is controlled by hormones e.g. insulin) you may prefer to follow up with an endocrinologist before going another direction with your doctor.

  2. I had H1ac of 6.3. I heard about how statins raise blood sugar, so I quit and 3 months later, it was 5.2. Since my cholesterol was higher, doc wanted me to start statins again. 3 months later. my H1ac was 6.5. What’s a body to do?

  3. While all of this discussion is trying to drive patients to get ever lower blood sugar results, the fact is that studies of type 2 diabetics have repeatedly demonstrated that striving for strict control actually kills people compared to taking a more relaxed approach. In fact, the scientific proof that stricter blood sugar control was killing people was so dramatic that the study had to be stopped on ethical grounds, which is something that only happens very rarely in scientific studies. There is a lot about diabetes and blood sugar control that conventional diabetes theory simply does not yet understand, so before ruining my life striving for strict control, I would take a close look at the Accord study and the many, many others that have confirmed it.

  4. Hey Everyone! So I just got back my A1C level and it came out to very, very high (7.9). This was extremely shocking to me since I have no family history of diabetes, am 26, not overweight (125 pounds – 5’5), and eat very healthy, organic foods (generally a low-carb diet).

    I’ve been testing myself everyday prior to seeing my PCP and my fasting blood glucose was at 88, and all post meals have been in the 80s. Have you guys seen this before? Just want to have some sort of idea prior to walking into that doctor’s office next week. Please let me know!

    • I read your story and it was exactly what happened to me. I did everything “right” by medical standards, and yet was pre-diabetic. The way I reversed it is realizing that fats are not bad. Carbs are. I have now been on a keto diet (80% fat) for 1 month and my FBG this morning tested at 85mg/dL. You can do this too. Just remember this simple fact. Fats are critical for life and will do you no harm unless you combine them with lots of carbs, Protein is also critical for life. Carbs are completely optional

      • Ahhh the enthusiasm of the newly converted Keto absolutists! Presh.

        You realize your meter could be off by 20%, right?

        You realize now you have your lipid panel to deal with on Keto, right?

        I’m sure you’re praying your lipids don’t matter and that it’s only “your fluffy large particles that matter” or you’re up the creek.

        LOL vegetable and fruit carbs are not “completely optional” in a person claiming they’re interested in health.

        My complete diet is vegetable/fruit carbs with low healthy fats and low-ish protein and my numbers are GOOD.

    • Also how long have you been getting these number? If you didn’t have a HIGH glucose, before…a doctor will NOT usually order an A1C.

      So why did you have one?

  5. Hi Chris, I greatly enjoyed your article on blood glucose variations. I’m a scientist, degree in Astrophysics and work in
    laser fusion. I’m diabetic. Found out about 8 years ago. My weight is 150 and height 9ft1/2in. I control my glucose through diet and can vary it pretty much anyway I want. I do not take medication. I have done many glucose tests on myself. The one that puzzles me is described here. Morning before breakfast 119, an hour later 90, 2and 1/2 hours later 97. This is not uncommon. I feel fine during this time. My diet is pretty consistent and is based roughly off Barry Sears Enter the Zone book. Is this behavior common? What causes it? Thanks

    • Reseach “dawn phenomenon” Its actually very common for diabetics to have their highest blood sugars first thing in the morning

    • Your weight is too low for a 9 ft 1/2 person. You could try reducing your height.
      Laser fusion, great, Where are the fusion power plants? perhaps the calculations are off a decimal?

  6. Puzzled.

    I posted previously about my elevated a1c which showed up last year (6.1). Since then, I dropped weight and started an aggressive strength training program. I saw an endocrinologist who ran my fasting insulin and looked for signs of LADA. My fasting insulin was normal (3) and my a1c dropped to 5.2%. The doctor didn’t see any antibodies for adult type 1 diabetes and when I asked the doctor to explain the results; the doctor said my body is processing sugar just fine.

    Did strength training revenue insulin resistance? That was the original diagnosis.

    Are there any other tests that I should inquire about? Have I lost any beta cells?

    I used to spike above 160 (1 hr) and 140 (2 hour) after a decently loaded carb meal (and before weight training). Now I don’t. I’ll hit 130 after 1 hour and 110 at 2 hours when I have a similarly carb loaded meal.

    Aside from my food tests. I’m on a very low carb diet.

    I posted to this forum so that those on track for type 2 can read this. For many, cutting body fat and building muscle may be the solution.

    I appreciate your comments/advice.


    • Hi Austin – Did you ever get any answers? I think I am a lot like you, though I haven’t had an endo check me for antibodies in 4 years. (Going soon.) I eat very low carb but my fasting blood sugar and A1C are still elevated. (100-120 fasting and recent 5.8 A1C.) So frustrating. Looking for ideas and more resources.

    • You wrote, “Since then, I dropped weight and started an aggressive strength training program.” Then you asked if strength training reversed your insulin resistance. Don’t you think that losing weight has much to do with with your much improved BG numbers?

  7. Hi There – I eat a low carb higher fat diet. After 10 hrs of fasting I woke up and took my measurements. It was 2.9mmol when I woke up. I have issues sleeping and waking up a lot and I’m trying to determine if my blood sugar is to slow.

    I tested after a basic meal of fish and veggies (1hr after) and I was 5.6mmol

    It’s great it’s not high but how do you know if it’s too low?

  8. So I got my A1c test results today,and it came back as 5.6. However,I keep a journal of the results of my blood glucose tests that i take on my monitor,and my fasting ranges are between 140-300..once it got as high as 596. Then 2 hours later,it was 375,so still a bad number to be at. My blood sugar never goes below 140,which is confusing because my A1c test came back at 5.6..And my blood glucose tests after I eat meals,always spike up at least 30-40 points. I’ve had 5 readings that came back with numbers higher than 200,and that was with no food in my system. I still have to take the glucose tolerance test..and trust me,i know my body well enough to know how bad my blood sugar spikes after I eat a meal..So my question is,if my A1c test came back normal,though I’m still getting high blood sugar readings with no food in my system,does this mean I could have an undiagnosed case of Diabetes? I also have high triglyceride levels as well. Any advice would be greatly appriciated..

    • A1C results are not accurate is you are even slightly anemic. There are a few other conditions that cause this also. A glucose tolerance test is far more accurate.

    • While A1c of 5.6 usually maps to Blood Glucose between 110 and 120, in some individuals it will correspond to average levels above 150 mg/L. You may be one of them. I think the larger question is whether high BG or high A1c is thought to be associated with long term risks associated with diabetes. I speak as a novice, but from what I’ve read I think the A1c is the more important measure. If your blood generally doesn’t become gluconated over time (what A1c measures) then what does it mater that BG (measured at any given instant with a glucose meter) is consistantly high?

    • Debra is right and depending on the cause of the anemia A1c could be either higher or lower. A1c can also be effected by other factors, such as drug interactions, even hyperglycemia. Why your A1c appears to be, and/or what is causing it to be low is something you probably will want to discuss with your doctor, and he/she can order tests to confirm whether it is reliable, such as fructosamine, A1a, A1b, and etc., as well as tests for anemia if suspected.
      Another possibility is that the meter is off or the test strips are bad (not to mention that technique may cause erroneous highs). Home meters can differ from Lab results by 15% even when functioning properly, but even then 15% off of 300 is still high. The first step here is to test with someone else’s supplies (or use a lab) to verify the readings you are getting are correct.
      The point I made earlier is that not being typical is not always a bad thing, that is assuming both A1c and BG results are correct, and it is a possibility that they both are. Which better reflects a state of health? A1c is the “gold standard” primarily because it is the most studied and is inexpensive. As a time averaged indicator of BG it may better predict complications resulting from consistently high BG. Meters, on the other hand, or instantaneous readings of BG are very useful for identifying what effects BG, like foods, timing, stress or behaviors. Modifying or eliminating such factors feed back into lowering the long-term average BG thereby reducing risk of complications. Meter readings are like daily quizzes; A1c is like a semester grade. The one results in the other, the object being to improve both.
      Most instructive at this point would be using the meter to try and identify what lowers BG readings and identify patterns rather than worry about the specific numbers. Once results are achieved which are consistently lower it will be interesting to see how that impacts upon a future A1c test. Eventually, an accurate A1c cannot be further reduced in spite of ever lower and lower BG meter readings.

  9. The veterans administration has labeled me diabetic. They took my blood after I slept for 2 1/2 hours up late the night before slamming Pepsi playing video games and rolled in there eating a bag of honey BBQ potato chips. I had no clue they were going to test my A1c and glucose. I told them I just ate they said it won’t matter. My test was through the roof 297 glucose 8.8 A1c. Now here’s the question I’ve got, I’ve never experienced any symptoms of being a diabetic like ever, I can eat like absolute crap and nothing happens. So long story short the VA scares the ever loving shit out of me. I keep saying hey I’m pretty sure you guys botched my test, they don’t listen try to put me on medication I say nope to that, I buy a tester and start sticking the hell out of my finger daily. And after every meal and randomly throughout the day I get the following values 100, 104, 110, 107. Now bear in mind I ditched the soda and have only eaten food I make now for the last 4 weeks. I go back to them in May so they can monitor my diabetic condition…. the 30th I see a civilian doctor for a second opinion. I just have major doubts that I have an issue. I’d say the issue I had was I can’t eat like a 20 year old anymore. Any way wouldn’t mind some input and thoughts on this. I intend to follow up here with the results from the civilian doc.

    • So you’ve made some positive changes. Good for you! Be sure they check your A1c again in May and you should be able to see it has improved because of those changes. However, with your 8.8% last time there’s little doubt about your diabetes. While the 297 reading means nothing because you just ate, the A1c is an average created over the previous 3 months and is unaffected by what you just ate. When you test at home the reading you get before you eat should be near the reading 2 to 3 hours after you eat. Because we don’t know the circumstances of your 100plus Glucose readings its impossible to comment on them, but if you were fasting they’re not in the “normal” (i.e. non-diabetic) range. It’s not bad to try diet and exercise in lieu of medication when you’re first diagnosed but even with those changes most people eventually need to add medication as they age and their diabetes progresses. When, what and how much is what makes us all different. Good luck!

      • After eating and taking my blood glucose test 1-2 hours after eating for the last 4-5 weeks it has returned a value daily between 90-113. So far the highest readings I’ve gotten correlate to when I’ve had bouts of PTSD and stress 182 and 184 I’ve only seen those numbers once on the same day, I took a random sample and pretty much dug myself into a deeper state of depression that day.

        My earlier post was not very clear those tests were taken after eating an hour ish after.

        Today I believe I am not diabetic how on earth can a diabetic continue to have normal values????

        My fasting levels the last 3 weeks have been between 78-92.

        Something else is going on and the veterans administration tried to put me on metformin from a single a1c test and said Dude your type 2.

        More to come my appointment is fast approaching the 30th

        I’ll be showing my civilian doctor the readings from my one touch meter.

        My life style changes however have helped significantly my blood pressure went from being 120/86 down to 108/68. Those were my readings before hand surgery yesterday.

  10. I just want to share a personal revelation. My fasting glucose levels kept being 110 up to 130. Post prandial was always normal. So I started a examining the different things I did before bed. One thing I did before bed was to take my blood pressure medicine Cozaar. I decided to start taking it in the morning instead. Ever since then my fasting glucose level has been below 89. This morning it tested at 77.
    I hope this helps someone!

  11. I’ve been told I have pre-diabetes and I certainly do not want this to keep going in the wrong direction. Last blood test was A1c 5.8 and 101 glucose. I’ve been testing my glucose levels according to your suggestion on and off for a few months to see if I can track the culprits. My fasting blood sugar is always between 94-111 (mostly 101+). It never rises beyond 120 even 45 minutes after a meal except when I tried eating just brown rice. Then it rose to 140. In the evening after a meal and a glass of wine it’s only 80. I’ve tried no carbs at all, no alcohol, Berberine, etc. and can’t seem to figure out what is causing these erratic numbers. I eat 90% Paleo and have also read about the dawn phenomenon so have tried a snack before bedtime. I’ve also tried intermittent fasting. The lowest AM reading I’ve ever had was 87. But there is no rhyme or reason to the patterns so I can’t figure out what is causing this. I do have low cortisol as well as low steroid pathway hormones and wondering how/if this relates. Any insights/suggestions on how to turn this around so it’s not continually creeping up would be appreciated.

    • Carla, most people have what I call red flag foods. We know that it is the carbohydrates that effect the blood sugar levels. Carbs are found in all our foods except our protein sources like eggs and your meats,some veggies, Is very low in nuts and cheese. The good new is carbs are our bodies main source of energy for our cells. There is very little symptoms to diabetes so most people do not really know. Being tired all the time is one of the few symptoms people experience. The amount of carbs in the rice, because it is a starch can push the b.s. levels higher. If you would balance the carbs with some source of protein and a little fat you might not notice such a high. And it could be that rice is one of your red flag foods. Two hours after you eat anything, if you get a spike like that, then monitor that food closer, how much did you have and what did you have with it. This can tell a lot but sometimes it is just hard to know. Typically the starch group and of course sweets is what gets most people.When we go to long with out eating our body kicks in an gives us energy from stored sugars in the body and we can have a higher number instead of a lower one, so it is important to eat regular spaced healthy meals.Exercise is a great benefit to keeping those number lower to, and some days it just dont seem to make sense what you do. Pain, illness and stress also effect these numbers somewhat. The American Diabetic association is a great place to get reliable information from. If you are getting high readings regardless of the why the body is sending you a warning that the pancreas is not working as effectively as it has in the past, an now is the time to make those changes. I hope this has helped. Is hard to answer like this, I am a diabetic educator so I see this a lot.

    • I’d love to share resources if you’ve found anything. My situation seems similar. I eat low carb, do hot yoga and intense workouts (one or the other every day). My numbers are really similar to yours, though I rarely get a low post-prandial unless I eat too many carbs – like my pancreas is giving extra effort since it doesn’t usually have that many carbs to contend with usually. Western doctors can’t figure it out and don’t think I have a problem since A1C is under 6… even though I eat so little carbs! So frustrating that they don’t get it! I’ve spent too much money on functional medicine and just want to keep trying my own thing. I do think Berberine and black seed oil taken at bedtime, along with some protein, helps a bit.

  12. 57yrs, was a gestational diabetic, I have been on 2000mg metaphormin since 2009, I had taken the 3 hrs glucose test several time and failed miserably.My morning readings r great, My 2 hr post reading have and are always high (155-255)….however my A1C is 5.6, my weight is good….I have been using a short term insulin for my meals-Asparta, works well. My Dr. wants to take my insulin away, due to my normal A1C #’s….Your thoughts?

    • I don’t know what your carbs/insulin units ratio is but seems to me reducing the amount of insulin you use would be better than stopping altogether cold-turkey. If your A1C can be controlled with less artificial insulin let your body supply what its meant to supply.

  13. Hi, hope you are doing well. I was hoping you could help me resolve a dilemma. My morning blood glucose levels range between 95 and 99. However, after constantly monitoring the levels at 1, 2 and 3 hour intervals respectively, I have concluded them to be normal. After about 2.5 hours of a meal, my levels range from 85 to 90. Also, my fasting levels (8 hours without a meal) are always under 90 at night but they are close to 100 in the morning. Could you please shed light on this? I shall be ever so grateful.

  14. Hi Chris,

    I have observed that when having a meal that contains both fats and carbs my blood glucose takes longer to rise, and it takes longer to go back to base. So the graph/curve of the spike takes longer to complete: in my case it takes about 1.5 to 2 hours to reach a pick of 160 when having both carbs and fats, then it takes another 2 hours to go back to base.
    when having carbs without fats the spike is lesser and going back to base is shorter (the same amount of carbs will not get me to the 160 peak but more like 140). Also, I know for sure that I am not insulin resistant (on the contrary, I am very insulin sensitive).

    My questions:
    – Your recommendations for doing the OGTT are based on consuming only carbs. But what would be the recommendations (numbers) for a healthy individual when fats are consumed as well with the carbs. Would they still remain 140 after first hour, 120 after two hours etc. Fats definitely change the curve right?
    – Is there a natural way to “prime” insulin (maybe through eating some food that spikes insulin but not glucose, or supplement), before consuming carbs such that the pick will be lower? … because in the case of being insulin sensitive and yet experiencing this high pick it seems that the response mechanism of the pancreas is delayed in my case? Is there a variety in the response time among people and therefore that would be normal still? (I have tested negative for type-1 and type-1.5, that is no auto immunity against pancreas)

    • An OGTT is a diagnostic test, and as such in order for the results to be relevant one performs the test as prescribed. Consuming fats anytime during the test would totally invalidate the results. There is a hormone that is sensitive to fats consumed which slows the progression of what is eaten from the stomach to the small intestine; fats, carbohydrates, proteins and indigestibles, the whole shebang. So, that fats plus carbs takes longer than carbs alone to peak and then return is entirely normal. There is some variety from person to person how quickly BG is metabolized, but mostly what you have observed is a function of WHAT is eaten.
      As far as the magnitude of your peak that is mostly a result of how many carbs you consume and how quickly, but is also affected by how you collect your data. Do you check your BG every 30 seconds for the whole two hours? No? You may be missing your peak value by virtue of timing. Also consider that a Glucose meter is considered “accurate” even when yielding a measurement 15% off the true value. With this in mind, 140=160 under certain circumstances.
      Your body’s release of insulin is in direct proportion to your blood’s glucose level (unless you’re completely T1). Therefore there is no way to “prime” your blood with insulin other than via injection. (The body’s insulin reaction is pretty rapid anyway.) The best way to lower your BG peaks, if that is your goal, is to EAT MORE SLOWLY, and to consume fats with your carbohydrates. Diabetics are taught to not just eat an apple, but eat an apple with some peanut butter.

  15. Chris, you wrote: “One caveat here is that very low-carb diets will produce elevated fasting blood glucose levels. Why? Because low-carb diets induce insulin resistance. Restricting carbohydrates produces a natural drop in insulin levels, which in turn activates hormone sensitive lipase….”
    Maybe because the article is so old the above wrong information is iin it still ? The reality, as Jason Fung has explained well it is that when insulin drops liver glycogen is first released. If one was diabetic-2 or pre-diabetic-2 before one went on low carb the liver is larger and fattier than normal. That means longer time with higher than normal fasting blood sugar. There are two ways to quench this smouldering fire: Several weeks on ketogenic calorie restricted diet. Calorie restriction is a must, as the energy in the liver must be used up. On a ketogenic diet it has been proven time after time that calorie restriction does not reduce metabolism as long as there is minimum body fat left, which means a gradual restoration of perfectly healthy insulin levels can be attained without freezing, which means when the targets in FBG, waist measure (and body weight!) are met, all is stable. A faster variant is to combine fasting 3-5 days in a row which brings insulin down much quicker. The drawback here is that FBG tends to go up as long as the liver isn’t “empty” of glycogen or fat . But after a few weeks like that the liver is restored! (Eating carbs at night is counter productive as it raises insulin and only gives a temporary lower FBG as insulin stays high preventing glucose from liver to flood the system.) Lowering insulin is the safe way to empty liver sugar stores but it means a temporary flooding with glucose, until the liver store is empty. Clearly a finite process, but after 2 days without lowered FBG many believe that the theories put forward above are right. I have however tested Jason Fung’s ideas on myself, and they worked! I lost 9 kgs (20 lbs) over 3 weeks fasting 5 dayas and eating 2 days. Energy and body temperature great all the time, ended about 4 months ago. FBG came down to 3.1 for me at the end of the 3rd day. Since I at the same time was full of energy my “hypoglycemia” was accompanied by ketones, providing that extra energy. Today my FBG is 80 (4.4) eating a low carb diet, nearly ketogenic! My waist also reduced significantly during the IF ,and it stayed down! I am amazed that it was possible also for a rather old guy like me, 70, to remove that stubborn bump, often through sad experiences named the widow-maker.

  16. There’s something a bit funny phrasing-wise in the article. It says “continuous glucose monitoring studies suggest that the ADA levels are far too high” which makes it sound like you’re measuring ADA levels in the blood. Maybe the ADA levels ARE too high. =D! Kidding aside, thanks Chris. Long time reader.

  17. Your 2nd to last paragraph has left me wanting more information and it seems to be where most articles leave off and I have been searching for MONTHS the answer to this question. I would love (NEED!) to hear more! Here’s the paragraph that left me wanting more info and I will explain with my own situation following.
    *If you’re following a low-carb diet, fasting blood sugars in the 90s and even low 100s may not be a problem, provided your A1c and post-meal blood sugars are within the normal range.

    I have been doing low carb (Keto) hardcore for 8 months, no cheats and staying at 20g of carbs or less with an occasional 40g day. I noticed at 8 weeks into the diet that I was not losing weight, knew there was a medical hangup. I decided to test my blood sugar levels. All post meal #’s were excellent (Under 120, usually averaging around 108) but noticed that my fasting blood glucose numbers ranged anywhere from 123 – 163. So discussed this with Dr. Wanted to put me on Metformin and I asked for her to allow me to continue keto to the 6 month mark and to see if it would change my FBG. I lowered my protein intake (worried that maybe too much protein was causing a glucose excess?) and I began to slowly lose weight from my stall. But I stalled again and again. in 8 months, my weight loss has been 35lbs with no cheats and I added Intermittent Fasting to my regimin. So I know that my FBG has to be the culprit behind my stalls. At the 6 month mark, I agreed to Metformin as the numbers were not changing(Sigh – I did not want to, but something needed to give). I had blood work done, thyroid was fine, cortisol was fine, my vitamin levels fine and my A1c was at 5.7. I was prescribed 500mg of Met at night with dinner. At first, it did not lower my FBG, it stayed in the 140’s, with occasional dips into the 130’s. And finally after 3 weeks, I added Turmeric + Cinnamon to my nightly dose of Met. This finally started bringing my numbers down. Mostly in the 115 range with an occasional number around 108. So I am seeing progress. BUT your paragraph, that I quoted above, says that if you are doing LCHF, then these numbers may not be a problem (I know my numbers above the low 100’s are a problem, but what did you mean, that it may not be a problem in the low 100’s if you are LCHF? Can you send me links to read? I’m battling something fierce here and I can’t figure it out. Something is hindering my weightloss in a big way and I know that it has to do with high fasting glucose and while I am finally getting them to come down, I feel like I am still missing something (and why do I feel like giving into Metformin is going to create a larger problem for me?). I’m desperate to lose weight. It’s coming off painfully slow (I’m 44 but no where near menopause yet, according to OB). I know that I am not eating things I shouldn’t be, I have re-evaluated carb creep, studied Jason Fung, hung on every word of Eric Westman, yet still, I am struggling to get this fat loss moving! I feel like I am definitely fat adapted because I’m not hungry, I can go hours and hours without eating, all of the tale tale signs of ketosis are evident. What can I do to get over this huge hump of extreme insulin resistance and start losing this weight once and for all? I cut out dairy and still no improvement. So I added it back in. I am missing something somewhere. I am grateful that I have lost 35lbs (and inches too!) and I know I shouldn’t be ruled by the scale, but I feel like I should have lost more inches by now and more weight. Any insight would be so appreciated by me! IF I eat breakfast (I usually try to fast) it’s 2 or 3 eggs with spinach scrambled in or green peppers / onions (keeping an eye on carb count), lunch is usually a salad with meat and home made ranch dressing and dinner is always a protein with a veggie (Cauliflower, greenbeans, spinach, broccoli, yellow squash, zucchini – something along those lines). I rarely ever do any crazy recipe baking and prefer to keep it simple, but occasionally, in desperate times, i will make a mug cake with almond flour or make jello fluff, but it’s pretty rare.

    • Oh and I watch my macros carefully. I stay around 50-60g of protein per day and maybe around 100g of fat per day. I’ve played with the fat macro on multiple occasions for weeks at a time to see if It made a difference, I will go lower (80g or higher and stick to those for a few weeks to see if there is a trend up or down, but nothing seems to make a difference, fat wise. I am usually right around 100g per day, give or take 10 grams either way. I’m at 20g of carbs. I’ve tried upping them to 30-40 with no change (I stall out here) and I have actually done just a few days with 10g of carbs or less, no change or even several days at 0g, but I miss veggies too much and 0g seemed to cause more issues than it’s worth (going back to the eating too much protein causes excess glucose theory???)

    • Do you monitor with ketone test strips? Dr. Robert Atkins writes about stalling on a carb regulated diet. Thyroid among other things, but you said yours was fine. I’d bet your high FBG isn’t CAUSING your slow weight loss; I think they’re both SYMPTOMS of the same thing, whatever that might be.

    • I have also done low carb and lost 68lb but put it back on over a couple of years.
      I have now lost 75lb on the Blood Sugar Diet and watched my blood sugar A1c drop from 11 to 5. I was on 2000mg of metformin a day and that has also dropped to 500mg but I am likely to come off it altogether at my next review, as in my opinion I have successfully reversed my diabetes.
      The reason I am replying to your comment is that on both diets I have also ‘stuck’ at regular intervals and the only thing that helped on these occasions was to INCREASE carbs until the weight loss started again – sometimes just one carb meal would be enough, other times a couple of days, but every time I stalled, this worked.
      A day ago, I had bread three times in one day and was convinced I had put weight on, only to find I had lost another couple of pounds. I don’t know why it works, but it works!

      • Tricking your body and taking it out of keytosis from starving it from sugar is the key. The body will naturally return it self to normal and then after a few days of cheating on your low carb diet start the process all over with the carb reduction and your body will again start to burn off fat again. So it’s good to cheat and add carbs for a few days when you can’t seem to loose any more. Your body will tend to stop loosing the fat as a defense mechanism to save its self from starvation when in keytosis. When too much weight comes off all at once your body will again try to save its self and eventually start consuming muscle to feed it.

    • Jennifer P, It sounds like you are doing great with your diet. Are you exercising at all? Building muscle may add pounds, but you still lose inches. Building muscle is also great because it helps to change your metabolism. (I’m talking about moderate exercise and muscle building, not becoming a professional body builder.) My own personal goal is 30 minutes of moderate exercise a day, which may include walking, riding my bike, using the elliptical machine, nautilus weights, and yoga. (I don’t do all of them every day.)

    • I suggest that you read How Not to Die and follow a whole food plant based diet as Dr Gregor suggests as closely as possible. See how that works for your overal health and not just the issue expressed above. It sounds like it shouldn’t be too hard for you being that you eat better than the average person.

    • Thanks for sharing. I struggle with the same problems. I can’t get the last 10 pounds off. I wonder if having my FBG always over 100 stops my ability to be in ketosis. I’m a try adding a higher carb Day here and there. Will also try adding cinnamon and tumeric at night. I hate that it has to be such a pain. I guess it’s because we are so good at storing fat for survival!

  18. I’m hypothyroid and have been on thyroid medication for about 15 years. I’ve gained a considerable amount of weight in the last few years even though I eat a healthy diet and exercise. My endo has been checking my A1c for the last 3 years and it’s gone from 5.7, back down, and then 5.8 and now up to 5.9 recently. My recent fasting blood sugar was 77. She wants me to start s low dose of metformin. I’m confused about the higher a1c and lower fasting blood sugar. Thoughts?

    • An A1c of 5.8 would indicate that your AVERAGE blood glucose is close to 120mg/dl. If your FBG is 77 then your non-fasting levels are probably well above 160 (maybe even higher than 200). A “normal” person should spend very little time (non-fasting) above 140. That’s probably why she’s prescribed Metformin. 77 is surprisingly for an A1c of 5.8, but if your FBG was say 100 with an A1c of 5.8% she might not have prescribed the Metformin. You should ask her. You may not be prediabetic and as the author writes there may be better ways for finding out what is going on than having an OGGT, but you may want to get a glucose meter to test often at home and you may want to educate yourself on Insulin Resistance.

      • Actually, my a1c this time was 5.9 and my FBG was 77. It’s strange. I’ll look back and see what my FBG was those other times that my A1c was in the pre diabetic range and post.

        • Sound like hypoglycemic swing for you. You probably drank black coffee before the blood test. Don’t drink anything except plain room temperature water, and make sure you didn’t eat and didn’t drink anything except water for 12 or more hours.

        • Remember FBG is the least accurate marker for disglycemia because it is only a snapshot, i.e. it is not time-averaged, and it is more easily influenced by other factors including how active you are just minutes before the test. A1c=5.9% correlates to an Average BG of 123mg/dl.

    • My a1c was 6.5 and I was put on Metforman… It caused me to have ketoacidosis because I couldn’t eat. My fasting blood sugar I stopped taking it for 4 days because I was admitted to the hospital. My A1c went from 6.5 to 6.1 in 7 days. While in the hospital my fasting blood sugar was between 77 and 89. I got one reading of 110 because my nurse made me eat graham crackers and drink apple juice before bed. Since I been home, the my blood sugar stayed between 88 and 96. I ate pineapple before bed and that’s probably why I got 96. Idk… I think I’m pre-diabetic, but I don’t want to chance anything. I constantly check my BG because this is a wake up call.

  19. Hello,

    Fasting blood glucose is 176
    A1C is 5.2%

    Similar results 4 months ago

    Not anemic

    White male 70 years old

    My Dr. says since 5.2% is in target range – just ignore the elevated glucose number

    Any advice –

    Thank you!

    • Did you eat ANYTHING in the two hours previous to the 176 reading? No? Get ahold of a glucose meter and check your fasting BG again.

  20. Hi Chris, I had gestational diabetes for my pregnancy, before I got pregnancy, I had a test on my A1C and was 5.3. I had excellent control with my GD and my BG has always been under 7. However, I just had the baby 2 months ago, and I have been testing my sugar level after meals, fasting has never been a problem, 2 hours occasionally goes high after high carb meals. But sometimes it was like two hour BG spike like 9 or 10, then 2.5 hours back to under 6..almost seems like there is a delay in my insulin…I also started to test my one hour BG, and it has been higher than 7.8, normally around 8.4. Shall I get concerned?

    • I’m in a very similar situation. I was dx with GD at 26 weeks and very easily diet controlled. Rarely had a number above 140 (1 hour tester) and when I did it always was below 120 2 hours post meal. I’m 2 months postpartum and I’ve been spot checking and my 2 hour number seems to be lagging. I had a hefty pizza meal with close to 100g of carbs and my 1 hour number was 130 and my 2 hour number was 132! My 3 hour number was 110 when I checked out of curiosity.
      Tonight we had a quick fast food meal between running errands and again it was close to 100g of carbs. We took a 30 min walk when we got home and I was so happy to see my 1 hour number at 115. Checked the 2 hour number and it was 143!! I don’t get this!!!

  21. This is a fabulous article which outlines considering patients individuality in context to disease prevention and managementbrather than looking just at lab testing alone, misleading many doctors to misinterpret the numbers and not serve their patients well, again the limitations of evidence-based medicine in clinical practice

    • I couldn’t agree more. My doctor just sent me for an A1C test and I have diagnosed anemia. My 12 hour fasting blood sugar checks (at home) are never below 150 and run as high as 175….for 7 straight days. Yet, my body craves sugar.

  22. Why in the heck doesn’t someone from this website answer a question….looks like there are a lot more QUESTIONS THAN ANSWERS ON THE SUBJECT…..but I’m just askin”

    • You do realise you’re “commenting” on a blog which was posted over 5 years ago, don’t you? The best you can expect is some novice Johnny-come-lately like myself to comment on your comment.

  23. I am a 26 year old male and am overweight. I have never paid attention to my health. My usual meals are high in carbs and sugar. Recently, i did a post meal blood glucose test and it was 168 after a very high carb meal. My friend says that this is way above normal and that i could be having pre-diabetes. How can i know for certain that i do not have diabetes, and am still in the pre-diabetic range? Also, is it possible to reverse pre-diabetes and get back to normal?

    • I have been a diabetic for nearly 15 years. The first 10 trying to treat with diet and exercise the last 5 on 2000mg metformin daily. My last a1c was only 7.5 but the last month sugars have been very high. Fasting being between 11-17.
      My doctor just added glyburide to my prescriptions and a new hbp medications as my bp was 158/70. I’m worried I may be causing long term problems. My regular fasting blood sugar for the last few years has been between 8 and 10.

      • While you should always involve your doctor in complex diagnosis like this one, you can order your own test at directlabs.com

        There docs write it up, and you go to quest diagnostics near you to get the draw, the you get the answers online, which you can the share with your doc (if you desire)

        Hope this helps!

      • You can buy an at-home A1C test. Available at most drugstores and at amazon. Do a google search on “at-home a1c test”.

      • Go to Wal-Mart and get a Relay A1c test it comes in a pack 02 two and cost 23.00. and you can get your A1c results in 5 mins.

    • i was diagnosed with type 2 diabetes in 2013 and tried exercise and diet control but my sugar yo-yoed and i decided i didn’t want to send the rest of my life on metformin or glipzide so the only thing left to do was learn to do the keto diet. so i went on youtube and studied all the videos from scientist ,m.d n.p’s and keto recipes now my blood sugar never runs over post 140. you must give up sugar and foods that turn to sugar. The first week will be pure hell it’s called kept flu and u withdraw like a junkie and want to quit,but after about 3 days life will change .u feel superior to sugar eaters. i did this and i am a 71 year old african-american female.now burning fat and losing fat. i feel good and feel younger. i feel empowered. oh do only mild exercise until u feel strong again. good luck

      • Carolyn Gray is absolutely correct! My post prandial blood glucose numbers were quite high for years (150-300). I finally started a ketogenic diet and my blood glucose numbers have dropped into the 70’s and 80’s. Also, I have lost 31 pounds without any cravings or effort. Perhaps Keto won’t work for everyone, but everyone with life-threatening diabetes owes it to themselves to try this. As I said meals based on the Keto diet are not even difficult and very tasty.

  24. Chris:

    I am a old patient of yours from 5 years ago. I have been following a low carb (30-50g/day) mostly paleo diet. I consume little or no table sugar or sweetners (except for what may be added to sauces when I eat out) and get my carbs from vegetables, limited rice and limited fruit. Most of my diet is healthy fat and proteins – tuna sashimi, grass-fed steak, beef bone soup, raw milk kefir, plain greek yogurt, eggs, baked salmon or ocean fish, steamed or sautéed ocean shrimp, salads and vegetables and occasional fruit like kiwi, bananas, mangos, watermelon and lots of fresh young coconut (3-4 per day) both the coconut water and the meat.

    I have noticed that my fasting blood glucose (mg/dL) has been between 105-110 and my A1c is around 6.1 – 6.2% but my OGGT/post meal 2 hours after lunch over the last three days has fluctuated from 96, 132 and 120. My blood sugar has not gone over 140 but again, I consume very few carbs and no wheat, grains, or sugars (other than those from fruit in the morning, fresh young coconuts throughout the day, or occasional rice, dark (85%) chocolate (seldom) or once a week air-popped popcorn with olive oil. In fact my lowest levels, at 96-98, are usually 2-3 hours after I have eaten more carbs from chocolate or air-popped popcorn. Could my body be overcompensating from a low carb diet and producing higher blood sugar levels since higher carbs seem to result in lower figures two hours after eating them. My doctor has prescribed metformin (500mg once per day) but so far I have tried to see if I can manage through diet and have not taken the medication. Again my latest fasting blog sugar level is 110 and my A1c is 6.2% even though my two hour OGGT levels are consistently all below 132. Should I be concerned? Should I take the medication? Note that my lipase levels are at 653 mg/dl (normal is 23-300) and my CKMB is at 31.2 (normal 0-16). While my LDL is low, my VLDL is high at 48.8 (normal <30) and my triglycerides have risen over the past six months to 245 (normal <149.6).

    • In addition, I should add that my other blood tests are normal except for slightly elevated uric acid (476 umo/dl or 8 mg/dl) levels and slightly low Vitamin D (26.9) and HDL levels (37). I do try and exercise 3-4 times a week for 20-30 minutes each time, I weigh 156-158 lbs, 5″8″ tall, have normal blood pressure at 110/70 and I am 53 years old.

  25. Thank you for this article. I had a blood panel done as part of a physical. I got a call that everything is ‘normal,’ but after looking at my report and Googling what all of the acronyms means and so forth, I wasn’t happen with a couple of levels glucose, at 99, being one of them.

    Thanks for the clearer information. I am active, but I think stress and secondarily diet are factors. I’m going to make some lifestyle changes to get these levels back into optimal form and at a follow up get a full lipid panel.

  26. My a1c Level for 3 mo blood check up was 6.7 yet I test twice a day and he readings are 106 96 112 I watch everything I eat and check the labels as well as the carbs can you explain this my dr keeps saying I eat junk food that is not true

    • What is your daily carb intake? Getting rid of grain entirely especially wheat and keeping carbs to under 30grams/day, my dad has normal blood sugar and is no longer considered diabetic and has shed 75lbs and I just started and am no longer considered prediabetic and down 30lbs and counting.

  27. My a1c Level for 3 mo blood check up was 6.7 yet I test twice a day and he readings are 106 96 112 I watch everything I eat and check the labels as well as the carbs can you explain this my dr keeps saying I eat junk food that is not tru

    • Not trying to explain anything, just mentioning that your diet and numbers mirror my own. Five months ago diagnosed T1 and using CGM. 43 unit Lantus daily plus rapid insulin at meals.

      • Hi I was just diagnosed with type 1 and my blood sugars are all over the place. Today before dinner, I got a reading of 98 so I did not take insulin. Then after dinner my levels were 135. Ugh. I hope I figure this out. Is it good to stay under 30 carbs a day? I am on 60 carbs at breakfast and 45 at lunch and dinner with two snacks. I take 20 units of L insulin at night and then adjust before meals if my levels are over 100 with apidara. I take metformn 2x a day.

  28. Hello Chris, I have been dealing with emerging LADA since 2012. Back then my A1c was 4.7 my c peptide was 0.77..ref range 0.80 to 3.10, and my GAD65 was >30.0 REF RANGE 1.0 or less. No positive IA-2 or insulin antibody. These were quest diagnostics ranges. I do have Graves Disease of the thyroid although that has been in remission for years.

    I have checked my blood sugars off and on since the doctor told me I may be heading to lada type diabetes. But that not to worry about it. My primary and most other medical technicians and nurses have never heard of 1.5. When I ask my primary to monitor me for it, he just looks at me and says you dont have juvenile diabetes!

    I was never vigilant about it till recently because I figured the doctors should know , right? Now I am checking because I feel sick all the time, headaches sick to my stomach , fatigue that makes me feel like im going into a coma. And blood sugars all over the place.

    My FBGs have been between 89 and 110 in the mornings, but its my post meal bg’s that are scaring me to death. post meal is 155 to 192, and it takes a bit before they go down to 121 or under. I noticed ketones in my urine at trace to sometimes moderate levels also.

    The problem is every time I ask my doctor about it, he does a stick test and its in the so called normal range ie: 95 to 118. So is it going to come down to a DKA event before they will admit I have diabetes? I am really scared been feeling terribly sickly for about 6 months now. Will I die if I go into DKA, I live alone also so is this something I wont have time to call for help? I have so many health conditions, I have UC and UCTD, Sjorgrens syndrome, the thyroid issues that flare from time to time, I have some kind of motosensory nueropathy in lower legs, and a form of small vessel vasculitus. I dont think I could survive diabetes on top of them all.

  29. This article is fascinating. My dad who is 73 just got diagnosed with pre-diabetes. Over the last several months, he’s lost 20 pounds without trying. His fasting blood sugar level is 120. Do you think that could be cause for his weight loss? I am worried it could be something more serious.

      • If this gives you hope, last year in April I went to the emergency room thinking I was having a heart attack. They found my BG to be at 380 mg/dl (it was probably like that for a couple of years at least) and my A1C was around 13. I changed my diet and started exercising. I get my carbs through veggies, beans, and very seldom rice and bread. When my BG spikes above 120 after a meal, I do something that works some major muscles in my body, like legs. I do stairs but it is totally your preference. Today, a year later, my BG is constantly around 100 through the day (depending on what I eat and after exercise it dips) and 80 to 90 fasting. My A1C is now 6.4 and going down (4 months ago it was 6.7).

        It is possible to control this with discipline, and it doesn’t have to be painful! I still eat a lot of variety, and I enjoy beer! (and not always in moderation). Have hope!

        • Oh, and I will add that 5 mg Glipizide is all I take for the diabetes. That is a very baby dose, and it helps my body produce more insulin. I could totally manage my BG without it but my doc won’t take me off of it quite yet.

    • From all the research I have done, your dad’s situation is diabetic. His kidneys are working overtime to flush out the excess glucose in the blood in effect urinating away the calories. This is the cause of the unexplained weight loss. He needs to get diabetic treatment before his kidneys and other organs suffer permanent damage.

  30. 63 year old female – normal weight , exercise a lot. All cholesterol levels are good. Had a1c levels as high as 6.1 and just got test results today of 5.6 (after really watching what I eat). My fasting numbers are always 99, 100 or 101. Was pretty proud of my a1c of 5.6 till I saw fasting of 100. If a1c goes down should not my fasting number too?

  31. Was wondering if anyone else has the same problem as myself. I used to weigh 237lbs with a fasting BS of 333 and A1C of 9.8. After extensive lifestyle changes and exercise , wt loss, and food changes my wt is now 174, fasting BS is 102 and A1C is 5.9. My problem now is sometimes when I eat a light meal my blood sugars readings can be in the 150s. They have come down where my ranges are 90s to 120s. Case in point, yesterday my fasting BS was 101, I ate for breakfast 2 hard boil eggs and 2 slices of turkey bacon. For lunch I had a grilled chicken salad 2 hrs after I ate my readings were under 110. I ate 3oz of grilled chicken with a side of cauliflower, and 2 hrs after I ate I started to feel sick. I thought my BS was going to be low but when I checked it the reading was 152. I am so confused why this is happening

    • Hi Tiffany! That sounds like you really have taken charge of your life and have recovered to better numbers all around! However, I am noticing the confusing meals you speak of and couldn’t help but notice the chicken. I just read the book, How Not to Die, by Michael Greger and he talks about arachidonic acid in chicken that can be inflammatory. And it seams to me, getting down the inflammatory response is key. I’m not an expert! But you might enjoy the book I mentioned. It has helped me a lot! Good Luck, and GO YOU, Tiffany!

  32. I’m a 52 y/o female, 130 lbs. My question is, why did my FBG go from 91 down to 85 only 10 minutes after eating a banana muffin AND a cupcake? I’m not diabetic. We just took blood sugars in class as an experiment.

    • Sometimes the finger tip tests vary widely and its very aggravating. You can only assume you are near one of the numbers.

    • Many times the results are inaccurate, either due to poor cleaning of the site, malfunction of the machine/sticks, or simple patient excitement. When I use to get a wild result, I’d rewash my hands with a different soap, try different fingers or sit for a few minutes to calm down.

      Assuming that the test were performed correctly, its common for blood sugar to lower right after a meal because insulin usually reaches the blood stream much faster than sugar, let me explain:
      The time your body takes to absorb sugar varies greatly between foods, even first thing in the morning. The different types of “sugars” (like fructose, sucrose, galactose, or glucose) are usually combined within foods, and they all need to be converted to glucose differently for your body to absorb it.
      There are many factors that affect the timing of the conversion, and the quantity of glucose available after eating (diet, pancreas health, tissue glucose resistance, stress, etc). However, our bodies can release insulin even before eating by just thinking about the food, and the blood sugar available will be temporarily lower due to a higher-insulin lower-blood sugar ratio.

  33. I’d like to measure my BG post meals but am unclear about process. Testing 1 hour and 2 hours after meal? And what is target range?

  34. I am a retired registered nurse and am 76 years old. I have been diabetic for about 15 years mostly with only Metformin 1500/day. Last August I was diagnosed with Afib at the same time as my doctor told me I had to find another doctor due to changes in the health system. STRESSOR! The only abnormals in my labs were Cholesterol 209,Triglycerides 192, and HA1C 7.4 .I was put on Xarelto. Tests were set up at a heart clinic . Prior to the tests, My brother died, I was told I did not need surgery on my shoulder and was so happy about that that I ate a large amount of chocolate ice cream (no added sugar) the day before the test. My stress test (treadmill) came back normal ,my EKG came back normal, my echocardiogram came back normal. My 48 hour Holter readings came back that I had afib and a heart rate of over 120 and was put on Metoprolol .After the Xarelto my fasting blood sugar went to 225 and I immediately gained 6 pounds. My new doctor put me on Glimepride 2 mg. I could not tolerate the Xarelto financially and physically so I was put on Coumadin .I had another EKG that came back normal Then my BS dropped too low in the afternoon,and I stopped my Glimepride. Went on the Paleo diet and lost the 6 lbs in a month. But my fasting blood glucose is high….188 this am.
    I am having much difficulty with my diet. Eating high fat, low carbs, My diet consists of eggs, meat, butter, sweet potatoes and green beans.Avoiding foods that affect the Coumadin. I feel that my original stress caused so much problems and it went downhill from there with all this medication. My third EKG showed no aFib so I guess I go in and out of Afib. My one doctor said a fasting 160 blood sugar was normal for a diabetic. This is all so confusing! I feel like I am really messing up my body. Thanks for any reply.

    • You poor thing. High fat? Seriously? Those high fat low carb diets are horrible, IMHO. They may — may — look good at first, but see the long term. I don’t want to frighten you, but long term on those dies is, well, not so long term.

      I have been watching nutrition videos about eating plant based diet — specifically about diabetes and cancer, and heart. ONLY by good eating, my cholesterol went down 60 points, my BP is down, my tryglicerides crazy good. Im so happy. And I lost weight, and feel good. the guy that gives the information has been doing it for 20 years, Dr Greger, MD. He hasa about 200 very short youtube videos. All science based. All he does is report the scientific literature, in every short video, thats what he does.

    • Oh my, Judy! But medical community is head in sand on treatments that bring health instead of reliance on meds. Check out the rest of Chris’s articles and also Dr Richard K. Bernstein who has a good forum to peruse and excellent books available in kindle, hardback and used bookstores.

      You will have to take charge of your own health destiny. Consider by your own devised trials (test test test to find what foods affect you and McKesson meter with TRUEresult test strips stand up with the freestyle freedom lite at a fraction of the cost…look on Amazon) what is best for your health. Dr. Bernstein says we ALL deserve good blood sugar levels.

      I have same addl issues, warfarin, metoprolol, afib mostly just the once when I had pneumonia coughing spasm. Check out Dr Koufman on silent reflux.

      LCHFMP can be good but studies show vegan can help some people. We are all unique, standalone, never one size fits all. Don’t give up. YOU can DO IT!

      Godspeed your journey!

  35. There is a lot of great information here. I am confused however, about the rationale that LC eating induces insulin resistance which elevates fasting blood glucose levels. I’ve been on a LC diet for about 45 days now and my numbers have been lower than I’ve ever seen. This morning they were 66! I try to stay under 25 calories a day and do not take medication. Prior to the diet, my post-meal numbers were sky high, often in the upper 100s and even into the 200 range. Now they are typically within the 90-120 area.

  36. yesterday i did my fasting blood sugar not finger prick but blood sample sent to the lab it was 5.8mmol/l.i am not a known diabetic.my electrolytes are within normal range and i am still waiting for my hb1ac and lipids level.in october last year my fbs was 5.0 and it has been so for the last 15 years.since i am a nurse i get easy access to blood prick test.i did my prick 2hours after taking my lunch and it was 5.2.i am not obese i am 70kg and my height 1m80cm.

  37. My fasting blood sugar was 116 at my last physical in Nov. he did not tell me that I was prediabetic until I called him and asked about that level being high. My cholesterol is always 160 or less. Triglycerides are on the low end, good cholesterol is extremely on the high end which is good, the bad cholesterol is on the very low end. My blood pressure is always 85/60 or so. It runs low. I have a one touch ultra monitor and tried it out today for the first time. My FBS was 96 then 101, then 92. All this in a matter of a few minutes. My husbands was 79. So I guess I am on the high side. My Dr. Told me the blood work looked great and Merry Christmas. That was when I asked him by phone about the FBG being 116. That’s when he said “oh you are prediabetic” but keep doing what you have been doing. I am 57, female, at 120, Bmi is 25, very active. I do drink wine several times a week, not much sugar and I eat lots of salmon and salads. Not many carbs. What could I do different? All my parents, grandparents and siblings were/are diabetic and on meds. If it’s in the genes, what more can you do? I don’t need to lose weight. Thanks. Darlene Moore

    • Darlene, I have a reply to Angela today you can read about CRP for something else to do. Your numbers are the same as mine except my fasting is a little worse (higher), other lipids sound about the same. Also your wine and food sounds about the same, and family history is the same. See if you can see Angela’s post today and get some meaningful info from my comment. I keep my inflammation below the .1 which is the lowest the high sensitivity CRP test can measure. I have had .8, and then found turmeric lowered it to “too low” to measure mark which is <.1 as the result. You can also read about the Insulin test on Dr. Mercola website. I got that test and was pretty pleased using Mercola's recommended levels. Beware the regular medical system is waiting for pretty high glucose levels and need people to be very deep into diabetes before prescribing meds. There are greater risks of having too low glucose (fainting while driving or on stairs for example); thus they have to make sure glucose is so high that the meds will just help from going too too high. For pre-diabetes the best things we can do is avoid sugars, carbs, and try to get lots of exercise. After that we have like an average 110 to 120 glucose and like your Doc says, try and keep doing what you are doing to stay there.

    • Darlene,

      Make sure you are getting all 46 essential nutrients the body can’t make. Even a slight deficit in one critical component can impact your body’s ability to properly control blood sugar. My family had a history of Diabetes and my mother died of kidney failure last year. I refuse to give much weight to the genetic concept as to many studies show you can change your history. I take the Sona vitamin/mineral complex and a blended Omega product. There is also a product called Diabetes Defense which has a patented process and double blind clinical trials to back up benefits. I have perfect sugar and refuse to ever take any prescription drugs. I found the above on Amazon and also a site called essentialvitaminsandminerals.com

  38. Aghhhh! I’m frustrated! I was DX as prediabetic July 15th, A1c of 6.2. Scared the crap out of me. Started lifestyle changes the next day. I’m basically on the Mediterranean diet, lots of veggies, fish, and whole grains. I cut out high GI carbs, all sugar and anything processed. I limit my carbs to 100 a day. If I don’t prepare it, it doesn’t get eaten. I stepped up my exercise and, as a result, have dropped 30 lbs. I still have 15 to go to get my BMI under 25. My PP numbers are almost always 120 or less at one hour and between 95 and 110 at two hours. My FBG is almost always around 98 -105. Had my A1c checked today and only dropped to 5.8. I’m a little disappointed as I’ve been working hard. I thought it would be lower than that. I am not currently on Metformin. Am I expecting too much too soon? Words of encouragement and advice to get my numbers lower would be greatly appreciated .

    • Angela, 6.2 is an average of 131 mg/dl, and 5.8 equates to 120 mg/dl average. That is a pretty big jump and improvement if you consider that as 24/7 x 7days a week cumulative ongoing improvement. Just Google A1C converter and you can out in the numbers your self. My lesson learned is becoming pleased with every small victory in this department; and as well it is wise to check improvement in inflammation reduction by getting the CRP test at the same time as your A1C. I have years of disappointment trying every supplement touted for lower glucose. I do find much ease and comfort knowing I can keep my inflammation under 0.1, and that my A1C equates to under 120. Why 120? well there is a great book(s) by Jenny Ruhl e.g. Blood Sugar 101 which explains the severity of spiking over 140, and benefits of staying below that, and the absence of risk below 120. After much review you should be able to also conclude that eating in ways that keeps an even 120 more less, is tremendously better than meeting a FBG, or having an A1C of 5.5 but self measurements after some meals of 160 for example. Overall you have to be thrilled with what you have accomplished. One topic that I have not found investigated is A1C risk assessment under a near Zero inflammation situation. I always hear all diseases start with inflammation and when you have it the first medical objective is to reduce inflammation. So I would like to know if an A1C that equates to 120 average is safe when CRP is <.1. CRP can be reduced quickly with Turmeric (boiled and taken by the teaspoon, 4 -6 a day). I hope you can eat Jenny's book and learn about turmeric. Congrats on changing your lifestyle – I know it works – 5 years for me so far and will never go back.

        • Glenn, do you have a link for turmeric preparation? I dry roast mine in skillet, add water (1:2 turmeric to water, 2 tsp black pepper and black seed oil), keep cooking as I stir until it reduces to paste consistency. I put tsp of paste in coconut milk. Interested in your prep technique. Gratsi and Godspeed!

      • Unfortunately, turmeric, cinnamon, etc. don’t work well by themselves. I have experimented with my own BG and it had little effect.

        One of the problems with type 2 diabetes is beta cell burn out, according to articles from John Hopkins and other institutes. When beta cell continuously produce insulin, they can become damaged and burn out over time. This is why type 2 diabetes can be a life long problem. If you aren’t to that point, then you don’t want to do things that make your body produce more insulin, you want to make your body handle BG by other means, and the ONLY WAY TO DO THAT is through vigorous exercise. When you cause your muscles to burn a lot of glucose quickly, it uses other methods of signaling than insulin when transferring BG to the cells. This gives your beta cells a rest, letting them heal.

    • Angela, you might want to check out the book “Grain Brain” . I try to avoid grains to rare occasions and small does. The mummies of Egypt were discovered to have lots of diabetes from grains. Grains are excellent for spawning civilization and feeding mass numbers to live into their 40’s. Beyond that, its pretty much poisoness like sugar is. Stick to the veggies and fruit for fiber and enjoy smoothies and quality meats and fish, eggs etc. nuts, seeds, avocados etc.

  39. Hi all. I had gestational diabetes during both pregnancies and was monitoring for the inevitable type 2 diabetes to come. It still took me by surprise. It is CRUCIAL to recognize and prevent diabetes asap. You may have to also go thru several docs before finding one that takes this as seriously as to you do. After 2 years of messing around with the wrong ones I ended up with excruciating diabetic neuropathy in my feet that now requires medication. The best advice I can give (not a doc) is to eat a good diet and exercise. Strangely the doc that got me under control with meds, did not give me the right foods to eat. It was my GP who is very homeopathic that did so. He explained to me that I make plenty of insulin, my body just does not recognize it. He said that insulin is the key that opens my cells so that the sugar can get in and feed them. I had to initially get on a long acting insulin. He told me if I did not get my diet under control my key maker (pancreas) would get tired, give up and I would be insulin dependent for the rest of my life. The diet is easy. I eat protein. I can eat nuts that grow no trees (peanuts do not). I can eat vegetables that grow above the ground. I can eat pit fruits and berries for good carbs (not a lot). Fruits, not the juices. It is important to get the fiber. Stay away from anything that is a seed or made from them: grains, rice. That is pretty much it. Doing that I have almost weaned off my long acting insulin and am taking only 1000 mg. Metformin/day (I can’t tolerate more than that). I am going in the right direction but wish I had never gotten here. Sorry for the long rant. I am not a doctor, but wanted to share my experience. If you do not think you are getting answers, find someone who can give them to you. It is really OK to ask your doctor questions and make sure you understand. If your doc is put out by that you need a new one.

    • hi,

      thanks for sharing your experience..

      but i wish to know what your insulin level pleasee

      i have a blood sugar level(glucometre) of around 20, which is high, and this last for more than 10 yearsss.. all doctor cant explain this because all test is normal ( liver, heart, everything)
      one day we got hospitalized and they injected insulin,,after that fall into a coma.

      we just test the insulin level and it seems to be ok

      anyone who experience to share please

    • Expecting a GP to prescribe a diet healthy for diabetics is not within the realm of Western Medicine practices. Simply put, most of them don’t have a clue. Diabetes (and Pre-Diabetes) must be self-managed on a daily basis.

  40. How would you recommend dealing with the inaccuracy of glucose meters? The FDA only requires glucose meters to be within a +/- 20% range of accuracy for glucose over 75 and +/- 15% for under 75. So a glucose reading of 120 could actually be as high as 144 or as low as 96, if in fact the 120 is accurate. This makes checking after meal glucose for more specific levels far more difficult.
    A 110 reading 2 hours after a meal could give a false sense of comfort if in fact your glucose is 132.
    Would you recommend an average of tests over a period of time? I think this may be why the A1C test is preferred. I have not researched the accuracy of A1C testing, I would hope that it would be fairly accurate as it can only be done in a lab.

    • Sandra, I use this website for A1C conversion.
      When I save my individual glucose measurements over a representative time period, the average should wash out any wild points, more or less. It is not perfect but if the meter is fairly accurate the average can be entered to the converter to get an A1C. Then you should get an A1C taken from a blood test for about that same period and see if they are close. I tried this 3 times and it was so close that I felt confident the A1C from the HMO and my home calculated A1C are both correct as one helps validate the other. I believe this is the only way you can find out. No one will know if your home meter is accurate or not. Hope this helps 🙂

  41. I read in a Q&A from a couple months ago that alcohol effects BG. I recently had FBG of 95 and A1C of 5.9. Told to keep carbs between 80-90/day. I’ve never been a big bread eater. I do like rice/pasta/deserts – but those things don’t make up the majority of my dietary intake. I exercise regularly (5-6 days per week short runs and light weights) but have a desk job. BMI is 23.2. I’ve always watched my calories- but now I’ve integrated carb monitoring as well. My alcohol intake (until recent blood work) was having 2-3 glasses of white wine several nights a week. I had been doing this for at least the past 3 years. All other lab work came back in normal ranges. I purchased a monitor because this is concerning to me. I know the many complications that can come with diabetes. I have had my FBG in the am reading in the mid 80’s. 1 hr postprandial mid 90’s and 2 hrs postprandial mid 70’s. I have stopped all alcohol intake for the past 3 weeks and I’m monitoring the carb intake. My question is… how much of an effect does the alcohol have on the A1C and BG? Will eliminating the wine reverse those numbers? Could those numbers be inflated by the alcohol and I’m not really bordering on diabetes because everything else is responding well?

  42. Question on BG levels. I have been diagnosed for a few weeks. I had an A1C of 12.4 and my BG in the mornings was over 250 sometimes would drop to 199.

    The first couple of weeks, my levels were consistently high, 250 to 330. Turns out, I had was on the verge of a heart event that resulted in a mild Heart Attack. It took almost two weeks after that for my BG levels to come down and level off and are now anywhere from 76 – 93 after exercise, and 95-110 before meals, 120 – 135 after meals. Occasionally it is in the 150’s or 160’s after I eat but usually in the 12–135 range.

    My fasting BG, after 9-10 hours of not eating (taken each morning between 4am and 7am is always 140-155. Pretty consistent in that range. I have even gone to bed (3 hours after eating) and my BG was 105 and the next morning it was 155 before eating.

    My question is: Is this normal when recently being diagnosed and due to the fact I am Type II and as I lose more weight, it will come down? I guess what I am asking is if I am watching my diet, limiting my carbs (counting my carbs each meal and not snacking after dinner – I give my self two small snacks between meals), should I expect immediate normal results or will this take time for my body to operate more efficiently? I am keeping my carbs at meals to around 30g a meal and 10 – 15 for snacks (if that).

    • I have the same AM problem. I have recently converted my diet to very, very low card by cutting out ALL sugar, pasta and bread. I tossed my diabetes meds in the trash (do not recommend this but they were not helping) blood sugars are half but when you consider AM 360+ DOWN to 180 after less than a week it is a good start. Fasted 21 hours BS was 128, ate a very low carb dinner with no food after 8:00PM. Bedtime BS was 168 woke up to 249 nine hours after eating. Will bring back on diabetic med that reduces liver glycogen, inject at night and see what happens. Test starts tonight.

  43. I know you say there is a follow-up article, but I did not find it. Standing alone, these types of articles are great at moving, say, 10 percent of the population from being at risk to having about 40 percent be at risk because of more detailed testing, but they do little other than give people one more thing to worry about. I presume the follow-up article explained ways to lower FBG or other risk measurements. Our school systems deal with “grade inflation,” but I believe the medical industry deals with “risk inflation.” When I was a kid, physicians did not worry about cholesterol until it topped 400. Then it was 220…200…180…. Same with blood pressure. Anything under 145/90 used to be normal, but “normal” kept getting lower, as new categories of risk were introduced, similar to the “prediabetes” categorization. Yes, in many cases, lower is better, and still lower (to a point) is even better. To the extent these articles encourage us to eat healthier and get a good amount of exercise, I am all for them, but I suspect they go further toward lining the coffers of the medical establishment that is simultaneously dismissed in these comments.

  44. I am totally baffled. 65 years old, slightly overweight female, hypothyroid but on armour thyroid. I tend to have sleep problems and wake between 3 and 5 am with tension and anxiety. Recently had blood work – glucose a couple of hours after breakfast was 93, C-peptide was near the lowest end of normal at .88 which is consistent with past years when I had low end of insulin levels when tested, including all through a 3 hour glucose tolerance test where insulin stayed at low end and blood sugars were not at all high and hardly responded to glucose. This was after having several fasting glucose readings over 100 but with normal A1C. The A1C this time was 6 despite the low C peptide and the 93 blood sugar. Doctor said it appears I’m over-sensitive to insulin so I don’t make a lot, but that I must spike at times for some reason. So I got a meter, had a fairly normal meal last evening and this morning after not eating anything for over 12 hours my blood sugar was 110! I did have a bad episode at 5 am of anxiety and tension waking me up. I read that fasting sugar can go up in response to stress hormones being released but the article was talking about actual diabetics. Does anyone have any experience similar to this? It seems I am always having strange and inconsistent test results in various ways.

    • Do you drink alcohol? I don’t mean to be insensitive, but alcohol can cause BG to go too low, and then your body can compensate the next day with high spikes. Also, do you have a high sodium intake? I am not on-board with the docs that say that high sodium is bad, at least until they can present conclusive proof and a consensus among other “experts” that high sodium is bad for you. So far there is no proof, but i have found that high sodium foods do cause a dip in my BG.

      Another issue. you said that you are slightly overweight. Again, no offense is meant to you, but when most of us say we are “slightly overweight” we are speaking of the mirror weight and not the scale and body mass index weight. I am “slightly overweight” but I am in the obese range. I am working on that. As you lose weight your insulin resistance will improve, and if you lose the weight through exercise, it will improve greatly. Remember, every day you spend with a high BG (above 120 and up) you are damaging beta cells. The cells in the pancreas responsible for creating the correct amount of insulin at the correct times. Lay off the caffeine, as that has been shown to screw up the body’s ability to regulate blood glucose.

      I don’t know what else to tell you other than, I wish you good health!

      • As far as the fasting BG being high, yes the longer you don’t eat tends to either make your body go too low on BG or too high. There are a few reasons for this. When your BG goes too low during fasting, your liver causes the release of glucose. If your body is insulin resistant, or your beta cells have been impaired, then your body cannot handle the glucose that your liver is releasing. This causes a spike in BG at fasting. The same thing will happen when you eat high carb meals.

        If you have a very low BG after fasting, it means that either your liver is operating properly and your pancreas is responding properly, or if it is too low (below 70) your pancreas is providing way too much insulin. This can also happen, and has happened to me. Too much insulin can cause hypoglycemia, and weight gain.

      • By slightly I mean BMI of 25.7 and I also have a relatively small waist. I have not been drinking alcohol. As I pointed out the biggest thing I don’t understand is how insulin levels or C-Peptide are ALWAYS near the bottom of the range – bordering on too low. Type2 Diabetes starts with HIGH insulin levels. Additionally I have Hashimoto’s thyroiditis (autoimmune). My blood pressure is around 115/70, my triglycerides are well within normal range and my cholesterol is fine with HIGH Hdl (high 60’s to low 80’s). There are none of the markers for the typical syndrome that leads to diabetes. As to the weight I’ve tried ketogenic diets – no weight loss – only lead to my digestion and GERD getting very bad. Just moderate low carb and whole foods is the norm but I can go around hungry and lose nothing or just eat enough to feel satisfied all the time and not gain. I can’t eat a lot at once due o digestion. I am the one at a gathering of people that is asked “is that all you are going to have – aren’t you hungry”. So it’s very frustrating to have these weird blood sugar issues when I’ve spent years studying health and nutrition on my own and going to integrative doctors. All the usual pat answers don’t apply to me – if they did I would know the answers. I also take a supplement at bedtime called cortisol manager to lower cortisol – still wake up between 3 and 5 with all the tension build up.

        • Alibar, Dr. Mercola recommends fasting insulin ideally under 3, where 10 is really bad. Unless you are under 1 maybe your insulin is OK. Just google his name with insulin test and read his analysis. You don’t mention your blood sugar levels, but if you are having trouble with digestion you can look into the alkaline diet and strive for more low PH forming foods. I used to have a hard time digesting fats of any kind until I increased my alkaline food in take — the easiest way I found to eat raw greens in consistent adequate quantity is with green smoothies. There are thousands of free ideas for this now on the web. It really worked for me, and anyone who does it for a month or more.

          • The “alkaline diet” is nothing more than a fad. Your body has to maintain a proper PH or it would be fatal. I don’t know where this idea that the body could be acidic, as a normal response to bad diet, came to be, but it is false. One instance where the body because too acidic is ketoacidosis, and that can be fatal and is immediately debilitating. Don’t listen to those who claim your diet is making your blood too acidic. It has absolutely no basis in biology.

            • I had a typo in there. The sentence “One instance where the body because too acidic…” should read “One instance where the body becomes too acidic…”.

            • I thought I would mention, incidentally a low alkaline diet is conveniently fruits and veggies. Because that is the best diet, the parasite people that latch onto the alkaline diet ideas push the fruits an veggies diet claiming it will balance your blood Ph. Your blood Ph is ALWAYS balanced no matter what you eat, because an imbalanced Ph will kill you. Yes fruits and veggies are the best for you, but it has absolutely nothing to do with blood Ph, nothing at all.

            • Lots of people do not believe in the benefits of converting their body water from an acidic state to a neutral pH about 7.0. It takes some study and interest in the pH of the intestinal tract towards assisting your digestion. I accept it as true that the body will maintain blood pH within a minute tolerance and has no problem decomposing body parts to get the necessary alkaline substances needed to achieve survival, although maybe bed ridden as things get worse. It is coincidental, or not, that very low sugar fruits and vegetables hit the list for top alkalizing foods. Somebody trying to deal with blood sugar issues could benefit from following the list, and avoid fruit that provide less progress, or add insult to injury. The alkaline diet is nothing more than a road map to help you convert your body water throughout all your cells. It takes a year for the average person, and using the pH strips helps you see when you finally are nudging your body into a healthier defense and stronger digestion to encourage greater healing throughout the body. A urine pH of 6.5 to 7 will give better evidence of total health than a proper BMI. Plenty of thin good BMI people have cancer and diabetes. So pH is another measurement that is affordable and simple to do at home. It provides another form of a goal to challenge us to control our diet/food types. Since I have taken body water pH seriously I have had no illnesses, and have no signs of aging anymore.

              • You cannot rely on urine to test the acidic level of the blood stream. If people knew anything at all about how the body balances pH, they would know that the pH of urine will always fluctuate because that is one mechanism of the body keeping the blood’s pH balanced. Regarding the pH of the digestive tract, it is around 3, give or take a tiny minute amount. The digestive tract is acidic because it has to digest food. The rest of the body is 7 within a small tolerable range. Anything outside that extremely small range and you will die. It is impossible to adjust your pH through diet. The only way your become too acidic is the side effect of drugs, such as metformin, and other similar contributors to ketoacidosis where your body is burning nothing but fat and protein which causes too many ketones in the blood causing acidic environment. This is rare, very rare.

                • According to ncbi.gov medical research website for public awareness, the small intestine rises to 7 from 6 as food enters from the duodendum and ends up at 6.7 at the rectum. If the urine PH never gets over 5 the cells are stuck in acidic conditions and the body is ill for it. The stomach is made for acid ph of 4 and lower, but the healthy cells of the rest of the body like to be in a solution a little like ocean water. The urine includes acidic waste products and represents a typical pH of the cellular water and a reduction due to the waste water. Thus 6.5 urine is not too shabby. Anyone who can eat a steak and potato dinner and score 6.5 after digestion is doing pretty good. Anyone who eats a huge salad and scored 4.5 after digestion is doing pretty bad. PH is logrythmic so 4.5 is 100 times more acidic than 5.5. None if this is talking about blood, just relating to 70% of body composition, ie water mass. Its takes allot if vegetables to turn the tide of an acidic ocean within. It took me 1 year to see a .5 change. And about the same each year with a balanced diet trying to keep high pH foods in the daily routine, and don’t pig out on acidic foods. If someone has cancer they can go heavy on green juices and smoothies to improve body eater a little quicker.

                • No amount of factual articles that I throw at you is going to convince you that your body cannot be acidic without experiencing extreme, life threatening symptoms. So let’s just drop it. You clearly haven’t performed the research necessary to determine that pH is carefully controlled by the body for good reason, and it is extremely rare for a body to be out of balance regarding pH. I really wish you all wouldn’t push this hype on people, scaring them into buying things like alkaline water and such. Yeah a mostly vegetarian diet is good for us, everyone knows that, but it has absolutely nothing at all to do with our body’s pH. Now stop the deception right here and now!

                • My road to Low Carb started on the $17 Alkaline Diet education package. Best thing I ever bought. It taught me how to maximize the potential of low carb and permanently maintain my weight and health. All my prescriptions and OTC crutches went in the trash and my Doctor says “keep up the good work”. Alkaline dieting repairs the gut and this is now the hot topic online. It teaches the healthy oils and nearly identical Paleo foods. It teaches you to listen to your gut response and slowly avoid the things that take away your vibrant energetic feeling. I never bought a water alkalizer or any drops, but I have made lemons an every day thing and I try to keep my animal protein to normal portions while filling the plate with vege items and snacking with nuts and pumkin seeds for example. When I do indulge at parties I just stick a little tighter to my alkaline plan the next couple days. The proof is in the pudding when people who see me after years say I look better now than 10 years ago and want to know what I doing. Most of them decide to stay on their beloved foods and age before my eyes. My wife is astounded to see her peers looking so unhealthy while she in the other hand was carded last week and the cashier was blown away when he saw her DOB. We see the celebrities who defy their age and can look in the mirror and say, wow we are even older and look as good without makeup. Yup I love what the Alkaline teaching is all about:)

              • You mentioned the acidic level of your intestines. Yeah your digestive system will always be highly acidic, and nothing you do will change that. Your blood and body acidity however will always remain the same. Your unrine will vary because your body is always adjusting. This isn’t rocket science, it is biology 101, and you all need to take a lesson!

                • If people wish to eliminate medications and feel very well, the Alkaline diet is worth a try based on all the claims from regular people. There is no need to know Biology since the test strips are color coded. Normal every day illnesses disappear as the strips come out yellow to green. While in the red – orange color people still typically need headache and acid-reflux relief (often asthma and allergies are common as well). These symptoms should clear up. Once the test results are consistently green people can play around with high acidic foods and notice how the urine pH is still green, or yellow at the worst. This indicates the body has taken on a bold alkaline front and is readily able to enjoy the benefits of fish and grass fed beef etc. Headaches, shortness of breath, and heartburn are things of the past. It is very common to feel 10 or 20 years younger. The only down side is it may take 6 to 12 months of being patient before the strips change color so it can be discouraging and you need to hang in there.

        • Mine was 105 one morning but when took it again in 2 minutes it was normal. Sometimes the meters don’t work properly.

          Also, dehydration may cause a higher fasting reading.W


    • I have similar results with my blood sugar number in the morning.I travel for work and live about 3 months a year in hotels.I usually have to go to bed early because my day starts early so sometimes I would take a sleep aid and I would not wake until norning.My morning glucose reading would be really low for a type II diabetic,100 or less generally.
      Now that I’m back home,for some reason I have been waking up at 4am every nite,probably stress also.My morning glucose has shot up to 140 levels!. It was as high as 170 but I’ve been taking B5 ,B6 and juicing Bittermelon which seems to be helping.I’m 60 so I’m close to your age .I think hormone levels might play a part here.

  45. Hi,

    I am a Juvenile Diabetic for the past 3 decades. I am on insulin from the age of 7. I am 40 now.
    Last 10 years on Medtronic Insulin Pump. With all this my 11 am spike is still a challenge.
    Even with a normal fasting between 75-100 I still see a spike at 11 am even with a 10 g carb diet administering 8Units of fast acting novorapid. It goes no less than 230 and a sudden steep down after 11 am . Which drops to again 80-70 by 1 pm.
    Tried all tricks.. no carb breakfast, 10gms carb breakfast.. More Bolus, Higher basal ..No stone left unturned.

    How do I handle this. Is there a way to break this. I am an Indian, Vegetarian.
    However my A1c I am maintaining anywhere between 7 to 7.5%

    Looking forward for some responses.

    • Hi,

      I am also T1D, and not in any way a medical practitioner, so please take my experience as simply sharing my experience.

      You could ask your doctor about changing when you inject your basal, if you’re back to using NovoRapid and a basal. He or she will probably want to see consistent testing and documentation around the 11am spike, so keep that in mind should you wish to book an appointment.

      i used to have a lot of trouble when I injected my basal at night. I would have a significant need for more bolus in the morning, and then BG would drop in the evening and through the night, sometimes precipitously without any on-board bolus. Sometimes there’d be a significant drop near lunch, as well. With a switch to injecting the basal in the morning in combination with a low-carbohydrate diet, I’ve found that BG is much more stable throughout the day and night. I do sometimes need to inject a little bit of bolus in the morning, regardless of intake of food (which of course also may require a bit of bolus).

      Do note, that these results were most prominent when I adhered to a low-carbohydrate diet, and was much easier for me to determine trends due to the stability of fewer carbs and less insulin injection.

      Additionally, if you’re on the Medtronic, you should be able to increase the basal rate for that time period, as they (at least currently) have the ability to change multiple times across the day.

      Finally, you may also ask about trying out two daily basal injections. I have no experience with this, however and cannot offer any insight.

  46. Recently I was tested for my fasting glucose level while I had a cold and was alarmed to see it was 126. my AIC, however, was 5.5 and I was told that was normal but I should return to have my fasting glucose test in a few weeks when the cold is not in my system. Do you have any comments/opinions regarding my situation? Thank you.

    • When you are sick, your BG will spike, and sometimes high. Test your BG when you are not sick, and also get your A1C tested as that is an average of BG levels over a few months.

      • Think about this. When your body is sick or damaged, it needs extra energy to heal along with maintaining normal functions. So your liver will tell your body to release more glucose into your blood stream so it has enough energy to do everything it needs to do. Also, when we are sick we tend to not eat as much, and that also tells your liver to trigger the release of more glucose.

        You may be completely normal, which is why your doc told you to get your BG measured again when you are not sick. Diabetes is found by measuring your fasting BG and a random measurement of BG after eating, as well as measuring A1C. A1C is an average of how much BG is clinging to your blood cells over a few months (2 to 3 months). So it will be a good indicator if you are truly pre-diabetic or diabetic.

      • Thank you Derik. I will be getting tested again when I am better. My A1c was normal but my concern for the fasting BG is there. Hopefully, next time it will be normal or better and if not, I will have to deal with it. I appreciate your response.

  47. I have been eating VLC for the last 6 years and where as my numbers come back ‘normal’ I still worry that they are only ‘normal’ because I eat VLC(no sugar, no grain etc). Is there any worry with these numbers when on a daily intakes I have VLC and have not eating grains/sugars for 6 years?

    fasting glucose 5.2mmol(Canadian)
    Hemoglobin A1C 5.7%

    I had my blood urea come back out of range(8.1mmol) so just wonder why, if there is any possibility I am pre-diabetes with these ‘normal’ range numbers but feel they are ‘normal’ because I eat VLC.

    • Those are pre-diabetic levels. If you raise as you eat carbs, then you may be diabetic. As long as you keep your BG and A1C as close to normal as possible, you will be fine. You definitely need to measure your BG daily and have your A1C taken a few times a year (every 3 months is good) for a while to ensure you are staying in range. Start exercising more because that will lower you BG as well. If you exercise, you will be able to consume some carbs, like beans, barley, etc. and still maintain a low BG. A fasting BG above 90 is not a good sign.

      • Thank you for taking the time to write back. Interesting to see that my numbers mean pre-diabetic in the us, here in Canada my numbers are considered ‘normal’ . I have made an appointment to go talk with dr about this as I have always felt I was pre-diabetic. Diabetics does run in my family just thought I would never get as I have been eating VLC so long.. I do get a bit of mild exercise, I’m a mom of three young boys and keep busy. My weight is not overweight per say(around 165lbs-5’6″) but I do have lipoedema so my legs are on the larger side and are quite heavy. I find anything more then walking now days is difficult on my legs/knees. I will def try to get more walking in and go in soon tide to talk about getting a monitor. Thank you again for your wealth of knowledge, much appreciated.

        • If you do get a BG monitor, I suggest getting the TrueTest monitor. You can get it on Amazon and I find that it is very close in accuracy to one of the most accurate monitors available (the One Touch UltraMini). The TrueResult strips are only about $18 per 100 where the OneTouch strips are around $80 per 100 online and $140 per 100 at the pharmacy. I use the TrueResult, even though my insurance won’t cover this brand, so that I can measure several times a day if I need to. After a week or so of measuring BG 2 hours after meals, and fasting BG, you will get an idea of what spikes your BG. Carbs aren’t bad, it’s the quality and quantity of carbs you should be concerned with. A high quality carb offers more nutrients, fiber, and protein than a low-quality carb. I consider low-quality carbs to be things like white rice, any bread, and sugar. Milk has a lot of sugar in it and most people don’t think about that as being a contributor to spiking BG. I replaced milk with plant based calcium sources like Kale, and calcium supplements.

          High quality carbs are things like beans, brown rice, any vegetable, and fruits that have a high fiber content to slow the sugar digestion.

          Always eat your carbs with some protein. You don’t have to worry as much about this with beans (specifically black beans) because they are a good source of protein. Protein, like fiber, slows the sugar digestion and results in a lower BG spike. Check out the various sites that offer a glycemic index and a glycemic load list for foods. Follow the low glycemic index and load and you can reverse your pre-diabetes (if that is what you have).

          Here is one of many sites that have a glycemic index and load chart: http://www.health.harvard.edu/healthy-eating/glycemic_index_and_glycemic_load_for_100_foods

          The American Diabetes Association representatives frown when you mention the glycemic index. That is because they are not well trained and use government backed talking points about diabetes. So I tend not to listen to them too much, but they are coming around. In the past 5 years or so, they seem to be paying more attention to low-carb diets and glycemic index. My “Diabetic Educator” wanted me to stick with a minimum of 100 grams of carbs per day (she specifically mentioned white rice, potatoes, and bread) when my BG was 370 mg/dL back in April of this year. That was the last time I went to see her. Since then, I have controlled my BG very well usually sticking to around 60 to 80 grams of carbs per day. The trick for me is exercise (I walk 12 to 22 flights of stairs at least once per day) and eating protein with my carbs.

  48. I just had an odd experience. I went to a movie and decided to pig out on popcorn, knowing it isn’t a normal thing for me and I can always exercise afterward to bring my BG back to normal. I fully expected to spike to around 170 or so with that much popcorn (it was a lot). However, half way through the movie (and all the way through my popcorn) I started to feel shaky and strange. When I got home (about 2 hours after the popcorn) I took my BG. It was 57! Not good! So I am making a little pasta now to bring it back up. It is up to 71 now, so it won’t take much popcorn. This is without my glipizide! I haven’t taken that for 2 days because I ran out. I was going to drink a few shots of rum to help bring my BG down from what I thought would be 170ish (alcohol causes the body to produce more insulin). Thank goodness I didn’t drink any! I could have died from hypoglycemia! WHEW!

    • Well I believe I found the answer after reading some posts and articles. Apparently excessive salt not only makes your body retain water in the blood system, but also reduces potassium, and both can cause low blood sugar. That is a relief! I thought something else was very wrong. Anyway, I had some pasta and went up to 109 in a couple of hours. I feel pretty darn good now.

  49. My doctor says i have hypoglycemia but I dont show any symptoms. I briefly tried intermittent fasting to see if it broke my fitness plateau but after the diagnosis I dont know if I should continue. I switched back to small snacks every two hours. On the other side my blood tests per this article are not that bad. Fbs 84, post prandial 2hr test at 73 and A1c in 4.6. How can i confirm if im really hypoglycemic?

    • Have you been diagnosed with type 1 diabetes? Probably not since you are not taking insulin (I assume). You don’t seem type 2 with those numbers because your A1C is an average of over about 3 months. So you have been perfectly normal for about 3 months or so. Those numbers you show are perfect! However, drinking low carb alcohol (like rum, vodka, etc.) will lower your BG even more because it causes the body to produce more insulin and since you don’t seem insulin resistant at all, then that could make you hypoglycemic fast.

      Throw some more high quality carbs into your diet (like beans and barley) and don’t fast when your BG is low. Also don’t work out too hard when your BG is low. Fat burning mode is good, but you don’t want to go hypoglycemic in the middle of a tough workout.

  50. With fasting sugar levels of 105-115 on most days and A1C of 6-6.1%, I am pre diabetic – who exercises every day intensely and stay out of any high GI. I found out that my morning readings are the highest, which is just before I head to the pool or the Gym at 6AM.
    Later in the day, I have blood sugar levels that drop below 90’s and quickly settle after meals.

    Can the timing of exercise be related to the highest morning readings? Could the body prepare sugars when it is accustomed to regular training at sun rise?

    • I have a similar issue also and was wondering what it means — my fasting blood glucose, when taken in the morning after a 8-12 hour fast, is always 101-108 mg/dL, which is “pre-diabetic.” However, random blood glucose readings throughout the day are in the 70-85 mg/dL range, and post-prandial readings never seem to go above 120 mg/dL. I’m fairly healthy, eat low-GI foods, exercise, etc. No matter what I do my FPG is always high.

    • Tom,

      In the mornings the body naturally emits “wake-up” hormones such as cortisol to supply more sugar in the blood to get us going (cortisol levels are generally highest in the morning). Alternatively at night cortisol is generally lower thus not as much sugar in the blood and you’d expect to see a lower FBG.

      And absolutely the body can anticipate exercise which would cause a release in the exercise/wake-up hormones as well.

    • Wow, this article was written back in 2010 and still getting frequent responses! Way to go Chris!

      Tom, Travis is correct… You may also be over training. I just listened to Rob Wolf’s podcast episode # 289 with Dr Richard Maurer. He was pre-diabetic in his 40’s. A lean long distant runner, he attributed it to a genetic predisposition. He recommended a low carb high fat diet with shorter exercise routines and more strength training. However, the really interesting part was his explanation how over training can impact thyroid T3 conversion slowing you metabolism and increasing insulin resistance (he explains this in detail and provides nice analogies).

      I should also add, he stressed (as does Chris K.) everyone’s metabolism is unique and cautioned against a one size fits all diet. While it worked for him, someone who is hypoglycemic or sub clinical thyroid would likely struggle on a LCHF diet.


  51. After a stressful fall of (admittedly ) overindulging on chocolate and bread I found myself with a fasting BG of 111 and A1c of 6. I was horrified and have cut out all bread and treats.
    I eat a high fat low carb diet with lots of vegetables, I’m 61 and I’m fit with a BMI of 20 . I’m a yoga teacher and have been doing weight training as well. Now I’ve added twice weekly spinning at the YMCA.

    All this took my FG to 97 and my A1c to 5.7 . Of course it’s better than before but the trouble is I don’t know much else to do.
    I had been taking Glucosamine sulfate for some knee pain- and it does overlap in time period with the elevated levels, so I thought I might cut that out. I’ve ordered a glucose meter and strips etc.

    I can’t afford to lose more weight at my age. Any other ideas ?

    • Dianne, sugar is now known to be an addiction as strong as that of coccaine. Your daily walk of shame ot the cookie draw is something all of us have had to deal with at some point. There are many books and programmes designed at assistng people to break their sugar additions – just google it and a few options will come up (like “I Quit Sugar” by sarah Wilson; the “21 Day Sugar Detox” by Dian SanFilipo etc).

  52. Diabetes runs in my family. I have been tested several times for it and have always came out clear. However I get severe migraines in my eyes, dizzy spells, extreme nausea to the point I can’t eat if I wait too long, and my vision starts to dim even in well-lit spaces. My mom gave me her testing meter to just watch my blood sugar levels throughout the day and I’m finding my blood sugar levels are 70 to about 80 between meals and 110 after i have something to eat or have orange juice . Is blood sugar a factor or should I be looking at something else?

  53. I was diagnosed with gestational diabetes at age 34 with my first child. I have never been overweight, am athletic and an avid runner. When I had GD, my fasting glucose was usually mid-90’s. I would have post meal spikes of up to 180. I controlled blood sugar with diet and exercise, and my baby was 6 pounds 1 ounce and born 5 days after his due date. Post-baby fastings were in the 80’s. About 8 months after giving birth, I noticed some tingling in my hands and feet, starting testing and my fasting glucose readings are now between 105-128! Took an OGTT and had a 2-hour reading of 152. Because of learning how to eat a low-carb diet I actually weigh about 10 ponds less then before my pregnancy (5’6″, I weigh 135 now, 145 before pregnancy). My a1c is 5.6%. It doesn’t make sense at all, my endo is even going to test me for MODY (a genetic disorder which causes elevated blood sugar but no complications otherwise). It doesn’t make any sense, as diabetes does not run in my family, and I never had any weight or blood sugar issues before the pregnancy. I have been tested and confirmed that it is not type-1/auto-immune related, and I am producing insulin. The tingling has since stopped b/c I am going pretty low-carb just to be safe.

  54. I have made a completer change in my diet as recently diagnosed with Diabetes Type 2. I am watching carbs like crazy, have increased fiber, and no fast food!! i set goals like 40grams for meals and 2 30gram snacks/day. I dont even hit near the carbs I’ve set and this morning I had coffee, checked my blood sugar at 9:30 before my protein shake and it was 335??? I take Metformin 500 and Glyburide 2.5 q am! shouldnt it be coming down??

    • What I have discovered, and this is not from a medical source, but it is that blood glucose continues to be made from stored fat in the liver until the liver receives the signal that it needs to change course by your pumping some carbs in. I realize this is totally counter-intuitive, but even a lot of exercise on rising does not stop the liver from producing carbs.

      Fasting blood glucose is the other side of the coin from mini-fasting (read up on that) as a weight loss technique. Generally speaking, you use up your existing blood glucose about four hours after your last meal and during sleep your liver starts producing it and keeps on producing it until you eat some healthy carbs to let it know you are not starving.

      Consequently even if you exercise, etc., after rising, you won’t find blood glucose declining in my experience. My plan is to take FBG level immediately on rising, and then eat as quickly as possible after that, not a lot, but pack in some carbs (some oatmeal?) of a healthy complex nature to signal your body, “Stop producing carbs, I’m eating again.”

      So, from my point of view, the key thing regarding FBG is to get it stopped ASAP, then go ahead with exercise & low carbs & post-prandial measurements. Once you think about this, it’ll seem obvious which makes me wonder why we are measured for FBL, but never told in medical settings how to reduce it ASAP.

      (By the way, I’ve learned that the little hand-held BG measuring devices are wildly goofy. I’ve gotten so efficient with home testing that, using he same blood from the sticking, I can get it on three test strips in 90 seconds, and the values reported are ALWAYS different. Just now I did that and the three scores (same blood, same device, different test strips) went from 89 to 101 to 93. Go figure, but don’t get anxious, it is just part of the deal that favors pills over natural treatments.

      • About the exercise, your BG will decline when you exercise because your muscles will use the existing glucose in your blood first. Rigorous exercise is the best for lowering blood glucose. The other day, I was bad and had some refined carbs (that’s a no no for anyone). My BG shot up to 170 mg/dl from about 100 mg/dl within an hour. I ran up and down 8 flights of stairs and lowered my BG to around 90 in that time. It really depends on how insulin resistant you are but no matter how resistant you are, for type 2 diabetics, exercise WILL lower your blood glucose. That’s why we have to be careful when on medicine like glipizide (increases insulin production), because rigorous exercise can drop you to dangerous levels. I walked fast for a while last night, and this morning I woke up at 63 mg/dl and had to quickly eat an apple which bumped me up to 83. Thank goodness I hadn’t taken my glipizide yet! You won’t control your type 2 diabetes without exercise. It will get worse and worse as you age unless you get your butt moving!

        • Hmmm. I don’t see how this is a reply. Of course, Blood Glucose declines with exercise. My point was about ending the body’s need to produce Blood Glucose that is measured by Fasting Blood Glucose.

          Exercise will reduce Blood Glucose but it won’t shut off Fasting Blood Glucose production in my experience.

          • I replied because you made it sound like you were saying that exercise doesn’t reduce blood glucose. I guess I read your comment wrong. I apologize. And yes, your liver never actually stops producing glucose. What it does is slow down and starts storing glucose as glycogen for later use. Then, when the body needs additional energy in the fasting periods (between meals and during sleep) the liver signals to release the stored glycogen. If the body is insulin resistant, or in the case of type 1 diabetics, fails to produce insulin at all, that’s when we get the high blood glucose levels above 90 (not including just after a meal).

      • By the way, if you do exercise rigorously, and your BG is still very high and/or rising, check your urine ketone levels. If they are also high STOP EXERCISING and get to a doctor! Your body may be becoming too acidic which can happen if your body is so insulin resistant that it will use fat and protein as energy instead. This can lead to ketoacidosis and that is a very dangerous condition. You can find out more here: http://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547037/all/Diabetic_Ketoacidosis

  55. I am female, 44, at a healthy weight, and have always had my A1C checked regularly because diabetes runs in my family. Recently I was surprised to learn my A1C was 5.7. I started checking myself at home and discovered my fasting glucose was consistently over 100. Ate a 70g carb meal and tested at 190 an hour afterward, 143 after two hours. Scared the crap out of me. Started a low-carb diet immediately. Have been doing that for a week and fasting glucose is still high–this morning was 118. What am I missing?

    • Do you exercise every day and vigorously 3 times per week? That will go a long way to reversing pre-diabetes, which it sounds like what you are experiencing. Your body is becoming insulin resistant, probably due to inactivity. Walk fast for a half hour every other day, try to run other days, and maybe work some light weight. You should be moving for at least a total of 30 minutes per day. It doesn’t have to be all at once. I walk stairs a few times per day for 10 minutes each.

      • If exercise and diet changes don’t work, you will want to see your doctor as soon as you can to get a handle on this before it gets out of control. Anything above 140 can do some pretty bad damage to your nerves and vessels in your eyes. I experienced eye damage, but it didn’t diminish my sight at all, thank God!

  56. I am a recently diagnosed diabetic patient which came to me as a surprise as I had always gone for comprehensive medical checks every 6months prior to now and the doctors assured me everything was okay despite a HBAic of 6.5 and an FBS of 113g/mol. However, last month, I noticed a change in my body system and went to the same hospital where an RBS revealed my blood sugar was 408g/mol. I was admitted in the hospital for 6days and had to change hospital when the Physician insisted it was a Type 1 DM and i had to go home on insulin despite much plea to try drugs. The second hospital insisted it was a Type 2 and discharged me after four days on drugs. I am on four diabetic drugs now. Yesterday, my RBS was 71g/mol and I got scared and took only the medformin as I am more concerned of going into Hypoglycemia. My pandra after that was 180g/mol. I have seen both an endocrinologist and an Opthamologist and they assure me things are okay. I am tired of drugs. Please what is the best way out of this? Do we have a choice in going herbal?

    • Do you exercise every day and vigorously 3 times per week? That will go a long way to reversing pre-diabetes, which it sounds like what you are experiencing. Your body is becoming insulin resistant, probably due to inactivity. Walk fast for a half hour every other day, try to run other days, and maybe work some light weight. You should be moving for at least a total of 30 minutes per day. It doesn’t have to be all at once. I walk stairs a few times per day for 10 minutes each.

  57. I am struggling, I am eating everything I am supposed to but my sugars in the morning after a meal & meds is close to 240, what should I ask my doctor & what should I expect?

    • You need to see your doctor NOW! He will test your blood glucose and most likely prescribe Metformin (inhibits glucose production in the liver) and Glipizide (increases insulin production). Metformin can have some side effects that aren’t life threatening but aren’t pleasant, for example, diarrhea. I was only on metformin for a month or so and couldn’t take the side effects, and I am now only taking glipizide (2.5 mg).

      The first thing your doctor will tell you, beyond the medicine he will prescribe, is to start exercising every day. You need to make your muscles work to increase their insulin sensitivity. You will never control your blood glucose without exercise. Exercise is the most important thing for a type 2 diabetic.

  58. Hey guys, I wonder if any of you could help me?

    I’ve been on a low-carb diet for ages. A1c is 4.4% and FBG was 4.7mmol (85mg), both as of last week.

    However, this week I’ve been trying to reintroduce carbs to around 150g, and have decreased my fat. Yesterday I was caught short in a restaurant ate a tiny plate of roast sweet potato, beetroot and black beans. It probably weighed around 250g. An hour later I got 7.8mmol (140mg). It then decreased.

    Today I ate 70g of white rice with some crab, and again, got 7.8mmol (140mg). I also got a reading of 8.4 (152mg) a few minutes later but I don’t know if that was accurate as 5 minutes later I got 6.9 (125mg).

    What do you think? I’m terrified. Some people have entire PLATES of rice, I feel like I’d die in that situation?!

    Thank you 🙂

    BTW I’m 23 and have no other known health issues.

    • I don’t think there is anything wrong with introducing different carbs into your diet as long as they are high quality carbs. White rice isn’t really a quality carb because it has been stripped of most of its fiber and nutrients found in the husk. Eat brown or wild rice mixed in with it, eat small portions of it, and eat it with a protein. The 140 mg/dL spike is normal for that many starchy carbs as long as it returns to normal (around 90 to 100) a couple of hours later. If it doesn’t, walk some stairs for 5 minutes, or take a fast walk outside for 15 minutes. It will come back down. Above 140 seems a bit high, but again, if it is very short-lived (1 to 2 hours) that is okay. You don’t want to go many hours with a high BG level because it will damage many systems in your body, most frequently the small vessels in your eyes. I take a walk after every meal, even when I am on a low-carb diet. Again, it’s not about carbs, it’s about the quality of the carbs. If the carb doesn’t offer high fiber and other nutrients, it’s not worth it. Starchy carbs are not worth the hassel in my opinion.

      • The comment above was assuming you are either a pre-diabetic or type 2 diabetic. This won’t work for type 1 diabetes and can be dangerous to exercise with a high BG in type 1 diabetics. You need to adjust insulin according to your planned meals if you are a type 1.

  59. one of the problems with diagnosing pre-diabetes with the fasting blood test is that you have to go to the doctor or lab to get blood drawn. By that time, a person’s waking glucose level (which can be significantly higher) has come down. Someone with a 96-110 “fasting” level might wake up with 145 or higher. Unless one is obese, the ADA-based system just looks at them and says, “You’re ok” instead of asking “how do you feel in the morning when you wake up?”

    • I think the best way to test your fasting blood glucose is to do it yourself. You are right, when you do it at the doctor’s or in a lab, your BG may be lower or higher because you haven’t eaten in a while, and much longer by the time you get the test done. Different people react differently to fasting. Some folks will spike higher and higher the longer they go without food because the liver will start to produce glucose as a result of lack of energy intake. Some people will dip low in their BG down to normal or lower during fasting. If you want a very affordable tester and strips that are very close to one of the best, OneTouch Ultra Mini, see my profile. I buy the more affordable tester and strips now that allow me to test very frequently without excess cost.

  60. the doctor after a medical test told me i was at the risk of pre -diabetes, i had the symptom especially of urinating frequently, and i started all the dos and dont as recommended by my doctor.
    recently i still urinate a bit more frequently but in two days now my blood sugar level read 78 and 83 respectively.
    what is likely to be my problem and the reason for constant urinating

    • those numbers are very much in normal range. My doctor said Benign Prostrate Enlargement is the typical cause for more frequent urination. He offered a pill for it to help reduce the enlargement so common in men as they get older. I some times take B-complex before bed and it seems to work for some reason. I consume allot of fluids for 3 hours before bed which is not the best idea, but the vitamin B seems to work anyway.

  61. I have actually been having trouble keeping my BG above 70 today! I had to eat candy. I think I am ready to stop glipizide, and then I will be drug free! 🙂

    • Derik, this is what the Diabetes Summit said the Doctors are afraid of, because too low is very dangerous compared to too high. One doc said they can never be sued for the known progression of high glucose with medications, but the opposite is not true. They said this makes the situation for avoiding helping people with pre-diabetes, since meds can make them too low and have fainting and injury or worse. Given their tool box has only meds, and an upside down food pyramid– we need to pursue alternative methods of control outside of mainstream. These comments in this blog seem to align with the Summit’s conclusion of what to expect. You best follow the plan you found for yourself if it works — I just go for tests since I pay insurance premiums. I spend lots of Whole Foods and some supplements besides. Maybe you heard the new word is Disease management Provider, since healthcare provider is not accurate 🙂

      • Yeah, my doctor is actually impressed by my exercise and diet, so he has already mentioned taking me off of glipizide. He took me off of metformin a while back because of the horrible and costly side effects. Glipizide is safe but it can make your BG drop too low. I can’t exercise when it gets around 80 on glipizide because I lose a lot of glucose when I do. I may stop the glipizide on my own. Not normally advised, but considering my situation, I think it would be okay. Sent my doc a message today about it.

        • Its true some meds do things that cause issue if you stop – blood pressure for sure as my friend and wife attest to. I argued with my Doc to quit Statins and he got angry and said just take it– so I got angry and swore never to take it. Like you I changed my diet radically and got better in many ways. So it worries me if we really need Doc’s permission to try to make progress while staying on the med — unless they are really with you on the plan–sounds like your’s may be a good guy trying to work with you. Mine was so happy with the LOW LDL results he could not accept the improvement from diet alone. I had to learn on my own that leg pain issues are normal for statin takers — he just said I was getting old and did not consider the possibility the meds were involved. Enjoy your new life — you are one of the lucky ones who found the cure.

          • Is your LDL still low without the drugs? That is something I am working on now. My LDL was within range, but my HDL was too low, and out of range. I just need to lose more weight, and I am confident that will happen faster once I am off of metoprolol (beta blocker, slows metabolism). My cardiologist put me on that because I was having tachycardia episodes almost every day while I was on metformin. He is talking about taking me off of that after my next visit.

            • My LDL is typically 130-135 without any meds eating like you talk about. The LDL and total are not that meaningful anymore — its the Triglyceride/HDL that was shown to predict cardiac issues, i.e. statistics of people who had serious problems also had ratios 4 to 1 (or like 200/50 for example). Since these people with problems never had ratios below 2 to 1, it is now considered very low risk to have Tri/HDL of 100/50, 120/60, 140/70, etc. Thus its the bad triglyceride levels and insufficient HDL that indicates the level of risk is on the rise. You could still have an LDL of 160 and a total of 240 and be very low risk if TRi/HDL was 120/60 for example. Personally I believe my fish oil commitment is working the magic. I get 90/55 on average and sometimes better. Look for good DHA/EPA content and low mercury fish oil. Or try krill oil.

          • This sounds a lot like the doctor my parents have. My father had a heart attack at 50 (smoker, rarely exercised, and ate a SAD diet). His doctor at the time was great and got him to quit smoking and change his lifestyle. A year later, our family doc died and he was shuffled to his current doctor. Statins were ordered, followed by morphine patches for the incredible leg and back pain that began 6 months later. Then came the anti-depressants for the changes in mood. Now he’s on about 9 different medications and he’s told that it’s because he’s fat (he is) and old (not really). I shake my head when my parents tell me how well they’re doing on their weight watchers diet that encourages cakes made from coke rather than oil and eggs. My mom is “prediabetic”, and always thrilled when the doctor tells her that she’s controlling her blood sugar well (she doesn’t monitor) but I cannot fathom that she is in good control at all. It just makes me sad that a doctor can do this to people.

            • You have to be tough with doctors. Mine is rarely available, and when I was having multiple ER visits because of tachycardia, I tried to follow up with my doc, but he was booked for over a month. I told him that either he make himself available or I am finding another doctor. He made himself available. I am also the one who is pushing him to take me off the meds, but I am putting the work in to make him agree (lifestyle changes).

            • Sarah, sorry to hear what your father is going through. When I was on the statin I complained of leg pains and the doctor said its just from getting older. On the Diabetes Summit this past spring (online webcast interviews) they said doctors are addicted to seeing low LDL scores from the statins and can’t see past that one thing. Many respectable Doctors on line are saying the statins just cause more harm, and the proof is out that no body avoided serious heart problems because they were on statins. The only good thing found was for those who had heart attacks already, the statin helped delay the next one. That just says if your plaque is already clogging you up, then keeping the flow of LDL concentration lower can help prevent further clogging. The root problem is still there, plus the side-effects will exist. On the Summit they said normal progression is for amputations which is completely acceptable industry standard, along with open heart surgery etc. They also said the best all around help for lower risk is to eliminate processed carbs/sugary stuff all together and reduce starchy carb vegetables (potatoes), but carrots are not actually high carb unless you eat a bushel. And most people find out that grain foods are a big problem for them, so no breads and minimal rice etc. Wheat is now considered the worst food ever engineered in the lab; and per the book Wheat belly, and others there is no more Wheat from old times – its 100% GMO now, so we just have to make sure not to eat food that has it. Most people get way too much of this– per the Summit, the Food Pyramid is dead wrong on the grains are good for you recommendation on the wall at the Doctors’ offices. Diabetes is a fantastic business since most people can stay ill for 50 years with modern treatments. My Dad made it to 86 when dialysis was next and he decided to pass (no pun intended). He amputations and bypasses wore him out I am sure.

          • I received a response about the glipzide from my doctor yesterday. He is letting me cut the pills in half now, so I am taking 2.5 mg per day instead of 5 mg. Now I just need to get off of the metoprolol and I am gold! Metoprolol was given because of side effects from the metformin. Metoprolol can cause weight gain, and has decreased my ability to think clearly and to lose weight. It slows your metabolism.

          • I’m having trouble with my blood glucose. I’m not diabetic or anything but get light-headed a lot. My levels are usually in the mid to low 80’s when I get light-headed and weak. I sometimes skip meals out of not knowing what to eat. I want to eat healthy but am so confused with “complex carbs” “proteins”. Is there a website or something to simply get me started eating right?

            • “The Diabetes Solution: How to Control Type 2 Diabetes and Reverse Prediabetes Using Simple Diet and Lifestyle Changes” by Jorge E. Rodrigues and Susan Wyler, and “The Johns Hopkins Guide to Diabetes”. Those are two very good books and both contain dietary guidelines. They are geared toward diabetes but everyone should follow these healthy eating habbits.

            • Also, your BG levels are perfect! Maybe throw some healthy grains or more beans in your diet to give yourself a little more high quality carbs.

              • And never skip meals! Eat the veggie rainbow, more fish, and more beans (like black beans)! Eat lots of leafy dark greens too, like spinach and kale!

            • I forgot to mention, if you are experiencing dizziness, you may want to get checked out by your doctor. Low blood pressure and high blood pressure can cause your symptoms. Blood tests are relatively inexpensive with insurance. Go get checked out! Better safe than sorry.

              • Yeah, went recently. He said maybe anxiety?
                I just wanna figure out this eating healthy stuff. It seems confusing having always just eaten whatever. Now that I’m getting older (34) I’m more concerned, since my Dad and grandparents are diabetic.
                Thanks for the info.

                • Diet is pretty simple really. Give up breads and get your fiber from veggies and beans and supplements if you want. Avoid ALL PROCESSED MEATS (deli meats). Avoid beef, pork, and lamb as they contain a chemical that when metabolized creates a carcinogen which has been linked to colorectal cancer. Avoid Every other processed food! Eat whole fruits and veggies, beans, LOTS of leafy greens (spinach, kale, chard, etc.). Eat fresh water fish and chicken a few times per week (chicken without the skin). You can’t go wrong with that diet. And the reason I said avoid bread is because unless you make whole grain bread yourself, they add all sorts of toxins to any processed foods now, including all breads. Drink water only, and occasionally green tea. Stay far away from juice and soda. Juice is super high in calories and sugar, and lacks fiber. Soda is high in sugar, and diet soda introduces carcinogens into your system linked to neurological issues and cancers.

                  Basically, anything that you can grow, eat. Anything that requires extra processing, stay away, or be very cautious.

                • Also, minimize or avoid caffeine intake. Caffeine causes the body to go into overdrive, screws glucose control, and causes the body to not be able to absorb nutrients from your meals, essentially causing malnutrition in the worst cases.

  62. Has anyone tried asking about the relative meaning of high-sensitivity C-reactive Protein (CRP) levels with A1C levels? I used good doses of turmeric daily to get CRP down to <.1 which was no value on the history chart. The 3 month prior was = to 0.1, and the 3 month before that was 0.8. Thus Turmeric seems to have completely eliminated inflammation that is measurable by the high-sensitivty technique. The reason to ask is because I thought we worry about pre-diabetes levels as they induce inflammation which kick starts the diseases. So does higher glucose in pre-diabetes range matter if CRP is 0? I got no response from the Doc and I have not seen this mentioned online. If there is interest in the turmeric concoction I can provide the recipe or link. I take 5 teaspoons (using the silverware spoon) of the thick broth after boiling the powder. The organic powder is 8 or 10 bucks from Amazon or Starwest Botanicals.

    • The turmeric broth lasts a week or 2 in the fridge, so you only boil a small batch 2 or 3 times a month. 1 lb. bag lasts months too. This potion keeps my arthritis pain to almost nothing, and I only warn it also is a colonic detoxifier – no issues, just don’t expect to have constipation. My understand this pretty much eliminates any chances of getting colon cancer- a great thing! No inflammation — no cancer.

      • My wife boils about a 3/4 cup of water and stirs in 1/4 cup of organic powder. This makes it easy to spoon out of jar each day to add to other drinks or you can drink a shot glass size (as seen on Dr. Oz.). Ideally you add black pepper which enhances absorption in the intestines to the blood stream. My wife does’t like so I take a small cap of Bioperine (i.e. same thing). What I read is if you skip the black pepper then most of the turmeric will travel to the colon and kick the crap out any inflammation trying to take root down there. I think the bioperine must help since my hsCRP was so low the lab could not measure any inflammation markers in my blood. Plus it seems like the easy way to have a regular colon cleanse at the same time. Friends in southern California go to a juice bar that serves Turmeric shot (in the glass). On TV the other day, Dr. Oz guest doctor (his father in law) says he has the evidence this stuff kills cancer in every organ! Drink up – a half shot a day should do it (I take weekends off unless my arthritis is painful).

    • We should all be working toward being medication free; however, if your blood glucose is out of control, meds are necessary to quickly bring it into control. I was on metformin until I made lifestyle changes to bring my BG under control. It only took 2 months. My doctor has taken me off of metformin now, and now I take glipizide. He is talking about taking me off of that now too. Diet and exercise are the key. Nothing is as effective as those two combined. Stay well away from refined and starchy foods, as well as fatty meats and deli meats. Start eating more dark leafy greens and a rainbow of veggies, and exercise at least a half hour a day, and when your BG spikes. You will see a dramatic difference in your BG level within days!

  63. Everyone interested in Glucose measurements and their relative status in terms of having any degree of diabetes should explore thediabetessummit.com

    That summit took place a few months ago. These Doctors and Practitioners pretty much said the general Doctors we are all seeing do not have the answers- the answers are a work in progress they are all doing there part in finding out. The most profound statement made was that most Doctors have no training in diabetes and just follow the protocol of their organization or mainline. The horrific part is that they have to wait for us get to that point of very high numbers and start us the normal array of treatments, which takes us down the path towards amputations etc. The statement was made “this is the normal course FDA expects of diabetes patients and therefore the prescriptions will take us there”. The Summit is trying to charter a new course that helps us heal and prevent the complications considered normal in diabetes. Except for Metformin, all the drugs have hideous side effects to deteriorate our health; so much so that the people suggest not taking any medications at all, and trying a few novel things — which really translates to the low carb dieting for step 1. they said everyone improves with that.

  64. Chris,

    If someone is having abnormal blood sugars and your doctor isn’t listening to you about it what would be my options? I feel like the only way my doctor will listen to me is if I pay out of pocket for an OGTT and then show her the results. I honestly don’t want to do an OGTT because when I did the one hour screen it made me queasy.

    • The obvious answer is to find a new doctor. When you say abnormel, how did you find out? You must have some results from some tests. As I studied the subject, many do not recommend OGTT test as it does not reflect a real life situation and makes people sick. Why don’t you purchase a blood glucose meter, the strips can be purchased cheapl on the internet. Start checking your blood regularly, morning (fasting) and then after the meals, 1 and 2 hours. After a week or two you will have enough material to show your doctor how your sugar is doing. You can find out about your blood sugar from regularly monitoring your levels. You do not need OGTT to find out if you have or don’t diabetes.

      • Marty,

        I was recently hospitalized and I had blood sugars of 133, 160, 140, 135, 125, 125. They were taking my blood sugars during my hospital stay because my blood sugar was high (136) when I was admitted to the hospital. The 136 on admission plus the 133 are diagnostic for diabetes for a Fasting Blood Sugar. When I was discharged I was on a diabetic diet. My PCP won’t accept I have diabetes because I think its that I don’t have the 200+ readings.

        • I had my wife in the hospital also, ER, they were taking her blood sugar, most of the time it was higher, she did not have any diabetes for sure. I would not rely on the hospital measurmenta at all. You say you had 136 on admission. WHen did you eat, what did you eat. Such a number out of context means nothing.

          My suggestion is to take deep breath, buy a glucose meter and start monitoring your sugar for at least two weeks. Fasting in the morning, then usually 1 and 2 hours after the meals and before going to bed. I disagree with your doctor who wants to see 200 to take action. If after two weeks your numbers indicate prediabetes or something similar you need to take action into your own hands and find a new doctor.

          Five years ago I had ‘pre-diabetes’, and was overweight. The doctor wanted me to start taking some medication right away. I studied a lot about diabetes and first decided to lose weight, start exercising and eat healthy, no soda, cookies etc. Now I have normal weight, still eat healthy and there is not even a hint I have a problem with sugar. I don;t use any special diet, just eat healthy, maintain weight and exercise.

          • Marty,

            The 136 reading upon admission that I was talking to you about was that 6 am in the morning so it was an FBG. Some of those other readings were FBG as well. So anyway you slice it I’m not normal and according to the standard Chris mentioned that he would use I failed them.

        • Breanna, what you say sounds correct. Recently this year a “Diabetes Summit” was held on-line with about 40 subject matter experts all working with patients in various means. The entire series is for sale. I listened to most of them and I would say this summit is saying the regular Medicinal approach is not put into effect until the subject is in pretty bad shape, or many years into the problem development. People in the pre-diabetes condition are basically sent home with an upside food pyramid chart and exercise recommendations. The concluding remarks were indicating this is very sad — and we need to get help to get the Glucose down to normal as soon as possible before the meds for Type-2 just make the patient worse off. Your data sounds like you are in this state along with millions of us. I think they said “millions” if I’m not mistaken. The normal healthcare options don’t provide solutions yet, thus the “Diabetes Summit” approach is very special. I’ll admit I have tried the plant/herb, sea-weed powders, and vitamin/supplements on the market for Glucose lowering and just have yet to identify a winner. I do have my blood test records however and can say the Statin meds for lowering cholesterol also whacked my Glucose down to normal; however I got sicker and fatter and had more pain walking and stopped taking that in favor of a green smoothie /low carb / healthy fat & protein diet. My Glucose got higher than originally but the Triglyceride to HDL ratio dropped below 2.0 which is the new gold standard for Lipid fat tests over the LDL & total cholesterol scores. Plus I feel great with lots of energy. So what do the pre-diabetes / barely diabetes numbers really mean? I recommend the Summit videos if you have the time and a $100 or so to invest. Your questions however are just the beginning as the topic has no quick black and white answers. Honestly I was more discouraged after. But I have entered a mission phase of life to learn more and get more data on all facets of blood tests and foods. If you can make a hobby out it, then its rewarding to share and discuss with others in family and work situations.

          • Glenn,

            She still won’t diagnose me with either diabetes or prediabetes. I don’t know what I should do now. Any suggestions?

            • Breanna, your numbers mentioned would not trigger a verdict for Type 2, and for Pre it seems you have to have an A1C of 6 at least. I can’t recall if you had that result. I test that every 3 months now to know for sure. my FBG is always Pre but A1C is always below 6, so my PCP says its OK. That is the standard response it seems. Did you get a home monitor? I got him to prescribe it so at least i can collect data when i try a change. I think that and getting A1C every 3 months is all you can do. Unless yu can afford an Alternative assistance Dr. program. Eating veggies and healthy fats are the biggest aids to lower Glucose of course.

              • Glenn,

                Yes, I have been testing at home. My numbers range from 110 to 144 just fasting. Based on the those fasting numbers I would definitely qualify as prediabetic. I think its ridiculous I cannot get a diagnosis because my doctor is old fashioned. I’m going to print out all the readings for her to see and maybe that will change her mind.

                • Breanne, you can try — I have not been able to get my Dr. to talk at all, but he has been amenable to my requests for many other blood tests to compare (CRP, Calcium, Vit D, Testosterone, typical CBC -Complete Blood Count ). Only glucose is not cooperating well. I asked for Insulin test last week and he said it is not used anymore because the home scores are more useful. I asked for Homocysteine and he said they quit that 8 years as it is debunked. My feeling is the Dr.’s are trained to prescribe meds for good solid disease situations, and are not comfortable discussing what we are learning online from others. that is my take and I accept for the coverage I have this is my best bet for costs out of pocket. Plus I buy allot of Kindle books to learn from. You may end up in the same boat if your Dr. freezes like mine, or just poo-poos what we think. Maybe you can convince your Dr. to dig a little more for advise. Hope she helps you.

        • Just know that being injured or ill will spike your blood sugar, sometimes quite high. I believe it is you body’s way of providing the needed energy for recovery and repair.

    • Glucose is not the only test for heart health risk. You can look at the Anti-inflammatory Diet, Dr. Weil’s website has for instance. In his link for it, ” Elevated C-reactive Protein (CRP)” it says “If this test shows that CRP is less than 1.0 mg per liter of blood, the risk of heart disease is considered low; if it is between 1.0 and 3.0, the risk is average; if it is above 3.0, the risk is deemed high.”

      What is the connection? Well diabetes is known for heart failure risk, but all the complications of diabetes are associated with high inflammation. High inflammation is now known as the root source of most disease formation–you could say inflamed tissues are the incubation areas for the development of disease locations in the body. Since I have perpetual pre-diabetes numbers I have been examining other risk factors. CRP seems to offer one of the best collaborative assessment factors for heart disease risk, so you don’t have to use old fashion Fasting Glucose alone. My research has uncovered that High Glucose initiates inflammation issues in any of the organs. So I do my best to stick to low inflammation foods and supplements. Minutes ago I got my new HMO reading of <0.1. I was 0.8 in January this year. That was bad, but per Dr. Weil's link still low risk of heart disease. When it comes to Glucose tests, there seems to be no clear cut answers out there. So no one should worry until they collect a variety of bad indicators for risk. Of course inflammation cannot be a good thing unless your body is dealing with a short term issue that it will recovered and healed back to healthy status.

        • Derik, you make a good point. We get an invitation every year for a mobile unit that does this test for about $125. I have not invested that way, but I invest in in K-2 MK7 (Vitamin K2 from Natto). This has allot of press for moving calcium to where it belongs and even removing arterial calcium. It is “required” for people taking Vitamin D in does of 5000iu or more which I do. I maintain a blood level of 70 to 80 which is high optimum. But ideally the Healthcare insurance would give the artery calcium test — since they “care” if we have a developing concern, right? I think they only care about giving meds if you are justified with the correct high number; which the population is encroaching in greater percentages.

  65. 3 months ago, my doctor told me I was prediabetic with an A1C of 5.7 and glucose reading of 110. At the time, I was eating nothing but junk and fast food in large amounts. I wasn’t surprised. I completely changed my diet. Since, my fasting blood levels in the morning are between 66-72. Most of the day I range in the 70s and at 1 and 2 hours post prandial, I am in the 80s and 90s. Never went over 105 post prandial. I got my most recent labs back and A1C was down to 5.3, fasting glucose was 65. Last night, I ate a baked sweet potato roasted in coconut oil, 4 oz of baked chicken and some cheese. 45 minutes later, level was 185. 1 hour 195. and 2 hour 175. As you can see, these levels were not normal for me. Should I assume I have diabetes?

    • You might try again without the Sweet Potato- a good volume of carbohydrate with a low glycemic index takes longer to get processed- it stands to reason the glucose might be higher than you want. The fact that your numbers improved so dramatically after changing your eating suggests you are far from having diabetes, or even pre- for that matter.

      • Thank you for your response. I retried the sweet potato last night, but this time, only ate 1/2 and steamed instead of baking (because I read baking it can almost double the GI). 45 minutes after 95, 1 hour 98, 2 hour 102. I guess the reason I freaked out and assumed the high numbers from the night before were indications of diabetes, is because everything I read says a normal person with a high carb meal won’t go over 140 and mine were well over that. I can’t seem to find any explanation as to why it would have been that high

        • I have normal glucose but do check it occasionally. it does happen that I get a weird number once in a while. I retry again and it gets back to normal. So it is advisable to always repeat the test if the number is out of the ordinary. There should not be much difference between 1/2 and 1 potato. So you sugar seem to be normal.

        • I recently tried the concept of high fiber to see if I can improve my A1C and Fasting numbers. I hunted down the highest fiber foods and picked the big winners to try. It turns out these are high carbohydrate foods — I found black beans and a flax cereal that had massive fiber ratios and near 0 sugar. I ate a bowl with glee and waited an hour. My reading was 165, compared to my highest number ever of 130 with my low carb diet. Did some reading and reassessed the total carbohydrate of the food–answer was total carbs trumps high fiber when it comes to controlling sugar spikes. I returned the flax seed cereal to Whole Foods for my money back, and I accept small amounts of black beans as OK. I have had Pre-diabetes numbers for nearly 30 years and recent years on low carb, high verge & greens, rationed fruits and quality protein sources leaves me with higher A1C as Chris said above is expected (i.e. low carb dieters experience higher glucose levels). Its a mystery still. I suppose a more serious aerobic activity would be a good experiment next.

  66. My Dr. told me I was insulin resistant 3 yrs ago, and put me on Metformin . My tri-glycerides/cholesterol etc are always mid range. HBA1C is 5.00; FBG 95, and Insulin 15. I eat a low carb diet; BMI 24.5; exercise every day;very active. After 3 yrs on Metformin FBS was increasing to 100-105, but as I decreased the Metformin to 1gm /day instead of 2g/day my FBG has decreased to around 90 but insulin back at 15, whereas with the 2 gm Metformin it was 5!Very confused-any comments please? Thank-you.

    • Tina, I know I am insulin resistant and can tell after a piece of bread or small amount of pasta. My fasting glucose is 110 to 115, and with the low carb diet averages 114. I asked my Dr. for metformin “to try” as I read it is quite safe and has no side effect issues other than in the belly at first (no biggie at all). He refused saying it will hide the problem and I’ll not make life style changes. I think that is dumb since extra circulating glucose is just not doing any good over the long term of months and years. He did provide me the home monitoring kit however so I can keep an eye on changes as I try something new. I have no data on insulin levels to help in this discussion, but surely if you can optimize the metformin to keep your fasting marker down to normal, then you are doing great for yourself. This endeavor is pretty much trial & error until we each find our unique technique to manage blood glucose – hopefully you are checking the post meals and adjusting diet so those don’t get much over 120 to 140. From what I read, this is more important than the daily fasting number staying normal.

    • I had horrible side effects with metformin, mostly anxiety and tachycardia. Since being off, I have controlled my BG with glipized, exercise, and a good diet rich in leafy greens and black beans. I started with a BG of 375 when eating unhealthily, and now I maintain 70 through 100 most of the time just on glipizide. I have a lot of info on how I do it if anyone is interested. Most of it is diet and exercise. Drugs don’t even come close to being as efficient as diet and exercise.

      • Derik, have you researched glipized for long term safeness? I have not heard of it so I will so I am aware of it. I have been on kale and spinach smoothies for 5 years now and have had everything get better about my health except the BG is a little higher. I also barely eat any carbs but fruit and veggies (easy on fruit as they say too). I can’t jog due to a bad hip so I do gym but have not seen improvement-so I am trying to increase frequency and intensity. I wonder if you stopped the med if the diet and exercise alone will work?

        • Glipizide works by helping your body to produce more insulin. I guess it’s kind of like wine or grain alcohol, where it causes the body to over produce insulin (I would never suggest you start abusing alcohol to alleviate diabetes 2, but 1 serving per day could help). I have had no side-effects from glipizide, But it enjoys the same side effects as metformin, though it works differently. So there is a chance, but neither have life threatening side effects, except when tested by some university in Britain, they found metformin to highly associated with heart attacks of some sort. I have seen nothing like that about glipizide. I think it has to do with the dosage. Typically metformin is given in a minimum of 1000 mg per day. I had problems with 2000 mg per day (a LOT of very costly problems with anxiety and potential hear attacks). Even when they lowered me back to 1000 mg per day, I was feeling paranoid and nervous all day. It was debilitating. My doctor finally took me completely off of metformin. I control my BG mostly by diet and exercise now. And I stay around normal levels (70 through 90).

          • Oh, and to answer your question about stopping the meds. Never do that without your doctor’s approval, but I recently ran out of glipizide. I tested frequently with a low cost tester (see the link on my name) and was able to stay within normal range because after every meal I would run/walk stairs. Just work large muscles for 15 minutes or so, and you’re gold! It’s not easy and does require work. Also focus on many many many many leafy greens along with your normal diet!

            • Sounds like you are ready to stop the med and see how it goes — I think you sound like you were border line pre-diabetes and from what I have gotten out of many sources this is almost never given a prescription. I leaned on my Dr. to just let me try metformin a month or so and see what happens, but he finds a way to weasel out of it. I was think 750 a day only. I figure the constant 115+ from dinner till dawn, then 120 and finally down to 110 by afternoon cannot be good long term. You found some answers you can manage. I take 1/2 to 3/4 blender full of greens I drink breakfast, lunch. I could add more after I blend it and there is space. I will start trying that- thanks !

              • I was, and am, definitely diabetic. If I eat a piece of while bread, or a small mini snickers, etc. I launch to over 140 unless I have had under 60 grams carbs for the day. It’s not normal!

                • My first episode of tachycardia (a big symptom of high BG) in my life was back on April 16th of this year. When they took my BG (the first test they did) it registered at 375 mg/dL. I am definitely diabetic, but I believe in most people, depending on the cause, it can be reversed through lifestyle changes. If it is a malfunctioning liver or pancreas, or other organs causing the lack of or inefficient use of insulin, then I doubt it can be reversed. Every diabetic should have a liver function test and a test of the pancreas function.

                • I’m not convinced a diabetes tendency can be reversed, but that it is controlled through diet. I once read a lifetime of high sugar damages the insulin mechanism permanently. I was raised on high sugar processed foods and my wife of fish and vegetables and fruit in the Philippines province. She can eat high carb all day, while I can barely have a bite.

                • I am completely convinced the condition can be reversed depending on what’s causing it. If it is just insulin resistance due to fatty build up in the cells, then it can definitely be reversed and I think that was what was causing mine. I am on half my dose of glipizide now and even if I eat a small piece of candy (a mini snickers) which I only do to test out my theory, my spikes are completely normal. I go from 80 to 110 within an hour and then back to around 80. Losing weight is a HUGE must for ALL type 2 diabetics. If your pancreas or liver is malfunctioning, then yeah I would agree, there probably isn’t a way to reverse the condition.

  67. I have a low A1c, but a high AM fasting score which falls down to “normal” for me by ten AM or noon, and stays down until sleep. Good 2 hour after meal scores.

    There much be some technique(s) to interrupt the growth of glucose level during sleep, perhaps consuming a chunk of cheese just before sleep or even getting up at 3 AM to do a walk. Clearly fasting testing measures an internal meal of converted fat, and I want to control that part of my 24 hours, also.

    Can you recommend a way to control glucose level during sleep hours when daylight eating is under control?

    • I have the same High FBG every morning. Seems to match the description for Dawn Syndrome. As I sustain a low carb diet my triglyceride level is low and makes me believe I consume body fat for fuel as a baseline, plus the fact I don’t get hungary like carb eaters do. That sounds like your description I think. I have tested myself over all conditions and times and notice a consistent 110 +/- 10 and an A1c computation of 5.5 which translates to 114. Thus my data is telling me that my body is regulating the nominal range without lows and without highs, and stays in this narrow range. My morning value is 115 smack dab in the middle which is terrible per the FbG requirement for normal. I too am looking for evidence this is a good thing, or do I need to try to get to normal. I gave up on FBG and at best can try to get the A1C to shrink, and continue to learn about low carb eating effects on blood glucose and any risks. Bottom line, I simply cannot justify high carb intake and sugar induced inflammationi issues, while low carb feels so good and I know my body has to convert its own sugar needs. I just wish that average was under 5.3 so its in the ideal range suggested by Chris.

    • Dale and Glen, interesting information. I, too, have troubles with high FBS in the morning. I have not monitored by blood sugar the rest of the day although I have done two hour post-prandial. I am basically a low carb eater but I also have serious sleep issues with waking at 3:00-4:00 am and not being able to get back to sleep. Dawn phenomenon? Somoygi effect? Don’t know, guess I will have to check my 2:00-3:00 am to see if it is the Dawn phenomenon or eat some nuts or cheese before I go to bed to see if is the Somogyi. More biohacking is in order!

      • Natalie and Dale, having to get up and do something at night seems too radical for the long run. It won’t hurt to try and see if a fat-healthy food does modify the morning BG result. If it does then you are compelled to wake up which may not be the best if you are otherwise able to get a good night’s sleep. I will confess, after 6 months now, the dawn effect has not budged at all for me. Though I fasted till 10 am to get a blood test and the FG was way way down to 101 by then. At 6am it will be 115 — today it was 121. That is supposed to be the 2hour after spaghetti dinner number 🙁 I do not understand this “phenomena”. If you discover something to help please share.

  68. Hi..my readings are

    June 18 FBG: 131
    June 19 FBG: 117
    June 20 around 2hrs after meals: 113
    June 21 FBG: 117

    what do this numbers mean? am i pre-diabetic? i’m not getting my A1C test yet..im alarmed bec my mother was already diabetic since 2012..

    • Hey Reymelito, there’s no substitute for actually visiting a doctor, but I recently learned a lot about blood sugar readings so here’s how I understand it.

      Fasting blood sugar is your blood sugar when you haven’t eaten anything. It’s usually taken in the morning after you wake up and before you eat, because being asleep for the night is usually the longest time you go without food, so your body is in the fasting state and blood sugar is at its most stable/lowest point.

      Fed blood sugar comes after you eat, when your blood sugar will be at its highest point because you ate something and that percolated into your system through your stomach to give you energy. The thing is, you’re testing your fingertips. It takes a little time for the blood sugar to get from your stomach to your blood and from there to your fingertips properly. And how fast this happens depends on your system and on the food you ate. If you drank a sugary soda or juice, it’s gonna spike up fast and go down fast. IF you ate some beans, it’s gonna take a while to go up.

      So when you start testing your blood sugar you want to test at a couple times. I tested a lot when I started so I’d know how I reacted to different things, like almonds or cauliflower or fake sugar ice cream. If I really want to know what my blood sugar is doing with a new food I test half an hour after I started eating, then again at one hour after, and at two hours. That gives me a general idea of how my blood sugar is reacting, if it’s going up too far or staying high too long.

      Now, the first thing in the morning test. You’re saying your fasting blood glucose is over 100 first thing in the morning – you might want to do two tests, because there’s a thing that can happen. Your body does a whole lot of stuff to wake your brain up first thing, and one of the things it sometimes does with some folks is it dumps sugar into your system like a wake up call to get your brain going. So I’d test first thing, then wait an hour before you eat anything, and test again to see if your blood sugar went down a bit. Because fasting blood glucose is usually down below a hundred and fed blood glucose is usually up above a hundred but not usually higher than 120 or so (140 if you ate a ton of candy.)

      If you’re seriously worried – eat less sugar and more cheese as a snack, ditch white rice and pasta and replace them with sweet potatoes and lentils, stop drinking soda and fruit juice, start eating greens like broccoli and kale with your lunch and dinner, and TALK to your doctor.

      • bookwench, I actually tested in the middle of the night, first wake up, then 1/2, and 1 hour later before eating or any coffee. I really expected a variation, but it was negligible for me. The idea for the wake up sugar rush seems plausible — maybe it is true for many people- they should try it since if they are low before the wakeup they can relax about the issue.

  69. My age is 30 years.My blood sugar level was 167mg/dl when I took blood test 4 months back. after that , I did started exercise and followed diet about 2 months and my blood sugar levels are never crossed more than 125 even after meal. I stopped doing exercises nearly 45 days back .But the problem is I lost my weight nearly 7 kgs with in 3 months (81 KGs- 74 KGs).Today I went for GTT test and results are FBS : 113 mg/dl and after 2 hours GTT(had 75g glucose solution) is : 123 mg/dl, and HbA1c is : 5.7% ..I don’t know whether I am prediabetic or diabetic and don’t know meaning of the results. kindly suggest me ..Thank You.

  70. If a patient came to you with their meter having an average of 125 mg/dl from 33 readings would you diagnosis them as diabetic?

    • From what I have researched, that may be prediabetic. Still it is just as serious and should be addressed immediately through diet and exercise.

  71. I have had a problem for years with certain sugary or starchy foods. If I eat them, occasionally I will get a drunk feeling and need to go to sleep for several hours. This need is nearly irresistible. I feel hung over when I wake up. I had an abnormal 2 hour glocose test when I was pregnant a long time ago, my extended test was normal. My fasting sugar in always 98 on Atkins with few carbs, like 20. I had to go on Atkins when I began to feel sleepy and tired all the time with digestive issues starting last August. My PCP assures me that all my labs were ok. My brother and grandmother are type 2 dm and I have a daughter with PCOS andanother child with NASH. Both see endocrinology but I am not sure I need to. I feel like my doctors FNP doesn’t take me seriously and seeing him is like gaining an audience with the pope.

  72. I have been monitoring my glucose out of curiosity for about a year now. Prompted by they crappy way I felt when I ate sugary/heavy carb loads. I noticed that my fasting numbers were never under 90 (which is strange because a few years ago they were normally around 75 on routine blood work, sometimes 60 which is kinda low). And the most alarming part was that after I ate normal unhealthy food (breads, chinese food) I shot up to 160-225. The 225 reading was the highest and happened a handful of times. I freaked. I started to tell myself I had full blown diabetes. I requested blood work to be done over the course of this year, fasting were 95, 98. A1C was 5.2-5.6 which I thought the 5.6 was high but was told it was normal. I recently was referred to an endocrinologist after my PCP felt like he couldn’t do enough to reassure me. I explained my concerns and I was reassured by this endocrinologist that I was not diabetic not even pre-diabetic despite my high home meter readings. The doctor even laughed a bit which I did not appreciate. This experience just proved to me that doctors don’t truly care for their patients. Its only when your dying or close to dying when they finally can say ok I’ll share my “knowledge” with you, here, take some pharmaceutical drugs. I feel the changes in my body. I am a really thin person, there is no weight to lose but there is so much room in my life to eat healthier and take care of myself. Its truly in your hands. I’ve realized more than ever, as people it is so necessary to become self-reliant especially when it comes to your health.

    • If I were you, I would buy a glucose meter and start monitoring my glucose regularly to see if these are aberrations only. You may have a problem, because in a healthy person, a glucose reading 2 hrs after meal should be below 120, and 1 hr after the meal below 140. If you are over these numbers, I would find another doctor.

    • Sara, sadly your conclusion seems to be spot on – my personal experience is that the Doctors are not concerned when we are basically darn healthy compared to others they have on the agenda for the day. Many of us are interested in feeling vibrant and hoping for longevity without the pain and agony of our parents. So we are pushing the envelope as we get information and, dare I say, annoying the Doctors who don’t have the time or whatever to learn all this stuff. I use email with my doctor to squeeze out any bit of knowledge he has. It seems funny how he mostly avoids the question. But at least he will agree or disagree to a new blood test request and give a reason if he does not want to add the test to my list. I think you are right, we must take responsibility for ourselves–it truly is challenging since the Web is loaded with info, and it takes a big commitment to find the nuggets of knowledge that seem worthy of trying. Plus how much have I spent on books? yikes. Sharing in the blog adds allot towards understanding what we otherwise cannot get feedback. Friends and family have too much mis-information, and trying to advise them is more often only hurting the relationship (since change is seldom welcomed unless we want to make it ourselves). thanks for sharing !

    • hey! 🙂 ok, so blood sugar doesn’t just spike in response to any old food, right? There’s a couple things to consider in blood sugar levels.

      First, sugar itself. Eat sugar, get a super big spike super fast, then a crash when your blood sugar goes way down. It’s big and dramatic and kids love it but it’s pretty horrible for you long term.

      Second, carbs. Get a spike- bigger and faster for simple carbs, slower and lower but still an increase for complex carbs. If you’re gonna eat carbs and not excercise try and skip the white potatoes and white rice, they’re super fast energy that goes away super fast or packs on pounds. The only thing worse for you is straight up candy. Complex carbs take your body a while to pull apart to get to the good bits, so the impact is less and the spike is more spread out and less damaging. You can still overdo it though.

      Third, protein. You get a sort of bump from protein. It’s not a spike but protein will push your blood sugar up a teensy bit and leave it there a while because it takes your body ages to digest protein, and you get the blood sugar results while it’s digesting.

      Fourth, get. Fat takes forever to digest and barely nudges your blood sugar at all.

      So if you ate a big meal with a sugar rush up frond and a starch rush after and a complex carb bump and then a big protein finish.. . Your blood sugar might go up and stay up for a while.

    • It is not neccessarilly the number of carbs only, but the quality of carbs that counts. Stay away from starchy and refined foods like white bread or whit rice. If you have white rice, mix high fiber beans in with them to slow the digestion of the carbs. Eat carbs containing high proteins and fiber like black beans, and eat more plant based foods, especially dark leafy greens.

      • That does not answer the question – what does CHRIS consider a low carb diet? In my book, anything below 50 g a day is low carb – and that would exclude unrefined carbs as well as refined carbs. That’s the way I eat and works for me. But is that what Chris considers low carb? I dunno.

        • Thank-you, Mandy. I am asking how many carbs/day do you have to stay below in order to be considered a low carb diet in Chris’ opinion. There are many thoughts on what it means to be eating a low-carb diet. I already eat only whole foods–no processed, sugar only from fruits (and I try to eat only berries, limited other fruits, and only eat fruit with a protein or fat), very very limited grains and not only a daily basis, good quality protein (very limited beef), healthy fats (coconut oil, olive oil, hemp oil, etc.), and a variety of vegetables (try to watch the number of starchy veggies) but probably need to eat more yet my FBS is in the high 90’s or low 100’s which seems way too high for my diet–that’s why I am asking the question on carbs and I am also interested on how much higher than the 85-90 mg/dl that a low carb diet will make your FBS run.

          • It’s different for everyone and it’s different for every food. You can’t just arbitrarily count carbs, which is why I said it’s the quality of the carbs that counts. If I eat a helping of black beans (not canned) that, let’s say for argument sake, contain 25 grams of carbs, because of the high fiber and protein in the beans, it won’t spike my blood sugar. On the other hand, if I eat a tablespoon of sugar containing 25 grams of carbs, it will get instantly converted to glucose and cause a faster rise in my blood glucose level. I would say get anywhere from 40 to 60 grams of quality carbs per meal. Quality carbs does not mean white bread (or even wheat really), sugar, juice, etc. It means high fiber carbs with protein.

          • I don’t just arbitrarily count carbs, and each of us has different issues, depending on your own metabolic damage… but carbs are the culprit for blood sugar, in my opinion (and that of many doing research in this field).40-60 g of carbs per meal! That would throw my blood sugar right out. Trial and error has taught me that I need to keep to about 30g a day to keep my blood sugar at a nice healthy level. If you can do it on 40g per meal, wow, lucky old you!. Beans affect my blood sugar as does any starchy veg at all, no matter how ‘healthy’ the carb is. I eat a handful of Cape gooseberries for dessert once every couple of weeks – and see a minor impact in my BS in consequence, but hah, you gotta sin sometimes!

            • I didn’t want to argue against the ADA because I figured everyone would come to the same conclusion. The ADA will kill you. Their diet promotes maintaining a BG above 140 which will damage, over time, every organ, nerve, muscle, eyeball to the point you will be disabled or die. My dad has followed their diet for 15 years and cannot control his BG. I followed a low-carb/quality carb diet for 3 months, and I can maintain mine. Don’t follow the ADA diet, it is suicide!
              I agree, it really depends on the person. If I have 50 grams of carbs, and they are high fiber and/or high protein carbs, I only spike to around 120. That is perfectly normal. However, if your body doesn’t produce enough insulin, or you are overweight and your cells are too full of fat to accept the insulin (insulin resistance) then your carb intake will vary.

          • Thank-you for the responses. Derik, 40-60 grams of carb per meal would make me gain weight instantly. I can eat that an occasional day but I, too, am like Mandy. 30 or so grams of carbs a day is all I can handle which is why I can have a few berries with my breakfast a few times a week, beans very occasionally, and I must watch my consumption of starchy vegetables. However, none of this answers my original question which is how many carbs per day does Chris Kresser consider a low carb diet.

  73. I have prediabetes .since the diagnosis I lost 20 lb
    My fasting glucose has been between 92 to 105
    But my post brandial glucose are between 102 and 125 only in one occasion my postbrandial glucose was 137.
    I eat carbohydrates but those with low glycemic load like avocado ,nuts , berries , tomatoes ,lentils chickpeas ,green beans ,cabbage etc. proteins and low saturate fats .
    I concern my fasting glucose still elevated
    Should I change my diet or add something
    I am not in any medication yet , do I need to start metformin?

    • For how long have had these numbers? How often do you check them? What is your A1C? The diagnosis needs to be confirmed by checking these values twice and I think at least a couple of months apart. Many years ago I had similar values and the doctor wanted me to start with medication right away. I turned down his offer and started to exercise regularly, also lost weight and after 6-8 months my values returned to normal and has stayed there since then. I don’t count any calories, carbs, etc. Exercise, keep your weight optimal and (unless there are some other issues) you will be fine. Check your sugar regularly so you can see the trend. With the numbers you have right now I would certainly not take any medication.

    • Sara, I have very similar numbers and diet to you (a little worse on the FG). I wanted to try Metformin to see if I could get FG down below 100. My doctor refused. I went to the lab the other day and got 105. He argues metformin will make an artificial change, and won’t take the effort for lifestyle. Though he never wants to hear about dietary changes so he may think I drive thru fast food. The only fast food I get is from whole foods market pre-made food like raw kale with quinoa salad. I would suggest you are not yet a candidate for metformin either. You ought to get the hsCRP test and make sure you have no inflammation. My goal is to find out if hs (CRP) is <.1 (i.e. they cannot get a reading unless it is .1 or more), then does FG of 100 to 110 even matter at all? So far I find nothing to support that, but plenty to say high inflammation is the root cause of all disease. So it makes sense no inflammation would mean no disease, and therefore FG would "don't care". Maybe in 10 years or so they will identify the relationship. Everyone should find out if they have a high CRP since it means disease is forming and you need to stop it. I always read that inflammation in the artery precedes calcification and LDL sticking to it. So no inflammation then no clogs and no heart issues — which leaves Glucose levels up for discussion. I always read Glucose causes inflammation, where buggy things grow and feed on the sugars. So it makes sense if that is happening the hsCRP will detect some inflammation. I always read and hear that Turmeric stops inflammation and can stop or prevent cancerous cell growth. Some would argue these connections cannot be publicized or the health care industry could crumble — they will say turmeric cannot be patented so there is no money in it. What if it did eliminate the hysteria of high FG numbers of 100 to 110 or more?

      • On the CRP – mine has always been too low to measure and my HDL has always been very high and LDL low normal. No high Blood pressure either and really only slightly overweight and low triglycerides also. Yet I had an H1C of 6 and doctor was convinced I had heart disease due to it and also put diagnosis as pre-diabetes and metabolic syndrome (I have NO signs of that other than the glucose) I had a cardiac calcium scan and had ZERO calcification (at age 66) which surprised him. He now says I have teflon arteries and I told him that I don’t think anything can stick without inflammation – he said that is a good theory – whatever that meant. I did get the A1C down to 5.5 with a very low carb diet though.

  74. Hi, I was diagnosed with gestational diabetes during my pregnancy. I was able to control it with diet and exercise. I recently deliver the baby and my random blood glucose level was normal (around 90) tested at the hospital. My OB told me to continue testing my blood sugar at home until the next visit. He did not tell me the range or anything to look at. Can you tell me if these numbers indicates whether I have diabetes or prediabetic? I am a little worried that I would develop Type 2 diabetes after pregnancy. Here are my #:

    Fasting BG: 70-83
    1 hr post meal: 96-150 (I am usually under 120 during breakfast and lunch, in which I do not consume rice. I am usually in the higher ends, passing 120 during dinner, in which I eat small amount of Jasmine white rice)
    2 hr post meal: 90-100
    random BG (3 hr post meal or so): 85-90

    Thank you

    • Your fasting and 2 hr are perfectly under the level Chris suggests so you don’t have anything to worry about. You can keep checking though to see how things go and if they ever change.

  75. Hi

    I have been unwell for a number of months, no energy waking every day with headaches. Nausea and vomiting at least once a week and my eyesight at times seems very blurred like I’m under water. A friend took my blood sugar one day and it was 11.1 which my friend whose a diabetic insisted wasn’t normal. The following day I took it again and it was 11.7. Since then because I’ve been worrying I have been taking them more regularly. I have had blood sugars of 15.3, & one at 24.5 but generally they are are between 9.4 & 13 and remain high up to three hours after food. Lately I have been having lows of 3.5, 3.1, & 2.7 after light exercise. When this happens the back of my head hurts and I feel sick and dizzy and extremely weak, I do start to feel better after I have eaten something. I also wake between 3 & 4 every morning drenched in sweat and very restless. I have had a HbA1c test which was 5.5 and my doctor insists there is nothing wrong. I don’t really real any different when the blood sugars are high but when they go low it’s horrible. My doctor is refusing me any more tests and I’m getting desperate because it’s affecting my quality of life feeling so ill all the time. Could the HbA1c test have been wrong and if the test measures the average then surely the low blood sugars would bring down my average?

    • Hi: I presume these are metric units? If so, you sugar is too high, you need to see another doctor. 11.1 mmol/L = 200mg/dl. Normal level are in the main article, but 2 hrs after the meal should be below 120 mg/dl and 1 hour 140 or less. After the exercise your number are very low. That’s probably why your average 5.5% is OK. It is an average. Again if these are metric units and you gave the correct numbers. 24 mmoL=ca 400 md/dl that’s dangerously high, this is causing your eyes problem and probably other organs are also being damaged. Also levels between 9-13 are too high. You need to find a new doctor right away if my interpretations of your numbers are correct.

      • Hi, yes they are metric units which is the measurement we use here in the UK. I feel like I’m going mad! Thanks for your response, I’m getting a bit desperate because I feel so poorly all the time. There are a couple of things that are puzzling me. My fasting blood sugar is almost always between 4.5 & 5.6 (100mg/dl ) usually the higher end which I believe is completely normal. I’ve only ever had one high reading for fasting and that was 15.3. From everything I’ve read it would be unlikely that I have diabetes because my fasting BS is always in the normal range, am I understanding that right? Also I’m not on any medication and from everything I read BS would only drop that low in a diabetic if you were on medication? For example I can be doing some light gardening for a couple of hours and I start to feel nauseous and I feel very hot and sweaty and my head hurts and I’m absolutely exhausted. I usually eat a slice of toast or some biscuits and lay down, after about half an hour I’m fine again. During these times my BS is nearly always below 4 and as low as 2.5 but sometimes I get the symptoms with readings of 5.2 although if I ignore them they keep dropping. When I told my doctor he said the readings are normal and nothing to worry about, he told me to stop taken readings because it was the cause of me worrying. He also said the high readings are normal and people who are not diabetic very often have BS this high after eating and as long as they return to normal there is nothing wrong. I am so confused because everything I’ve read states a normal healthy person will never go over 7.8 (140 mg/dl) and will always return to normal within a very short space of time regardless of what they eat. This morning I had two slices of wholemeal toast and a small glass of orange juice for breakfast. Before breakfast my fasting BS was 5.4, exactly 1 hour later they were 9.5 and 1.5 hours later they were 6.3, so coming down again. Is this what is meant by a short space of time? I would normally eat cereal for breakfast and my readings are usually around 12.2 and stay up much longer and don’t start to fall until after two hours. I could switch to eating toast but if there’s absolutely nothing wrong with me as my doctor insists then there’s surely no reason to watch what I’m eating, because these are normal levels. I’m currently seeing a rheumatologist for another problem. The palms of my hands turned bright red and feel numb and sensitive to hot and cold temperatures. I have unexplained muscle wasting in my forearms, wrists and hands, to the point were I have developed hyper mobile thumbs which are extremely painful. Over the passed 12 months the pain and muscle wasting is increasing and he hasn’t come up with a reason why it’s happening, I’m concerned this could be peripheral neuropathy caused by the high blood sugars. I really am at a loss as to what is happening and I’m terrified to mention diabetes to my doctor because he makes me feel like a hypochondriac! Any help or similar experience would be appreciated. One final question, I am confused by the term plasma and whole blood reading. Do blood glucose monitors read plasma or whole blood?

        • Karen, the foods you mention are all grain based (cereal, toast, biscuits). You may be gluten sensitive and developing an autoimmune condition. Look into the autoimmune protocol diet, read Sarah Ballantyne’s book The Paleo Approach. Best of luck.

        • Karen, it could be the high sugar rush from toast and orange juice are related in causing some of your other symptoms. I don’t think your symptoms are common for pre-diabetes or type 2. I have lived with someone who had the hot flashes daily which sounds a little like your description. It could be that whatever is causing your bad symptoms is also fluctuating your BS. The foods you mention are generally known to spike BS quite beyond any normal recommended levels. You could experiment with cutting out those and other grains too. If you have some fruit and add garden greens in a good blender you could give it a try and see if your symptoms improve. The “Beauty Detox Diet” by Kimberly Snyder has tremendous suggestions that will help get your body back on a normal track without meds, unless you have some serious underlying problem that needs medical treatment. It sounds like your Dr. does not think that yet, so may as well give it a go, like the best selling author has discovered in her global studies of peoples all over the world.

  76. Chris, I have written to you before. My triglycerides still are 34.
    My fasting blood sugars are around 74 to 80. Two hour blood sugars run 140 to 179 but they are down the next morning in the 70’s with a rare 80. My doctor said because I have thalessemia minor I have triple chance of having diabetes. She is adamant that I have diabetes and is prescribing Metaformin. I also walk every day alternating 4-5 miles a day. I am 5′ 8″ tall and weigh 144 lbs. What would you do?

    • Linda, your numbers do not seem close to diabetes, although the post meal numbers may be higher than recommended. Could be the type of foods you are eating. Everyone else is getting the Hemoglobin a1C test, or average glucose over 3 months essentially. I never heard of anyone having very normal fasting numbers and being Diabetic. If the a1C comes out more than 6.0, then maybe you have some concern to improve. Your post sounds fishy — its off base somehow, which also seems to be what your are wondering.

    • When I was first diagnosed with type 2 diabetes in January 2015, I weighed 203 lbs. I weigh 172 pounds today 4/21/15. I changed my diet and I exercise. My blood readings are between 120 and 106. Is this OK?

      • Hey! Have you taken a blood sugar reading in the morning before eating? If you take readings throughout the day, before and after eating, for several days and never get under 100- you have an issue. Just losing some weight is good but won’t necessarily “reset” you to not being sensitive to carbs.

    • hh, mix high carbohydrate foods with higher fiber plant foods to slow the digestion of sugars. fast digesting sugars cause high spikes after meals.

  77. I have had severe peripheral neuropathy for several years , am overweight and am now developing multiple “trigger fingers”. All my lab tests indicate that my blood glucose is borderline at worst and I have no contributing back problems. Is it possible to have diabetes and not show on all the standard lab tests? I have a strong family history of diabetes and multiple symptoms, but my labs always say otherwise. What’s up?

    • First, I am no expert on diabetes, but have some experience with it.
      Secondly, could you provide more information as to your lab tests. When were they done, what were the actual numbers? Do you also check your levels at home? How frequently?

  78. Hello Chris,

    My doctor says im pre diabetic.

    My last readings were;

    A1c 4.6%
    mg/dl was 146 thats what has me concerned. What type of regular diet should I be on? I am african american mid fifties.

    I have not been too active but kniw i gotta get off my tail and into some kind of exercise

    • 146 at what time? If you had a meal rich in crabs one hour after the meal this wouldn’t be a prediabetic number. Buy yourself a glucose meter and do regular measurments over a period of several weeks. Generally, one hour after the meal, you should be below 140, two hours below 120. If you get consistently higher numbers then you should first try to do regular exercises and watch your diet. Takes about 30 days for such an effort to have an effect on blood sugar.

    • Just one borderline number does not make you a prediabetic. You need to take several measurements done within a period of time to confirm it. Although, there is a study by the NIH stating that even lab measurements scan be 5% off.

  79. I had my CDC done 11-20-2013 and then one 07-09-2014 and another 12-31-2014:
    Glucose: 82
    HBG: 12.2
    Glucose: 97
    HGB: 12.5
    A1C: 6.1
    LDL: 142
    HDL: 45
    Tri: 106
    Chol: 208
    The dr. said I am pre diabetic?!?!!

    • Desiree, the A1C number is why he said that. Its supposed to be <6.0 for normal. Though the guru's doing all the studies and writing the books say 6.0 is still too high for normal. I got 5.8 and read that is too borderline for good health. Review the article above and this info is there, with 5.3 as the better target. A1C is an estimated 3 month average. If you really want to know your risk then getting your own measurements is best–you can see Kimberly below where I explained how to go about it to her. I have about 5 weeks of data now and feel much better seeing the variations over the day and various meal and workout situations.

    • A real low carb diet is 25 grams of carns a day or fewer. A moderate low carb diet could be anything between that and 100 grams a day.

  80. Hello,
    What constitutes “Fasting”? How many hours approximately?
    I had at Random Glucose test at Kaiser yesterday. My level was 94.
    I had a fresh juice (kale, celery, pear) 2 hours before the test and a full lunch 6 hours before.

    • Kimberly, Kaiser is expecting 12 hours with water only for fasting. The fresh juice will spike sugar readings but after 2 hours it should go back to the basal between meal normal. I recently got a meter and upload the data to look for trends. Kaiser prescribed the VERIO IQ meter which only has Windows App software. if you have a mac like me you can create an upload collector account for your meter on diasend.com Weirdly, I found my readings can be normal fasting numbers in the afternoon typically, while after 10 hours fasting I am pre-diabetic every day. I am so glad I got the meter since all my years of annual Kaiser 12 hour fasting levels have no meaning after all. If you get this curious and can spare the extra $20-30, the ACCU-check fastclix is very handy for the blood droplets. So much quicker than single prick lancets.

  81. I was on tradjenta for 1/2 yrs and metformim – all seemed fine.

    I recent had a peptide serum test that was low . I was also taken off tradjenta 2 weeks ago. On Metformin 1000 2x a day.

    This was all from primary doctor.

    Now my blood sugar is going up. a1c up and peptide serum low.

    I scheduled an appointment with an endocrinologist – I think its time!!!!

    • You need checked for GAD, HLA, ICA, IAA, IA2, IgA antibodies. If they won’t run the tests run out the door. Your screaming LADA.

  82. My daughter’s fasting blood sugar has been running 95-125, 75- 100 2 hours after meals. Just curious why the fasting number is higher than the 2 hour after meal number? She has been watching carbs more. Thank you for your time!!! Jennica

      • Helen, that is too close to trust the single measurement. You should repeat this a few times to uncover a trend. My own self testing would make me think the meter is not exact every time and your meal may not have had carbs or sugars. But I have also seen this a few times myself when the meal was quality fat and protein like chicken or fish. Somehow I guess that digestion work is lowering the glucose present in the blood. Maybe that explains your numbers?

    • That looks quite normal. The meal may have included complex carbohydrates which would take a bit longer to raise the blood glucose-but the spike is modest and soon returning to fasting levels.

      • Totally agree with Andrew, however the numbers are not ideal and if its possible to change diet and exercise to reduce these lower it would be a great thing.

  83. Hi, my fasting glucose reading this morning was 91. I ate breakfast and tested one hour later, it was 96, then I tested again another hour later, (total of two hours after eating) and it was 100. I am using the FreeStyle Freedom Lite meter. They seem like strange figures to me. My A1C in the past has been 5.7 to 5.9, so a little high. What do you think? I am on Synthroid now because the thyroid was eliminated with radio active iodine. I have to stay on the hypo end of normal with the Synthroid, or I will go into atrial fibrillation. Maybe everything works together? Thank you.

  84. Most of my life I have been told my sugar is a little high. But until the last year, I had never taken it serious . Then I picked up a meter at a friends urging. I was shocked to find my sugar sitting at 250 an hour after eating a half of a chicken sandwich. This has my attention. For the last few months, I have checking my sugar at different times through out the day, depending on how I am feeling. My fasting sugar usually ranges between 106 – 120. After eating I have seen spikes as high as 350 . For years I have been told I was pre-diabetic. With numbers like this, should I ask the Dr. to prescribe metformin.

    • Post meal readings like that strongly indicate diabetes even if your fasting glucose is normal & probably requires medication.

      • Post meal spikes like that also indicate you have a poor diet that may be high in carbs, especially processed and simple carbs, like sugar. You need to watch that. I have switched to a mostly vegetarian diet with fish (not fried, but baked with no additional oils). I don’t put any additional oils on anything, and I don’t buy anything packaged that has more than 1 to 3 grams of carbs total (packaged meaning prepared meals, etc.). I eat a LOT of greens, beans, and other veggies. I brought mine from a normal 350 to 77 between meal to 90 post meal in just a couple of weeks. My fasting level is still 115, but that’s because your liver starts producing glucose to compensate for the fasting. A little protein snack before bed helps that a little.

        • Oh, and exercise is extremely vital! I can’t stress that enough! When you exercise, your body is less insulin resistant, especially if you work the muscles. Muscles burn a LOT of glucose in a short amount of time. Doing things like fast walking from your car to the store, or climbing a few flights of stairs every day will make a HUGE impact on your glucose levels.

  85. For health and weight management I maintain a pretty low carb diet. I lean toward paleo and alkaline food regimens, watching the volume of high calorie healthy fats. I am also religious with green smoothies and greens&vege juicing in moderate amounts 5 days a week. My fasting glucose is generally higher this way but my triglycerides stay down 75 to 85. I am trying to validate if this is more healthy, while riding a nominal 104 glucose? I just started home testing and have a high of 115 after paleo dinner with red wine. I have been drinking a shot glass amount of boiled turmeric powder daily for a few months. In addition I started gymnemma with meals. My HDL has been steady at 60. I would still like to get pre-meal glucose below 90 to feel safe. Family history is bad heart disease so I am motivated to keep experimenting and following the success of others.

    • The greens are good. Also throw black beans in the mix (and other beans, but not broad beans). I stay under 40 on the glycemic index, and it has made a world of difference. I also cut out most animal protein, except fish. I also do some form of exercise every day because your muscles will burn a lot of glucose in a very short period of time. For example, I tested at 120 this morning waking up. I ate mostly greens all day, ran down 22 flights of stairs and walked back up (about 11 minutes) and i dropped to 77 Mg/dL before dinner. After dinner I was 93. That is pretty normal. I will also add that I am on a couple of meds, including metformin, but those only brought me down to about 120 for a couple of weeks. Exercise, greens, and beans are the key! I do no bread, potatoes, and other high GI carbs at all anymore.

      • Derik, thanks for sharing. I eat pretty similar to you, not so much on beans – my wife just started adding black bean and lentils into dinners. The early morning exercise seems like a good habit if I can swing it- I like it after work when I am loose and awake after sitting most of the day.

        • Yeah, I usually stay up too late to get up early to exercise. I am working on my sleep now, and have lowered my caffiene intake significantly, because around 8 hours of sleep is vital for a diabetic. That is when your body normalizes many chemicals in your body, including hormones that cause or limit weight gain. Obesity is linked to lack of adequate sleep. Exercise in the morning lifts your metabolism, and breakfast spikes it even more so that you don’t crash as hard in the afternoon and do things to feel good, like drink alcohol, or eat at the wrong time of day.

        • I really think that attacking the diabetes type 2 with a low carb diet and exercise for the first few months really does the trick. Today we had a retirement lunch for one of our employees. I ate a very large piece of stuffed pizza (crust on the bottom and top, HUGE carbs), and a very rich piece of cake. 1 hour later I was at 132, then 2 hours later, after walking up 12 flights of stairs, I was at 91. Right now, I am at 77. I am still on glipizide still, but I will bet it wouldn’t be very far from my BG without glipizide. Exercise after meals seems to be the magic bullet as well. I am really getting pretty excited about this.

  86. So when I test my blood sugar in the morning time ,most times it reads like 79-85,I checked it the other day after a meal and it was an hour after and it read 144 , now I’m worried as to if I am diabetic….,can someone answer me this question?pleease……..thanks

    • Fasting readings absolutely normal-post meal a bit high (but not diabetic level) unless it was very high carbohydrate. Why not try a few more post meal readings after varying the meal ?
      If they’re consistently high you may be on the way to developing impaired glucose tolerance (a possibly pre-diabetic condition) – but on the evidence of the readings you’ve provided you’re definitely NOT diabetic now.

    • What you are describing is a perfectly normal scenario for blood sugar levels. You’re fasting blood glucose levels are fine, and it is completely normal to have a slight spike, as is yours, after a meal.

      • Exactly. The damage to your body comes from long periods of time at constant high levels (weeks or more). I have read people spike as high as around 140, especially if they had bread, potatoes and other high GI carbs with their meal. Perfectly normal.

        • I have to correct or clarify my above statement. I say “normal” but only if it goes back down to a baseline of 70 through 90 in a couple of hours.

    • Luara,

      As the article said, any one reading that is a bit outside the norm when all other readings are normal is nothing to worry about. If you have fasted levels of less than 90 and an A1C of less than 5.7 then your 144 post meal reading is not a big deal as long as it lowers within 2 hours or so.

  87. Can someone clarify or elaborate on this?
    “One caveat here is that very low-carb diets will produce elevated fasting blood glucose levels. Why? Because low-carb diets induce insulin resistance. ”
    Everything I’ve read about insulin resistance or avoiding diabetes urges one to incorporate a low carb diet.


    • It’s not inherently low carbing, it’s the incidences of minimal carbohydrate intake after extended intervals of time, as opposed eating small amounts spread evenly thoughtout the day

    • I’ve been monitoring my blood sugar for several years. Lately my fasting blood sugar has averaged 122 over a 14 day period of time. Seems like the more I limit carbs the worst it is, but like others are told to limit carbs to reduce FBG

    • I have read that it is because, since you aren’t loading your body with glucose through the day, your liver produces it from fat and protein breakdown at night, during the fast. It’s normal to have a higher fasting reading. It should go down through the day once you start eating though. Mine does.

  88. Your fasting & postprandial glucose results look excellent, can’t understand why your A1C is 5.9% -would have expected much lower.
    This seems to be a consistent theme on these postings -interesting to know why.

    • A1C is the accumulation of glucose on the red blood cells over time (a few months) which is why it is a good indicator of your average blood glucose and can prove prediabetes even when your BG looks normal when you test it (it may not be normal when you aren’t testing it). Frequent high spikes that you don’t catch can cause a higher A1C.

  89. My FBG is between 70-80, my post-meal glucose (about 1 hour after) is 95-118 (the high # after generous portion of beef liver dish and 3 flax seed tortillas), but my A1c came out at 5.9%. I did start regularly exercising and strongly restricting my calories about a month ago, so I might have had less stellar #’s previously, but I just measured them over the last few days with home test kits to see how close to the brink I was. I have been 50-60 pounds overweight for a long time now, plus am of South Asian descent, so I have reason for concern, but hopefully with getting back to exercising regularly and controlling my diet, I can undo some of the damage. Regarding my #’s, should I just wait another 3 months to take another A1c and see what it looks like, or is there major reason for concern and I should head to the doctor?

  90. My mom is 80 with Alzimer
    her FBS is 200 . she take 1 metformin and 1 glybanglamid in morning and same intake in the evening,
    have you any idea about it

  91. I have a family disposition to diabetes. My mom, and sister have it. I have been checking my blood sugar after reading about how thyroid issues(I am hypothyroid and take 120 ml of armour) I effect blood sugars. I have had fasting blood sugars as high as 140 this week and 123, 103, 95 etc., but my blood sugar normalized to around 95 average two hours after meals. Does this mean trouble or fact I need more armour.

      • I agree with Derik but I think everyone is overly relying on the home tests and the A1C that Chris explained is also needed to get the whole picture, or as much as possible with limits of testing and chance to get them even. If I use just my fasting numbers I am in trouble, but the A1C says I am not too bad. Also the CRP says I am really fine. The Tryg/HDL says no worries for heart at all. So the story is not really clear with just the home glucose testing. Chris tried to convey this in his entry letter.

  92. This is in response to Donnas question about fatigue and headache pain after eating. The format of this forum is frustrating, as I searched the page for your name or comment and could not find it,so just bottom posting.
    My suggestion would be to keep good food diary so you can start to correlate what food(s) cause this reaction. Can be several days in advance of the meal, so it is a bit tricky to correlate. You should look up and be familiar with ‘the most usual suspects’ to help you better see correlations. Obviously, you would eliminate high glycemic and processed foods (anything that can cause rapid blood sugar surge), then look at dairy,soy, gluten/grains, artificial sweeteners, etc. Citrus is on the common allergen list (we tend to overlook it as being ‘healthy’). Be aware of the nightshade foods as well. Sorry if you have already commented on these things, I just dont see the previous posts. Good luck.

  93. my husband has 129 fasting reading and 94 post reading. He has undergone insertion of stent one year ago. Last 3 readings, the FBS is on higher side and PPBS is on lower side. I am worried about it seriously. Please suggest me on priority please.

    • The fasting reading is indicative of borderline diabetes. There is a condition called reactive hypoglycemia in which low blood glucose occurs after meals-this isn’t really the case here -the glucose is falling after meals but is in the normal range.
      Reactive hypoglycemia has a number of causes (I don’t think the heart condition is one of them) but is often idiopathic.

    • There is a condition called reactive hypoglycemia in which low blood glucose occurs after meals – this may be a mild version since the postprandial glucose,although lower than fasting, is still within the normal range. There are various causes of reactive hypoglycemia (I don’t think the stent is one of them) but it’s often idiopathic. The FBS reading indicates borderline diabetes but it’s confused by the lower readings at other times. Hb1Ac may be useful.

  94. I have a fasting blood sugar of 79 and an A1C of 5.6 which is considered to be at the upper limits of normal at the lab where it was tested. I had trigylcerides of 36, cholesterol of 164 with HDL of 96, and LDL of 61. I also have thalessemia minor. Bottom line: my doctor told me to watch that blood sugar or she would put me on metaformin if my A1C went up any more.

    • I would certainly query these results since they don’t seem right. FBG of 79 is excellent and not really consistent with the A1C unless your glucose is increasing sharply after eating.

      For tryglycerides the lower the better but this looks v.low. HDL is good cholesterol and therefore a high reading is good but for it to be more than LDL is incredible-the cholesterol results look too good to be true.

      You don’t look like a candidate for metformin.

      • Thanks so much Andrew! I am feeling a lot better about
        my blood sugar! level! If the doctor wants to put me on Metaformin, I will get a second opinion.

        Thanks again!

        • Linda, I agree with Andrew. You should check if your LDL and HDL are reversed. 96 LDL and 61 HDL makes good sense for excellent numbers. If they are like you wrote you should get a re-test. HDL carries LDL so bet LDL is really the higher number. A healthy system will increase HDL in response to more LDL. And don’t forget LDL is not bad, it is critical to live at all. Good HDL and low triglycerides mean incredibly more than LDL. Your glucose sounds pretty darn good. I just started home testing so its easy to check fasting in the morning and post meal spikes. This will be truth data without fudging averages for a one-time A1c test. My A1c is borderline high so I got motivated to home test. The media is pushing paranoia so we have to search for better evidence from the community who is digging into the facts and studies so we are not fooled by our doctors. I have my own long story on that my wife and I stick to our own info we find by reputable people and doctors writing the truth in books. I think you can rest easy at this point and just learn so you have confidence in your own diagnostics.

          • In addition to what others said, A1C is the average of your BG over a few months. It’s the collection of BG on your red blood cells. It can be a better indicator of prediabetes or diabetes sometimes than current fasting BG. That’s why doctors perform both tests. On average, even when you measure low, your BG could be higher than normal through the day and you won’t have many if any symptoms for many years. The CDC estimates that there are 8.1 million people undiagnosed for diabetes that, unfortunately, will find out the hard way eventually, like I did.

    • Anemia effects A1C. I believe it makes your A1c ‘look’ higher than it is. Some confusion on this point, as an article by Chris states the opposite (anemia=lower A1c). This from mayo clinic: “If you don’t have enough iron in your bloodstream, your A1C test results may be falsely high”, and I saved in Evernote a few other studies stating the same. Also, A1c is impacted by RBC turnover. If your RBC are long-lived (a sign of health) your A1C will be higher. You could try a fructosamine test next time for more info.

      FWIW- Your numbers seem god. Surprised MD would ‘threaten’ metformin. Do you eat a low carb diet?

      • Thanks so much Deb! I will mention about the fructosamine test when I see my doctor in three weeks. Too bad my doctor didn’t mention it to me. I try to eat and exercise regularly and I am probably eating a low carb
        diet since my husband is a diabetic and I have celiac
        disease. Thanks again!

    • You have excellent blood sugar results. Don’t even think about taking any medication on that account. A1C results are not reliable. According to the NIH site they can be .5% oFF it means that your result might have been betw. 5.1 to 6.1%. Also there are other formulas to translate 5.6% into the average blood sugar. As mentioned earlier, use Nathan’s formula: Nathan formula of eag = (A1c X 33.3) -86, then your avg sugar comes to 102.

      I got mine at 5.7 although I checked my sugar 3-4 times a day fasting usually 70-80, before sleep 80-90, after main meal 1 hr and 2 hrs (1 hr usually around 120 and 2 hours depending on the carbs betw 90-105. So 5.7% (being avg 120) was comletely wrong and nathan’s formula is getting it right.

      Check your sugar 3x a day, fasting, 2 hrs after main meal and before sleep. Do it regularly for a couple of weeks and then your blood sugar monitor can calculate the average. But if you get fasting below 90, 2 hrs after meal below 120 and before sleep below 90 or so, consistently, forget the averages and enjoy life. With such numbers don;t take any medication at all.

    • Update: My fasting blood sugars have been normal, but my blood sugars have been 116 at one hour after eating, and 179 at two hours after eating, and 121 after 3 hours consistently. My A1C’s stay at 5.6%. I exercise 4-5 miles a day and keep my weight down. The doctor wants to put me on metaformin. What do you think?

      • Metformin is the normal prescription for diabetes. The BG spike in the 170’s is definitely too high. I would start with diet and exercise first under supervision from your doctor. Express your concerns about being on medication and tell him or her that you would like to try lifestyle changes first. Becaue your BG is heading back to baseline a few hours after eating, it sounds like it may just be a combination of higher carb meals with prediabetes. But, check with your doctor about it. Even BG in the low 100’s constantly can cause irreversible damage to blood vessels in the extremeties and eyes, as well as organ and nerve damage over time.

  95. Hi, this is an interesting read!! I’ve been changing my diet and have a question. After sugar (sugar = frequent, but this happens maybe 1/2 the time) of varying amounts, I’ll have to sleep. Not just fatigue, but literally cannot stay awake. I only sleep for like a minute or a few, but it’s like the sugar on occasion makes me need to reboot or something. I had one glucose test a few years ago that was 103, but other than that I only see 87-90 (on a high-sugar diet). My theory was that since I’m EXTREMELY allergic to dust & pollen, so my immune system is running full-power all day, the sugar just overloads my system sometimes. Then someone described the same thing and says she has a “sugar intolerance.” I thought, Great! There’s a name for it! … But the only research I can find lists sugar intolerance as similar issues to lactose intolerance (which I have), and it’s not that… The Dr. doesn’t have any ideas, so I’m wondering if anyone here has any on what it might be? Obv I’m cutting out processed foods as much as possible, but trying to see how far I have to go with this. Like… natural sugars too? Wine? Limited or eliminated? Oh, so many questions…

    • I am having the problem with fatigue and headache/eye pain after eating. I sometimes sleep for hours. Any thoughts about this?

    • You could very likely have unknown food/food chemical sensitivities – headaches and this kind of sudden fatigue is very common with non-IgE immune responses to food due to a leaky gut. A Mediator Release Test would reveal unknown sensitivities, but keeping a journal of what you eat and your symptoms is a good first step! I would look into MRT/LEAP to address the food sensitivities.

  96. Hi, this year, I got my FBS tested last May and November 24 2014, got 5.5 result, however my doctor requested for a Hba1c also yesterday, got a result of 6.65. My urine also has no glucose and proteins found. Is this mean I’m diabetic?

    • In my opinion one reading does not make you a diabetic. You need to repeat A1C test in 2-3 months. Also I presume that fasting 5.5 is a metric unit (nmol/L) which translates to 99 mg/dL. The fasting number is just below 100 limit, but it is better if it is below at least 90 (5.0 nmol/L). I would purchase a glucose meter and the strips that can be bought cheaply on the internet and check the blood sugar daily in the morning before the breakfast, 2 hours after the main meal (should be below 120 or 6.7) and before going to bed. (I am using some of those Internet converters to convert mg/dL units used in USA to nmol/L). Is 6.65 a 5 number? (it would be high). Or is it a metric number corresponding to the average glucose of 119 mg/dL

      Then you will see a trend and can make the conclusions.

    • This looks inconsistent : 5.5 looks reasonably normal for FBG whereas 6.5% is high for A1C. Is your postprandial glucose very high / You may have impaired glucose tolerance (a possible pre diabetic condition) rather than diabetes. Interested to know how your Dr. explains these results.

      • Thanks everyone for your responses. Appreciate it. Update is that, my doctor yesterday advised me to get a new result of hba1c right in the hospital. As the previous one with the high result of 6.65 was at a satellite branch of the mother hospital. I got it this morning and the result is 5.8. So my doctor is right, her hunch is correct the first one is incorrect. But I think I still have to work on my diet and will cut down on sweets unlike what I did for the last 2-3 months.

  97. Eight months ago I completed active treatment for breast cancer. Including surgery, chemotherapy and radiation. Now I am on an aromatase inhibitor (Femara – generic brand Letrozole) for 5 years to suppress estrogen production. I have not had any health issues prior to this. My fasting blood glucose was 7.2 and A1C was 6.8 (in Canada). I exercise daily, eat healthy ( generally lower carb diet) and am maybe 20 lbs overweight. My doctor suspects the rise in blood sugar is related to the stress of cancer and subsequent treatments. My question is this…if medication raises blood sugar will losing extra weight lower the blood sugar, or will it be high as long as I am on the medication. Any comments to help are appreciated. Thanks.

    • I have been reading a lot about diabetes recently. I am not a health care professional. You need a specialist to answer the question about the medication and blood sugar levels. From what I understand if you are overweight, the worst scenario is the fat around your tummy. The fat releases some type of inflamatory chemicals that inhibit the functioning of the insulin. So getting rid of the fat would improve the functioning of the insulin. The readings that you gave, are those just one time readings or some averages? That fasting number is high also a1c but you need to find a doctor who ‘knows’ whether the medication causes the raise of your blood sugar. Your current doctor “thinks’ which is not good enough.

      If I were you I would monitor the glucose level 3x a day so you can discern if there is any trend. Also from what I have read, long-term stress increases blood sugar levels and you have had plenty of it i can imagine. WHat what yiou have gone through it is in the realm of possibilities that these are the causes of you higher blood sugar level? DO you have any symptoms associated with higher sugar levels?

  98. Hi,
    I need some advice as i am freaking out over my blood sugar tests. I have been monitoring my FBG for the past one week and my average FBG is around 94. My Post Meal after 1 hour of a high carb (starchy carbs) meal comes out between 145-149 and after two hours it is between 130-134. My A1c came out to be 5.5. Am in is pre-diabetic range or is this normal if you eat lot of starchy carbs?

    • First, I am not a health care professional just a regular person. What is your fasting level in the morning? SHould be below 99 but still better if it is below 90. What about the levels after normal meals (less starchy, meat etc). 5.5 is very good. 2 hours after a meal should be below 120. You need to check your levels for a little bit longer not just one week so you can see if this is a trend (also A1C after 3 months). You may be taking some medication that may affect your sugar levels. Right now I would not worry but would continue monitoring the levels.

      Try to reduce the starchy meals, also it is useful to start doing some regular exercises. If I were you, I would not worry now, I would continue monitoring, morning before the meal, 2 hours after the lunch a before going to bed. If you get the pre-diabetes numbers try exercises and (if applicable) reduce weight, more healthy food, less starchy.

  99. How accurate is A1C test? ON my annual visit my A1c was 5.7 and fasting 81 mg. The doctor suggested to watch my sugar. So I purchased two glucose meter, had them ‘calibrated’ (checked my blood at doctor’s office). I checked my blood 3-4 times a day am, pm 1 hr after main meal and 2 hours. In two months only once I had 1 hr reading of 145mg, otherwise 1 hr after meal I get 90-115 mg, depending on the meal, the two hour reading almost always in the 90s. Morning glucose, most of the time 70-80 occasionally low 90s. Evening before sleep 80-90s. Occasional random checks are always in 90s range.

    SO I purchased home kits to measure A1c. One was from Walgreen’s that gives a result after 5 minutes and then one where you sent the dried blood sample to a lab. After two months of the above data, my a1c from the lab was 5.8 and I did the test twice with the Walgreen’s meter and got 5.6 and 5.9.

    I understand that 5.7 equals to the average 120 mg. Which would mean theoretically 12 hours of 140 mg and 12 hours 100 mg levels. How is this possible? I barely have 120 ml glucose levels once a day. I am healthy don’t have any condition that would increase my blood sugar. I am puzzled by this.

    • Martin – I agree these results look inconsistent,but there are (at least) four formulas for converting Hb1Ac (A1c) to average glucose (eag) which give different results. The two main ones are:
      eag= (28.7 x A1c) – 46.7 OR
      eag=(35.6 x A1C) – 77.3 OR

      the less well known Nathan formula of eag = (A1c X 33.3) -86

      OR the ADAG 2007 formula of eag =((1.583 x A1c) -2.52) x 18.05

      Your Hb1Ac readings are quite similar and average 5.77 which results in average plasma glucose of 118.9mg/dl. or 128.1 mg/dl. 106.1 using Nathan or 119.4 using ADAG- the Nathan method being more in line with your random spot checks.

      If you google “the formulas equating Hb1Ac to average glucose levels don’t work with near normal glucose levels” you’ll find an interesting article/blogs on the conversion dilemma.It may well be that Hb1Ac is a better test for diabetes management than for normoglycemics (which you are).

      • Thank you very much for the reply. I will check out the article. I will watch the glucose for a while but it seems that I should not worry I just like to understand how thing work. The last few days my morning glucose was 73-75 but I will send another sample from that self kit to a lab. Just curious. Thanks again for your reply. I appreciate it.

      • One more thing. Perhaps you have seen an article on the accuracy of the a1c test itself. It is an NIH & some Diabetes Organization article from September 2014:

        How accurate is the A1C test?
        The A1C test result can be up to 0.5 percent higher or lower than the actual percentage. This means an A1C measured as 7.0 percent could indicate a true A1C anywhere in the range from ~6.5 to 7.5 percent. Health care providers can visit http://www.ngsp.org to find information about the accuracy of the A1C test used by their laboratory.

        This range is based on the inherent variability of the laboratory test, often referred to as the coefficient of variation. Different degrees of laboratory variability result in different ranges of possible true values. The range illustrated is the maximum allowed by test methods approved by NGSP.

  100. I have been following a low carb diet since January 2014 and became pregnant in April. After failing the 1 and 3 hour OGTT, I was diagnosed with gestational diabetes. Following the advice of others that have found them selves in the same situation, I also requested an A1c test which was a 5.4. Since monitoring my glucose levels at home, my fasting level is averaging a 99 and my post meal levels average 109. My doctor gave me a target 90 or lower for my fasting glucose levels and I am curious to know what level of carb intake I should target to reach this number.

  101. I’ve been having trouble with nausea since April of this year. When I got insurance (kaiser) I went to the doctor in July. She diagnosed gastritis and told me to take Omeprazole. She ran blood tests and my A1C was 7.0. She said I was pre-diabetic and told me to change my diet and exercise. I changed my diet, but I’m too nauseated to exercise. In fact, I went walking and passed out without any warning. I had the A1C done at the beginning of this month and it was 6.9. She put me on Metformin 500mg. I became even more nauseated and had cramps. She told me to stop and eat a low carb diet. I asked for a glucose meter prescription, but was ignored. I bought one on my own. It’s only been 3 days, but my numbers have been high. Fasting has stayed around 135, 2hours after meals has ranged from 132 – 200. She’s the only doctor accepting new patients, so I can’t switch. I was thinking about asking for a referral to an endocrinologist. Unfortunately, I live on the Big Island of Hawaii and the only endocrinologist for Kaiser is on Oahu. What do you suggest?

    • A1C of 6.5% or over is DIABETES. Fasting of 126 or over is DIABETES. Your numbers (both) exceed the diagnosis threshold for DIABETES. Not pre-diabetes, FULL BLOWN DIABETES. You don’t want to damage your pancreas further, lose vision, get wounds/ulcers, get ESRD or have amputations – you want to avoid or at least delay those.

      And passing out without warning could be an arrythmia that is so bad it drops your blood flow to the point your brain fails. Some of those can cause cardiac arrest, the heart stops, never starts again, and you die.

      You may need to go out of network, even letting all your other bills go unpaid (which they will if you die or become disabled). You need a doctor who can officially diagnose you with DIABETES and check to make sure your heart won’t stop, and in any event stop you from passing out – you may need medicines, lifestyle changes (more water, more salt possibly), a pacemaker, or even an implanted defibrillator.

  102. I have been under a doctor’s care continuously but have recently lost my doctor. Within the past month or so, I experienced a couple of blood pressure spikes that sent me to the ER. I had blood profiles taken there and no one mentioned diabetes or kidney disease. I began seeing a new doctor who told me I had diabetes and prescribed Metformin 500mg. My fasting glucose level was 107 and the HbAic averaged at 137. The doctor said I had “uncontrolled diabetes” but neglected to mention I also had kidney disease and low potassium. A specialist I was seeing for another condition noticed both and ordered another metabolic panel without HbAic–and the glucose level was at 97. This was about 4 hours after lunch. My question is this: If within the past three months I have been consuming way too much sugar and too many carbs [chocoholic and Pepsi drinker] would that affect the outcome of the HbAic as opposed to being tested again after being on a far more careful diet? I have certainly altered my eating habits! I don’t want to be on diabetes medication indefinitely when some graphs indicate I am only in pre-diabetes.

    • Presumably the HbA1c figure of 137 is after the conversion to average glucose and represents a reading of 6.4%-just below the cut off for diabetes of 6.5% whereas the fbg of 97 (normal) and 107 (slightly high) are non -diabetic. I think you would notice a fall in HbA1C after dietary/exercise changes.
      The description of your condition as “uncontrolled diabetes” looks at bit excessive !

      • I am having difficulty with the concept of pre-diabetes versus diabetes. If persons classified as being at the pre-diabetes stage, why are they given Metformin the same as a diabetic? Doesn’t that effectively mean “diabetic anyway”?

        • Marianne, the simplest of explanations is that big Pharma loves to make money and they also fund the physicians, who put profit in front of humanity and personal patient care. We managed to reverse my husband’s type 2 diabetes with lifestyle changes, much to the demise of his primary care physician, who gladly plied him with more and more drugs whenever he went for a check-up. Try a number of different physicians before making the decision to take medications. There are those like Chris, who care for their patients more than the profit they make.

      • A fasting blood glucose of 107 and post meal of 130 something does not call for medication. At that point dietary changes and exercise is important. Some Doctors do not have enough experience with Diabetes to actually be treating someone. And some specialist recommendations are questionable. As for me being in the pre diabetic range means doing alot of my own research to help the doctors manage my condition. Knowledge is power and second opinions are helpful.

        • I agree it surely doesn’t call for anything drastic, but Metformin may not be a bad thing. It helps with insulin resistance, which is going to be present in pre-diabetics (like me) as well. I took it for a while and it did help a bit. I stopped taking all meds I was on when I started having other health issues and haven’t started back on it yet, but may in the near future as my numbers are slowly creeping upwards. With diabetes, diet and exercise unfortunately isn’t always enough.

          • I have found a new doctor, who told me it was not necessary for me to take Metformin as my new program of a better diet and more exercise seems to be working. In one month I went from an A1c of 6.4 to 6.0. My non-fasting glucose level was perfectly normal on the latest metabolic profile.

            • Are you or were you on any statins? My A1C was 6.2, then dropped to 6.1 for the past two readings. I have lost forty pounds and have made a low carb lifestyle change as well as regularly exercising. I am trying to decide if I should drop the statin I have been on for 5+ years or not? My Dr. keeps saying the benefits of being on the statin outweigh the risk of getting diabetes, but the rise in my blood glucose has me concerned.
              BTW, the last test showed my FBG to be mid seventies, while my A1C was 6.1. I am so confused!!

              • Yes, I am on a statin for elevated cholesterol. No one mentioned a connection to me so far. I am going back to the doctor next month to see if my A1c has gone down any more.

  103. I just posted about my sugars lately after exercise, which is walking for me, due to bad back, etc, I cannot do any other strenuous exercises.

    Today, I had a sandwich, and then got carried away and ate several spoonful’s of Nutella chocolate butter, well, in the past, I never have gone too high. Today, I took a walk, it took an hour, so the reading was one hour after my meal and walking, it was 121, that was fine. Then, I checked again at the two hour mark, it was 178!!!!!!! I was stunned, I had exercised, it should be low!!!!!. I checked again at the hour and half mark, it was 161, then at 2 hours, 127, and at three, 110. As I said, I do not stay high for too long.

    This happened to me yesterday as well, I took a three hour walk, it was elevated when I got back, but I bottomed out at 80 after 6 hours. Hours 3 through 6 were getting lower and lower.

    Also, I noticed that if I eat two high carbs at once, I go high, but, if I only eat one high carb, I do not go up at all. I can eat a large spaghetti, it hardly raises my numbers at all, but, if I add ice cream to it, wham, up it goes.

    I am under such stress, it is unbelievable, and the depression is off the scales. I am miserable, I am so homesick for the states, I do not like New Zealand, my marriage is not good, we have been married two years, and they have not been good. My best friend died last year, and I lost both of my parents, my dad in 2012 and my mom 2005. I have no friends to speak of and am very lonely.

    Oh, one more question, I read that you start the timing that you start your two hours for testing at the first bite, that is ridiculous, I take it from the minute I stop. You see, what if the meal takes over an hour or so, I mean, how can that be accurate?? Sounds dumb to me. Oh well.

    • Just revisited this site & looked at interesting posts-especially from Susie Q. I don’t think the diagnosis of reactive hypoglycemia done in the 80’s was right-it’s quite normal to have low readings at the end of an OGTT, but the high 2 hour reading is almost diagnostic of diabetes whereas your recent results are more indicative of impaired glucose tolerance (IGT)- a pre-diabetic condition. When you should start timing your post meal readings is debatable – probably better to do it after a quick 20-30 minute meal when it won’t make much difference when you start the clock. Points to note are:

      -stress can elevate glucose readings
      – IGT does not necessarily lead to diabetes
      – Diabetes in middle aged adults only slightly reduces life expectancy if cholesterol and B.P. are controlled.
      -It looks as if you’re testing yourself far too often and creating an anxiety spiral -better to get a diagnosis from a doctor and follow the advice on B.P./cholesterol etc.

      • The 6 hours OGGT was done in 1980, and that was the one where the doc said I had reactive hypoglycaemia, mainly because I dropped to 50 at one point. I have no idea what the test numbers were in 2000, just that I had IGT.

        My blood pressure is outstanding, actually, on the low side. I admit, however, that my cholesterol is high, but my HDL is over 50, my naturopaths back home in the states are not worried about my blood fats, as I have always had great High Sensitivity CRP levels, low homeocysteine and no other inflammation markers. I had a very sophisticated carotid scan done on me before I left the states, two years ago, it showed clean arteries and no inflammation, I wish they did that test here.

        You are right, I have terrible health anxiety now over all this. One night, when I had an episode of high blood glucose after eating, I was so scared, I kept checking every 15 minutes until it went down, luckily, it went down in 2 hours, but I was shaking from fear, I am sure this did not help the readings any either. I wish I had support here, the husband just does not seem to really get it.

        I can not get the doctors in New Zealand to run the tests I had done back home, they do not even know about some of them. I feel so unsafe. The doctors have even said that even though the medical system is good here, since we only have around 4 or 5 million in the entire country, they are not as “in-tune” to all the issues I have and that if possible, maybe I should go back home. Well, that is more stress, I have no money for that.

        My last A1C was in January, it was 6.0, all I was told was to watch what I eat, and to exercise more, well, I have been doing that, for the most part, but, I can tell you, the docs I had back home, whom were very experienced and went to great schools, even had hard times with me on occasions.

        I am scared.

        • I’m not sure what tests the NZ doctors are saying are unavailable but would be very surprised if a carotid ultrasound can’t be done there -in the UK (& I think the USA) there’s lots of private companies doing them all over the country for about £100 -it only takes about 15 minutes. However, I don’t think it’s necessary.
          The A1C reading of 6% strongly indicates IGT
          Best plan now is to check glucose, cholesterol and B.P. annually, stick to the diet/exercise regime and get a prescription for metformin (or similar) if you do become diabetic. If you develop diabetes but other risk factors are under control, you should avoid major problems.
          Have you considered cognitive behavioural therapy for anxiety ?

        • Maybe you are testing too much and that’s only causing you more anxiety. I was able to lower my A1c to 6.0, the same as yours. I had purchased a glucometer and asked my new doctor for a prescription for the test strips. He told me not to bother testing at this point. Just to do what I have been doing that lowered my A1c. I’m sure he advised this for the reason people tend to get worried when they see a high reading–which will go down. You are obsessing about everything you eat, yet you are in the pre-diabetes stage. I ate the same carbs as always and my A1c still went down. What I don’t consume now is all that sugary stuff I used to, like pop and candy and cake. I’m losing weight, too. Eat moderately and exercise. You are making yourself sicker with all this worry.

    • Susie, I would just be consistent in when you start recording. The best way to do that is to start timing at the end of the meal. Bear in mind that high stress levels will also affect the readings at times. The effect of stress may also vary from day to day. The key is to keep low carb. If you do this and stay below 140 all day then you should not worry too much. The odd day where you get 180 after a blow out (say 1/fortnight) is indicative of poor glucose handling. It doesn’t mean you are going to suffer diabetic complications if you stay under 140 on the other 13 days. There is more information on my website at: http://www.drdobbin.co.uk/diabetes-t2

      • Thank you for your info and website, I bookmarked it.

        I am curious about Berberine. Dr. Jonathon Wright, (who use to be my doctor many years ago) of the Tacoma clinic in Seattle says it is better than Metformin, yet, when I use to take it, I got horrible acid reflux and my glucose levels rose. Same with Aloe Vera Juice, I have read nothing but praise on how it lowers sugar levels, well not mine, again, it raises them, as does anything that I take to lower them. I thought exercise was good, but now, I am finding out for me, it is raising it the second hour after I am finished with the walk. I feel like a freak of nature.

        I do know my cortisol levels are sky high, I never sleep, I am lucky if I get 3 or 4 hours a night, and I never feel fresh when I wake up.

        So far, my best control has been the low carb diet, so, at least I can stick to that, it is just depressing when nothing seems to work. I hate this stress.

        • Susie….you might want to read about adrenal fatigue issue. If you tend to be stressed a lot you might have adrenal fatigue. If you have AF…it will throw your blood sugar off. Many things will be a negative if you are a AF sufferer. Anything that is a stressor to your body will over tax your adrenals, which will have a negative impact on keeping your glucose levels in check. It can be emotional stress, body pain, food allergies, too much physical exercise etc…anything that can be a stressor. When your body is stressed, it pumps out the adrenal hormone cortisol (fight or flight response). However, when in adrenal fatigue, your adrenals have been depleted of this hormone and that is when your body gets into trouble, no longer being able to keep up with the demand. One thing then affects another. For me, it caused me to become food sensitive (affects BS). Caused me to have autu immune issues (low thyroid symptoms, swelling of neck, inflamed spine…affects BS). I had to go wheat and gluten free myself personally, went off thyroid meds (because when it is truly your adrenals and not your thyroid, because of it being auto immune, the thyroid hormone only stresses the adrenals more, causing further stress…and around and around you go). But I would not recommend that outside of working with a qualified Doctor, because it is a really tough thing to do. But hopefully you are getting the picture here…stresses affect your adrenals…depleted adrenals thus affect your glucose levels. That is why you likely are not getting a positive outcome when you exercise (likely too much). You might have to think in terms of less is better at this point in your life…and I would definitely encourage you to find out if you have any food allergies…again…affects your adrenals…thus your glucose levels. Best wishes.

          • Reposting, I typed the wrong email. Please disregard the first email address.


            Thank you so much for your help.

            I have been tested for food allergies, I am very allergic to wheat and eggs, sometimes beef as well.

            It is funny you mentioned the gluten, yesterday, I ate a gluten free bun, I thought, “oh wow, I have done it again, the bread will raise my sugar, but, when I checked it, it was still only 99!! Man, that is unheard of for me, usually when I eat bread, I go to 160 or more, fast. I am wondering if it is the gluten. I hardly eat bread however, but when I do, I pay for it, even food that has bread crumbs on them can make my sugar go through the roof.

            I have been under a tremendous amount of stress, I never sleep, cry all the time, and feel awful. I am soooo overweight, but, no matter how little I eat, the weight keeps piling on, I can put on 2 pounds over night easily, but no amount of exercise takes it off. I am beside myself with worry over this, no doctor here seems to know what to do either. I have been POST-menopausal for over a year now, and since that time, all my troubles got worse.

            As to my sugar levels in general, if I take the herb called “Gymnema Sylvestra, it stays down if I eat a high carb meal, I do not take it if I eat no carbs as my sugar never rises then.

            I agree about the adrenal exhaustion, I am sure I have it, but again, no doctor in this country to help me. However, my morning temps taken with my basal thermometer are always so low, sometimes they do not even register, but the dang blood work says my thyroid is fine.

            I will be going back to the states in May, I plan on seeing my doctors again, hopefully, I can get on the right track again, but, in the meantime, I do not want to blow up like a balloon, I am scared.

            God bless you for your help.

            Oh, I am a Christian as well, Colleen, I keep praying daily.

            • Suzie…I like you could not control my weight. However, since I have gone off my thyroid meds (I never should have been on in my opinion, it was diagnosed to me based on symptoms rather than blood test results…17 years…yikes) and finding what I believe to be the root problem, I have dropped weight. Anyhow if it is your adrenals that is the root issue, as I stated before it only causes them to be more stressed as the thyroid hormone only worsens it. You stated beef has a negative effect on you…try grass fed beef instead of grain fed…big difference…you don’t want to be eating beef that has been raised on gluten. Can’t sleep at nights? Adrenals too (try to get into bed by 10-10:30 before your adrenals dumps another shot of cortisol). For a season you might want to try eating very basic foods. Many spices have been contaminated with wheat and gluten. I could go on and on…but I hope this might point you in the right direction. If you do indeed have an adrenal issue…until you get it straightened out…you will not be able to get a handle on your situation. Sooo many people have this problem and don’t know it…Doctor’s are not very well versed on it so most don’t have a clue. Until you get your body out of an allergic state and out of crisis…you will not be able to lose your weight…or control your sugar levels. I am only speaking to you from a person that has been in health crisis for over 35 years…and finally finally am seeing the light at the end of the rainbow. I feel so excited because I am 55 and have lived most all my life on the sidelines and much in my home because of feeling so bad. One last thing…you might want to consider using only perfume free laundry detergent and rinse, shampoo and hair rinse, etc…because if you happen to chemical sensitive like myself…again…stress on the adrenals…effects blood sugar. Also, I only clean my house with hot water and vinegar…no chemicals! Just always remember, what ever effects your adrenals, will have a negative affect on your glucose levels. Blessings.

              • Thank you again.

                I am doing a basic, low carb diet, avoiding chemicals, and taking adrenal support supplements.

                As I shared before, my doc back home was working on this with me, but over here in New Zealand, well, they just do not get it. I have to wait, I guess, until I go home in May.

                Boy, do I ever know that Stress is a killer. I am the queen of it. I also have skipped heart beats, they scare the bejeebers out of me. They have been acting up more the last few weeks.

                Yesterday, I ate the same meal as last week, well, last week, my sugar stayed low, this week, it went high, I did nothing different, except my stress is off the charts again. I am lucky to get 4 hours of sleep a night, I am tired all day, yet, when I go to bed, I toss and turn and watch the clock. It is awful.

                • Suzie-Q,

                  I am 57 and your issues seem very much like mine 3 years ago. I’m just now feeling like I’m regaining my health, ever so slowly. Most of this started when I went low to very low carb. I have added carbs back in my diet and feel much better. Going through the change is a big part of it! Adrenals need carbs as does the thyroid.
                  As far as stress, since you are a Christian, live in the psalms. Let them be your spiritual food, let them be on your mind as you toss and turn at night. Mark God in your bible and then make a list of all the things he says about himself. This was my lifeline when I was so sick. Praying praying praying. Accepting your present circumstances as God’s place for you at this time, goes a long way in lowering stress levels as well. Verbally going through a list to thank The Lord for the blessing you have been given is a stress buster as well.

                  Basic foods as Colleen says was helpful for me.
                  Cod liver oil, and some blood sugar supplements were helpful to me. Light walking, sunshine, meeting people and frequent naps were my medicine.

                  Lighten up on the all consuming stress over diet, taking your bgl all the time.
                  The stress, the change, the adrenals & thyroid all play a part, and hopefully you will sail through this storm quickly.
                  My bsg went down after I began to get well and through menopause.
                  Magnesium is helpful if you are not sleeping. Try an essential oil that is for resting. Turn the lights down low an hour before you go to bed and stay off of computers before going to bed. You will have to train your body for sleep. Make sure it is dark & cool in your room.

                  Walk as you can, not for long periods, but enough to get out. Spend some time in nature.

                  There is hope.

        • One more comment Suzie…it is possible that why you are having better results when you are going low carbs you are eating less gluten…so maybe this is reducing a food allergy in your life, thus having less of a negative stress impact on your adrenals, thus having less of a negative impact on your glucose levels. I sure hope this will point you in the right direction. I know for my blood sugar issues (being hypoglycemic for 20 years) the adrenals have been the king pin (root) of over 30 years of ill health (chemical and food sensitivities (wheat and gluten), food allergies, inflamed spine, auto immune thyroid issues, etc). It has been a slow journey…but I am finally getting better. Of course…without my Lord Jesus I would not have ever gotten to the root of it…all glory to Him.

          • Thank you Allie for your comment.

            For the most part, I am trying to do all you mentioned. I have been “post” menopausal now for over a year, yet, the menopause symptoms are worse, not better.

            I am taking many vitamins, they are:
            Vitamin A
            Vitamin B complex
            Vitamin C crystals
            Vitamin D
            Good multi-mineral supplement.
            Broken cell Chlorella
            Blood sugar lowering herbs
            Carlson’s fish oil liquid daily
            Cinnamon, I open the tablets and sprinkle it directly on my oat meal, always does the trick of keeping my sugar lower.

            I take my doggies on a walk almost daily, IO have two Shetland Sheepdogs (Shelties) they keep me busy.

            I do attend a church, and have a few friends, but none I feel close to.

            Now, here is where I think my stress is coming from:
            I got married way too soon back in 2012, we both made a mistake, I left my country of America to move over here to New Zealand with him. I do NOT like it here at all. This is when my health started to go down hill at an alarming rate. I can not sleep, and I have tried everything to sleep, the room is cold, but the bed is hot, and I am always having hot flashes. My husband is not a good support system, he does not go by a lot of natural health treatments. He was married before and I believe still misses his wife. We argue all the time and I spend my days in tears.

            I am gaining weight like crazy, I do not eat that much, but my waist measurements are awful, puts me in the “overweight” range.

            As I said, I am way past menopause, but still have the symptoms of it, maybe even worse.

            I am not interested in food, have to force myself to eat, I get tummy aches so easily.

            I really think the move here, the rotten marriage, and oh, I forgot, the death of my best friend last September and my daddy’s death in 2012 have pushed me over. My dear mother is dead too, we were all great friends, now, as I said, I have no one. I am trying to hang on to my faith, but even that is wavering.

            Wow, now that I read what I wrote, no wonder I am having glucose readings that are unstable, my life is unstable.

            God bless you all for your help.

        • Susie Q,

          High cortisol is from stress. It increases blood sugars. Exercise if strenuous enough increases cortisol. Three hour walks may be too much for you. Try reducing your walks to 30-60 minutes and relax. Hatha yoga is super helpful. Give your adrenals a break and see if your blood sugar improves. Also your lack of sleep is causing your cortisol to skyrocket. Take care.

          • I concur with Allie, Magnesium (helps sleep) and a good Vit D3 (stress and anxiety). Of course other things too but those are essential. Carbs are important, just healthy carbs, and healthy protein. Your adrenals need both.

    • Susie,

      So Sorry to hear about your issues. I to am miserable. To many bad things happen. Knocked down by lighting, son struck by truck while on his bike, lost my two older brothers to tragedy, detached abdomen muscle, bad discs, holes in my stomach, bitten by poison spider, lost my dad, daughter burned by boiling water and oil in accident, daughter totalled our car, wife and daughter in another head on car crash, my wife lost her brother, her mother, her dad and sister killed in car accident all in the past 5 years, and there is lots more. Why do bad things happen to good people?

    • Hello,

      Its normal to have high blood sugar post exercise. When body is stressed, carbs stored in the liver are released in the blood stream. This leads to sugar level jumping.

      If you want lower blood sugar post walking then go for a slow walk.

      I generally go for a slow walk around 1 hr post my major meal. It keeps things stabilized.

  104. Thank you for part 1 & part 2. I am searching for the next article where you discuss how to monitor one’s own post-prandial blood glucose levels. THANK YOU!

  105. Hi Eva, It could be that if you are on a low carbohydrate diet that your fasting blood sugar levels are naturally higher as Chris has said in his paragraph starting “one caveat here”. The key is that your levels don’t go above 140mg/dl for extended periods, so it may be something not to get too hung up about, depending on your exact numbers.

    • Low-carb made me insulin resistant with very high sugars. Never again. I’m back to moderate carb and my fasting glucose is 79.

  106. Aloha Chris, thank you so much for this absolutely great article, I am much obliged. I have a question which has been bugging me for the last few days, I am trying to find out what it means if someone has high fasting glucose readings but normal OGTT? HbA1c just under 7 (which according to your article is high) but this is after nutrition treatment from being diagnosed with diabetes last year. In a year we went form HbA1c of 12 to 6.9 and on the way down. Blood pressure is normalized but LDL is still somewhat high. We are working on reducing all this without taking copious amounts of drugs much to the dismay of the medical profession. Therefore, I would be very grateful if you’d advise on how to solve the quandary of the hepatic malfunction.

  107. The doctor refers to diabetes and impaired glucose tolerance but these are separate conditions. A random reading of 200 wouldn’t necessarily diagnose diabetes unless there were symptoms. The diagnosis would be a fasting reading over 126, HbA1C over 6.5% or more than 200 2 hours after glucose ingestion .
    However, a reading of 200 would cause a strong suspicion of diabetes unless it was about an hour after a high carb. meal, even then impaired glucose tolerance would be possible.
    Stress/other illnesses can elevate glucose-there is a non-diabetic condition known as “stress hyperglycemia” sometimes seen in hospital admissions.

    • Agreed. There are other conditions that can cause high glucose readings. Diabetes and insulin resistance are most certainly two separate conditions, In my case I first received a diagnosis of diabetes, got a second opinion from another doc and was told it was insulin resistance. Got a third and final opinion and was told it was diabetes again. The only thing that was consistent was the plan of treatment. Metformin, improve diet, exercise, see you three to four months for blood work. I guess I should say that the plan of treatment is similar for the two conditions.

    • A one-time fasting glucose over 126 does not automatically make one a diabetic. I went through a period of high cortisol and hyperthyroidism and woke up one morning with a fasting reading of 146. Freaked me out but it was a one-time thing and no doctor has ever diagnosed my as diabetic. My HBA1c is 4.9-5.1.

      • Agreed Quayle-but in the UK the reading only has to be confirmed once for a diagnosis to be made. Which makes me think there will be several cases of misdiagnosis or reversed diagnosis – e.g. two FBG readings of 127 due to stress/other illness but subsequently much lower.

  108. Susie-Q I had readings very similar to yours. I did have A1cs that would run slightly higher. Like you I never experienced a reading over 200 “at home”. I questioned the results of GTT and decided to talk to my doctor about my concerns. ” I was told that if you ever at anytime have a reading of 200 or more that it is an indication of Diabetes”. One day I got a reading over 200 at home! It is pretty frightening when you test yourself and get a 200+ result for the first time. According to my doctor it doesn’t have to be a consistent reading. I was told that people who don’t have impaired glucose never get readings that high. It doesn’t matter how many carbs they eat their insulin will work effectively to handle the carb load. I decided put this information to the test. One day I tested my husband (who has normal glucose) after he had eaten a full plate of pasta. Pasta is a carb that will raise my levels quickly. My husband’s reading didn’t even go over 110 after one hour. It is also true that stress, depression and anxiety can affect your levels. Being ill can also have an effect on your levels. I saw evidence of that once when I caught a cold. Drs. advice can vary so be sure to do some homework on your own. Some doctors bounce between the terms “insulin resistant” and diabetes. What I’ve discovered is basically it’s not a whole lot of difference between the two. Both disorders result from having impaired insulin and both have to be controlled with diet, exercise, and/or medication.

    • One night, I went pretty high, we had a high carb meal, well, I talked my husband into letting me take his sugar reading, he was only 70!!!! I was close to 165. He goes very low. I spike at times, but do not stay there for long, by the end of the 3rd hour, I am always back to “normal”

      If I really watch my diet, I will always be in the 90’s to low 100’s after I eat, unless I am super stressed.

    • One night, when we ate a high carb meal, I went up to around 160, I think, it was high, that much I know. Anyway, I talked my husband into letting me take his sugar too, it was 70, he always runs low. I went back to normal after 2 hours, which is “normal” for me. I do not stay high for long.

      If I eat low carb meals, I never go above the 90’s or low 100’s after the meal.

    I like your site and wanted to show you this….. thanks

    OGTT / post-meal blood sugars

    If you recall, the oral glucose tolerance test (OGTT) measures how our blood sugar responds to drinking a challenge solution of 75 grams of glucose. I don’t recommend this test, because A) it’s not realistic (no one EVERY drinks 75 grams of pure glucose), and B) it can produce horrible side effects for people with poor glucose control.

    • Yes,I think I agree-but many doctors regard the OGTT as the gold standard and may recommend it in this case. It certainly shouldn’t be used when FPG is high or diabetes has already been diagnosed since the sudden ingestion of glucose could be quite traumatic. The HbA1C test could be a good alternative.

  110. My fasting levels are between 80 and 100, for me, those numbers are great. (These are plasma readings). My blood pressure is stellar.

    At times, I will spike to 160 to 180, depending in what I eat, but normally, when I eat no carb meals, I stay in the 90’s.

    I had a horrible scare last night. I had eaten no carb all day; well, that evening I commuted the mortal sin of eating a Quarter Pounder and fries with ketchup. I have done it in the past without a dangerous spike, and I thought since I had been no carb all day, I would not spike once. Well, I checked my B/S at 2 hours,, it read 204!!!!. I did it right away again, and it was 187, sill too high, but not 200. Well, in two hours it went down to 110, I am happy with that. I do not know what happened, I have never had those high readings before. I have been crying all day, it scared me. It seems the lack of carbs all day caused this. This morning I was back to n low fasting level, and I have eaten no carb all day, my readings have been in the 90’s, which is great for me.

    This is also strange, some days I can eat tons of carbs and sugar but my readings are great!? Other times, I eat lots better or the same meal and my readings go high. It is depressing.

    As far back as I can remember, my A1c has been between 5.5 to 6.0. I take herbs like Berberine, this is the same as Metormin, however, it gives me horrible heart burn. I walk daily for 45 minutes to an hour. I usually watch what I eat.

    I am under lots of stress, depression and anxiety, I guess all this can affect the reading as well.

    Anyway, just wanted to share, my numbers can be so odd at times, but I am working in if.

    • Susie -Q -your slightly high A1C and postprandial readings
      indicate a possibility of Impaired Glucose Tolerance and an increased risk of developing diabetes in future. An oral glucose tolerance test could be used to make a diagnosis.

      • I had one in the early 80’s and one in the early 2000. I got bad hives from the one in 2000, I was told I was insulin resistant, but how could it be accurate when I had hives?

        The one in the 1980’s was all over the place. Started at fasting 98, half hour, 198, hour one, 217, second hour, 166 third hour, 113, fourth hour 55, fifth hour 76, and sixth hour, 79. I was diagnosed back then with reactive hypoglycemia. That was 30 years ago. I went from feeling dizzy to having bad anxiety attacks while it was dropping.

        The one that gave me hives in 2000, was only 2 hours, I was not told the numbers, just that I was insulin resistant, like I said, how can it be accurate if it gave me hives? I was told to take liquid chromium. I have never had an A1C lower than 5.6.

        I noticed that lately, I spike at the two hour mark, but at the three, I am “normal”. Also, I will go to normal if I exercise after a high carb meal the first hour, but the next hour ( one hour after exercise) I go very high. Again, it goes down the next hour.

        I never stay elevated for very long.

      • It is called “true results” I had to order it from the states, I could not find any in New Zealand. I am from the USA and do not understand the readings here.

    • Susie-Q, the overwhelming message I get from your comments is that you’re laboring under an enormous amount of stress. Have you looked into the possibility of suffering from adrenal fatigue? It’s something I just discovered, and sounds a lot like me. I suspect you would fit the profile as well. I’ve been looking at a book by Dr James L Wilson, Adrenal Fatigue: The 21st Century Stress Syndrome. (Interesting bit of info for you, since you’ve seen Dr Johnathan Wright-he wrote the foreward!) I think it’s a great book. Part 1 is an overview, Part 3 is full of what to do to recover from adrenal fatigue. Things to do, and things to avoid because they stimulate already overburdened adrenals.

      Dr Wilson has a website at adrenalfatigue.org. Here is a link to a questionnaire. http://www.adrenalfatigue.org/take-the-adrenal-fatigue-quiz
      I’m just beginning to learn about adrenal fatigue, and there is so much to absorb. I’m hoping that maybe it will help you!
      By the way, I do a lot of reading at this site, and others, but this is my first comment ever. Your distress moved me to respond.

      • Thank you so much for your comment and concern.

        I went to that site and did the test, mercy, I scored way over 100, almost every question I answered I had to score “3”. I have always suspected adrenal mal function in my issues, but now that I am over here in New Zealand, I definitely can not get help, they just do not understand problems like mine. I feel totally helpless, I spend most days crying, I am crying now in fact. I am so, totally and helplessly miserable and there is not a thing I can do to change it. The money I came over with is gone due to the damn high prices here, my marriage is not good, I really have no support system, folks are nice, but they sure do not understand where I am coming from. The only little relief I get is when I walk with my two, sweet Shetland Sheepdogs. I so wish I was back in the states, but then, I would still have no one, my dear folks are dead, my best friend is dead, I do not have enough money to really get re-established, I really messed my life up when I came over here.

        My memory has gone bye-bye, it use to be stellar, now, it is awful, I fear Alzheimer’s, to be honest. I am 57, and falling apart at an alarming rate.

        I do have some good news. Yesterday, I ate the same as I did before (the day I got the higher numbers) well, this time, I only ate half of what I did that day, and my numbers stayed in the 90’s to low 100’s, that is wonderful for me.

  111. Hi!

    I have just got some testresults back after going to my doctor to check out my blood sugar levels. I can’t really make sense of the results by myself so I hope someone can help me understand them better.

    The reason why I went to my doctor was because my FBG (tested at home) showed 90 mg/dl. I have never tested myself before so I could have had these numbers forever. The FBG from the doctor showed 93 mg/dl, so quite close. My HbA1c showed 5,2 %. My BP is 105/70 and my Hb is normal. My post meal values are always at 120mg/dl at the highest and goes down to 100 about 2-3 hours after.

    The only number that I don’t get is the FBG that according to this article is borderline high. My other numbers are ok so I don’t get why the FBG is high. I am underweight and have always been. I’m 26 years old and my BMI is 17,2. I have always had a hard time putting on weight (so has the rest of my family). I eat around 130g carbs a day. Can my high FBG have something to do with me being underweight? Maybe my liver doesn’t have so much glucose in storage because everything I eat gets used up during the day? So when fasting my body has to break down fat resulting in high FBG?

    Thank you for commenting on this!!


    • Anna your doctor can give you an expert opinion but to me your blood glucose & blood pressure figures look fine. If the glucose figures are in plasma or plasma equivalent (nearly always the case these days) the fasting BG is very much in the normal range. If it’s whole blood it’s borderline high but well below the diabetic threshold. My earlier post referred to an article highlighting health risks of LOW blood glucose, so we should not aim for “the lower the better” . However,I would aim for a BMI of at least 18.5 because,similarly, being in the normal range is better than underweight but you would only need a small increase to achieve this.

    • I am totally over-joyed when my FBS is in the 90’s, it is seldom in the 80’s or lower, but for me, this is “normal” I am thankful that my FBS rarely goes into the 100’s, when it does, it is always under 110, and if I re-check a few times, I am obsessed with it, I usually can get a number in the 90’s.

  112. Hi Chris. Just stumbled upon this and I am very impressed by all the information. I have recently been diagnosed with diabetes (1 month ago) My FBS was 124 and A1c 6.7. I have complex regional pain syndrome that prevents me from getting a good nights sleep, I average 1-2 hours straight sleep then wake to the pain. I have revamped my diet to low carb around 100g/day. I have started exercising, but am very limited to exercise as tolerated due to the CRPS. I have lost 5 pounds since diagnosis. My doctor has me checking my BS only first thing in the am. It has been running from 110-138. I just checked my BS tonight after 2 hours eating and it was 104. Is my lack of sleep causing/contributing to diabetes and what can I do about it? I have had CRPS for 3 going on 4 years now. I was started on Metformin, but immediately had dark green, grainy stools. Now off it with stools returned to normal. I take more than enough meds for the CRPS and do not want any more added. Any suggestions and help would be appreciated.

  113. Chris, kudos on this very informative article. I have just been diagnosed as Type 2 diabetic. With medications, diet and exercise, I am maintaining my BG (Fasting, PP, random) in good control. How long does it take for my A1C to reflect my new average levels? When should I go for my next A1C tests?

  114. I suggest you google “Low fasting plasma glucose level as a predictor of cardiovascular disease and all-cause mortality”. It’s a U shaped risk curve with the healthiest in the range 80-109 mg/dl.(4.4-6.1 mmol/l.) -below this range was higher risk as well as above it.

  115. Chris, my A1c is 6.3, FBG is 94. I am thin (age 60, 5′ 10″, 138 lbs). I have lost about 8 lbs in the past 8 months and would like to gain it back. How do I do that without increasing my sugar levels?

  116. Very interesting read!
    My FBG: 96-120
    My A1C: 5.3
    Post meal: 110-125
    I have had spikes high up to 183.
    Have a weight loss problem, dry skin. Thirsty a lot.
    Doctor says I’m not diabetic.

  117. Hi Chris. I know this is an older article and I’m hoping that you still check these comments as I really need your advice. I have been checking my blood sugar lately and it has had a very odd pattern that I hope you can figure out :). Yesterday for example went like this and this is a typical day.
    Fbg 99
    I do intermittent fasting and workout before my first meal
    Pre workout bg (roughly 3 hours later) 85
    Post workout/pre 1st meal 118!!
    45 min after meal 87
    2 hours after meal 93
    Approximately 5 hours after 1st meal I have 2nd meal bg 84
    45 min after 99
    2 hours after 99
    3 hours after 95
    Pre dinner 95
    45 min after 117
    2 hours after 110

    I recently had a lipid profile done and the results are as follows:
    Total cholesterol 175
    Hdl 67
    LDL 99
    Trig 55

    I eat mostly paleo but I do have Gouda cheese (for k2) and kefir Everyday. I also eat moderate carbs since I am breastfeeding and all my starchy carbs are at dinner. Typically potatoes sweet potatoes or rice. I have a history or unexplained chest pains and MVP so the study that shows bg above 86 correlating to heart disease scares me. I tried adding a meal this morning to see if it would help with my readings and it made no difference. Any insight you could provide would be greatly appreciated.

  118. Hi Susie:

    I tried to answer you twice now and each time my stupid tablet lost the message and dropped me offline, so I moved to my PC. 😉 Easier in the long run anyway.

    Metformin is a real wonder drug! It is a first line drug against diabetes and is a very old tried and true drug. It has been used over 50 years with little to no side effects. The main and really only side effect is that it can cause gastrointestinal problems when you are first adjusting to it. So they start you with 500 mg and gradually raise the amount so your body can adjust. I take 2000mg a day split into 2 doses of 1000mg each. They are learning new and good things about Metformin. Lots of recent and new research going on about it because they have discovered it helps other things besides diabetes. It reduces the risk of cancer by 50%. It has been found to regrow brain cells and it might be used in the fight against Alzheimers, to repair damaged and older brains. Canada has a new study going on right now to see if it will help children who have suffered from brain cancer, and lost a lot of brain, to recover some of the brain. They have used it for years for PCOS.

    Here is what the Physician’s Desk Reference says about the dose… “… anything less than 1500mg a day is not clinically significant…” Give this quote to your doctor if he seems unwilling to up your dosage. He can check it with his copy (usually online anymore, but some doctors still have the hardback books)

    You know that high blood pressure in diabetics is tied into high blood sugars too so keeping the BG down in normal ranges helps keep the blood pressure down too. They are connected… It also helps with weight loss for most. So I sure would recommend you ask for higher doses as soon as you are adjusted to it. Don’t want a bunch of gas and the runs, but once you can tolerate more, you should ask for more. I love what my metformin has done for my health! I hate prescription drugs as a rule, but not my Metformin! Love the stuff. The maximum recommended dose of Regular (not extended release) Metformin is 2750mg a day. I am considering whether I might not want to up mine to that amount as I am taking the generic stuff and it is not as strong as Glucophage. I had to change to a weaker generic and it caused me to gain 10 pounds over a few months, so I think I will try to get mine upped to the maximum. Generics are NOT the same where metformin is concerned… but Glucophage is so expensive.

    • The number one diabetes drug in the world (metformin) just so happens to be drug mugger of a few nutrients such as CoQ10 and vitamin B12. Low levels of these nutrients can affect the brain causing memory impairment, confusion and depression. Also, the nerves could start to hurt, and neuropathy may develop because B12 protects the myelin which is a coating that protects nerve fibers. If you require metformin for your blood sugar, just “marry” this medication with the two nutrients so you can avoid or minimize the side effect. As to forms of vitamin B12, the best type is called “methylcobalamin” and is widely available by dozens of makers. The CoQ10 can be found easily as well in both health food stores and pharmacies nationwide.

      just an fyi. 😀

      • I take sublingual B12 and have never heard it causes a coq10 problem. Statins cause a coq10 problem but not metformin. A once a year b12 shot or sublingual B12 drops (around $4 at walmart for 6months supply) solves any possible b12 problem. Again, metformin is a true wonder!

  119. Hi Susie:

    Metformin is a real wonder drug and much research is and has been done on it. They have found it reduces cancer by 50% and recently research has shown it rebuilds brains by causing new cellula growth. They have been using it for over 50 years with little to n side effects. The only real side effect is gastro problems when first adjusting to it. So they start newbies with 500mg a day and slowly increase it. I take 2000mg a day split into 2 doses of 1000mg per dose. The Physicians Desk Reference says “…anything less than 1500 mg a day is not clinically significant…” So yes, you should ask for more. I dislike and distrust drugs with the exception of metformin, but I love what it has done for me.

  120. Hi susie!

    A couple of thoughts… age is not a disease and if anything you should keep a tighter rein on the blood sugar cause you do not likely heal a well as a kid, at least I don’t and I am 63. I think you are headed right with your new diet. Any A1C over 5 is known and proven to cause complications, minor at around 5 but the higher it goes the worse the complications become. Minor nerve damage at 5.0 but with high numbers you can start to find things like kidney damage, etc. So I disagree with your doctor on that point.

    Regarding the cholesterol, I had that problem too. HAD that problem… I will warn you the doctor will try to put you on statins and they are really bad, the brain is made of cholesterol you know and when you use statins to reduce it you get brain fog which is another name for brain damage. You can lose memory etc. too. Really bad stuff. If you will begin getting sun on a daily basis, I think you will find yourLDL and total will drop. That is what I did and it worked. Any drug that lowers my lipids also raises my blood sugar, by the way.

    The body makes vitamin D from sunshine AND uses cholesterol as the raw fuel to do it! My lipid went from over 250 to 130 and my LDL dropped to 9 all from daily UVB rays of the sun. I am considering getting a UVB lamp for this winter. Do a web search on sunshine, cholesterol and blood pressure. Both cholesterol and blood pressure drop in the average person in the summer… that is what keyed me in to start reading about it. Do a bit of personal research before taking any statins though… that is just my opinion, I AM NOT A DOCTOR and I don’t even play one on television ;-D but I have personal experience about your problem cause I am a T2 with the same problems. I tried statins, so i know what they do to everyone, not just a few. I tried the diet my doctor gave me fr 2 years and all that happened was i gained 4 pounds and my a1c was just below 7. I went on a very low carb diet, dropped 40 pounds from it while having cream, instead of creamerand butter instead of margarine. I ate better foods for my body and my taste buds. I quit being hungry too. Cravings disappeared. You are going the correct direction in my opinion. My doctor got real excited when he saw my numbers and at one point exclaimed that my labs were that of a 20 year old! Then when I told him I was eating low carb, he said oh no! That will kill you. Mind you he was holding my good labs in his hand when he said that, and I mean full labs covering 2 pages of results! So I take my dctors advice with a grain of salt and do not argue with him but remind myself it is i who will suffer complications from my diabetes, not him. Hope this helps you and please pardon any typos as I am not on a computer and do not have a keyboard writting this…no delete key either so for a typo I have to backup and retype everything. This thing also puts in wrong letters etc. sometimes.

    • Hi, Mary,

      Thanks so much for your thoughtful and detailed response! I really appreciate the time you spent sharing here. You did marvelously well with the typing….much better than I’d most likely do without a keyboard, for sure. I will look into the sunshine info you shared and have recently been getting some walks outside pretty regularly. I’ll also check into the lamp idea you mentioned for the upcoming shorter winter time. I am determined not to start on statins and appreciate your info regarding them, too. Perhaps I’ll consider asking my doctor to up my metformin from 500 mg to 750 mg per day if eating a more paleo diet doesn’t yield the results I’m seeking.

  121. It’s been 10 months since I was diagnosed as Type II. At the time of diagnosis my A1C was 9.5. After 3 months of diet changes, exercise and 500 mg of metformin daily my A1C dropped to 6.4. I am a 71 year old female my doctor was very satisfied. After reading through this thread and learning that the ADA guidelines are not the best to follow I am wondering about my next step. For a week now I have eliminated grain, legumes and dairy but also added a green tea supplement and drinking green tea and making a breakfast “biscuit” with flax meal, coconut flour, egg, baking powder and coconut oil. I have also ordered “Your Personal Paleo Code” and await it’s arrival. My doctor’s reasoning that 6.4 was good for me was my age….if I were in my 30s or 40s she would want it to be lower. She’s also wanting me to start on cholesterol lowering medication but we’ll recheck labs in January. I am not wanting to go in that direction. I also have what the dietician called “the dawn phenomenon” in which my fasting blood sugar is elevated. Any advice or comments would be very much appreciated. I just discovered this web site yesterday and am learning a lot! Thanks.

  122. Hi Jackie. My suggestion is to actually run a full glucose curve. Test before you eat, then every 15 minutes after for 3 hours. The lab is more accurate as home meters are allowed to be as much as 20% off, though most of the time they are no more than 10% off, if that. What are the soap ingreidents you use? Some soaps have unseen sugars in them, such as glycerine (the gly gives it away) check your protecals to be certain there is no problem there. I do use the relion PRIME meter and strips myself and find them to be accurate and very cheap at $9.00 per 50 strips. This allows for as many tests a day as I want cause it is only .18 per strip. Good luck and do that glucose curve.

  123. Thanks Mary
    I did do some testing last night. I ate a bunch of potato chips and my numbers stayed between 99 and 105, then shot up to 129 about 2 hours in. This morning my fasting was 109. When the lab does the testing, they say my fasting is 126. I have an Aviva tester, but going to get the Relion like mentioned here and see if it’s any different. That’s what I find so confusing. My numbers are all over the place. I sometimes feel like I’m having symptoms, like fatigue and a headache, but my readings are between 101 and 105. Any thoughts on that?

  124. Hi jackie. I too think you are diabetic. Have you heard of doing a glucose curve? A simple do it yourself home test that is fairly inexpensive. It tells the real story of what you blood sugar is doing. You see, often you have spikes that you do not see if you are only testing two or three hours after eating.

    To do a glucose curve, take your blood sugar before eating and write it down. After eating, the clock starts ticking! Take your blood sugar every 15 minutes for the next three hours. This will pin down where your personal high point is located.

    I thought my PP was wonderful and could not understand why my fasting and A1C was high, till after I did a glucose curve. I was spiking HIGH at the 45 minute mark but by two hours was back down, so i simply did not see the blood sugars going up in excess of 200. This simple do it yourself test will give you some really good information. Do use a timer though, as you can easily miss a test or two and not get as good of information as possible.

  125. So curious after reading comments here. I’m 52 years old, with a fasting blood sugar reading of 126 and an a1c of 6.1. I’ve tested my blood both before and after meals many times and the highest I have ever seen it is the 126. My triglycerides and cholesterol and both ideal. All my other blood tests are also fine. I do have some ketones in my urine. I do not eat ‘low-carb.’My NP says I am diabetic, but I don’t understand how all my numbers tie together. They don’t match what I’m reading here. I’ve certainly never seen my blood sugar at 140 or higher! Any feedback would be appreciated. Thanks

  126. Hi, been having BS issues for a number of years now and no-one seems to have any idea what is going on or worse, doctors don’t listen or care.
    I’m 61yr female, bmi 18, active, been LCHF & gluten free for the last 18 months. A1c was 6.3% now down to 5.8% so coming down albeit slowly. FBG 4.1-4.3 mmol/l

    The issue is this, I can do an OGTT and not get any rise above 6.3 mmol/l and no reactive hypo – so I think very normal.

    Food, however, if I eat more than 30g absolute max carbs at any one time I will go to 10-13 mmol/l, sometimes staying there for a very short time or for a long time, depending on the type of starch or sugar component – fruit short time, rice or grains a long time.

    Why can I take a massive 75g glucose with no effect, but ‘normal’ carbs have a bad effect on me. What is the difference in the mechanism for signally that insulin needs to be produced in the two examples. Because it seems that with food no signal for first phase insulin is either made or received, hence the big spikes, but glucose obviously triggers insulin release absolutely normally.

  127. Hi, my fasting (not eating for at least 8 hours during the day) blood sugar is normally around the 83 mg/dl mark. But my blood sugar after waking up in the morning is sometimes over 100 mg/dl. How do I interpret these blood sugar levels? Thx.

    • Hi Daniel.

      This is normal and true of everyone. When you sleep you have “sleep” hormones in your system, such as melatonin, for example. When you wake your body goes through a sort of flushing to rid the body of the night hormones, part of why wepee so much when we first wake. However, when these sleep hormones are flushed from the system,other hormones go with them, such as insulin. This is normal and as soon as the flushing process is over the body puts out new insulin and the Bg falls back into normal ranges, though 100 is technically normal anyway. A diabetic cant make insulin quickly and has no stored insulin to quickly replace it. That is why it is best to wait 3 hours before exercisg after arising for a non-insulin dependent diabetic. It is also why breakfast should be the smallest meal of the day. Even people with normal metabolisims have their highest blood sugar readings with breakfast. Also why the worse meal one could eat is a high carb meal in the am. A light breakfast containing protein is the best breakfast for a good metabolisim. NOT cereal, with sugar water (milk) or a doughnut etc. and OJ, the typical continental breakfast is a terrible idea! Really almost all sugars.

  128. I’ve used 3 different glucometers to test my blood sugar and the results were drastically different. one was 67, another 95, and another one is 115. This is my fasting blood sugar. Not sure which is the correct one. Then I went to the doctor a few days later to get tested and it was only 85, when it was 124 when I tested at home before going there. I like to monitor my blood sugar at home, but is a bit nervous when the results are so different. BTW, the glucometers I use to test my blood sugar are
    TRUEtrack, TRUEdraw, and Gluccocard Vital. Just curious if I should take any of these results seriously. Can anyone recommend a more reliable meter?

  129. When I stay strict paleo, I see my post prandial and fasting numbers are in the ideal range for the most part. When I deviate by having say a piece of pizza and pineapple my post prandial shoots up to 150-170.. So how do I find the medium ground in terms of how many carbs I should target in a day?

  130. I have posted as “Susie~Q” and “Susan”. I have a question. A lot of times my blood sugar will not spike until the second hour, it fools me on the first making me think all is well, then WHAM, it can be anywhere from 139 to 150, by 3 or 3 1/2 hours, I am pretty close to my starting level.

    I am taking all kinds of lowering herbs, I guess they help some, but sometimes, when I do not take them, my blood sugar is lowering, like the herbs are working opposite of what they should do.

  131. I’d rather estimate lower, unlike another had posted. I am inclined to agree that these numbers are closer to normal. We should be trying to meet the levels of healthy people, not the numbers of known diabetics using insulin. I, for one, totally appreciate the information published here.

  132. …… just another quick question, why are old posts shown at the top? Would it not be better to sort them with the newest at the top so that people can see the latest news?


  133. Hi Chris
    For the most part we are told that having elevated BSL causes heart problems, kidney problems etc; etc. My friend who is 76 has never taken any type of medicine (insulin, metformin) due to lack of trust in the Pharma companies and has had this for over 45 years without any type of side effect. The few times he has taken his morning levels they were always between 240 and 320.
    I was diagnosed with chronic pancreatitis at the beginnig of the year at age 62 with diabetes as a side effect. Metformin made me really ill so I was put on 26 units of insulin (Lantus) at night and 6 units of rapid (Humalog) before every meal. 2 months after taking the insulin, my average fasting levels were 169 (anything between 130 and 250). Like my friend, I distrust the Pharma companies. So I Googled it and came up with gymnema sylvestre as an alternative. After 1 month of this my levels had dropped and I needed to stop the Humalog because of hypoglycemia (down to 60ish fasting). After 3 months of taking this supplement I have been able to cut the Lantus down to 10 units.
    Now my average fasting levels are 112 (for a 2 month period).
    Firstly, how come my friend isn’t either dead or seriously ill with complications of high levels? Secondly what do you know about gymnema sylvestre?
    All I can tell you is it works for me.
    It also works for my friend as I told him about it and now his fasting levels are down to a pretty stable 130 – 140. Not brilliant but much improved on before (he still eats what he likes).
    I wish everybody on this site good luck with their quest for normal levels.


  134. Hello, I have just discovered your site and am very glad I did! I just finished reading this article and cannot seem to find the next one where you talk about to accurately take post prandial blood sugar readings, can you or someone else here direct me to it? Thanks!


  135. Your numbers sound great to me. Why do you keep checking? I am always in the 90’s to 100, fasting, have ALWAYS been that way for me this us normal everyone is different, we can’t all be text book perfect.

    I do spike at times, I come down after 2 1/2 hours, again, this is normal for me. I have been this way since I was 26, I am now 57 and in great health.

  136. Hello! (I’m from Sweden so I apologize in advance for my spelling!)

    I have a question that I don´t seem to find an answer to anywhere. My FBG is all over the place. I can test 10 times at home within 15 minutes and I get numbers from 76 to 109. If I take the middle value of all the readings I get 89 which is borderline high and indicate diabetes within a decade. My postprandial values are always good. I don´t ever spike and don´t get a number over 120 ever. I can go under 100 after 45 minutes sometimes. My HbA1c levels are also good and within a normal range according to the article. I can´t understand why my FBG differs. I am underweight and have been my whole life which is genetic. My BMI is 17,3 and I rarely eat more than 1300-1500 kcal a day. I counted my carbs and I guess I eat less than 130 a day. I don´t strive to be low carb I just eat little of everything. Can my BMI and diet be the reason why my FBG are borderline high? Should I do something about this?

    Thankful for any answer!

    • Have you considered your meter at home may be inaccurate? I was convinced for 3 months I was diabetic until I started having my doctor test me and always got normal results.

  137. How does all this fit with porphyria, where a high carb diet is vital – HIGH carb: 300 minimum, 400-500 during attacks?

  138. RE: Posting of blood sugar and A1c numbers. I find myself unable to comment with the information given. It would be useful to post more specifics like BMI, number of carbs per day (and an idea of their sources), and amount/type of exercise, etc. What changes have you made and what was the impact (if any) seen via your experimentation? What have you done to confirm the accuracy of your meter? Any experimentation done with avoidance of key allergens and the observed impact (grains, dairy, soy, corn, etc)? Are you attempting to optimize cell membrane function (paying attention to )3-6 ratios and environmental toxins?
    Yes, I agree with the comment about not getting too stressed about it. There is no ‘failure’ only feedback and the information IS useful as long as you are not discouraged about it. It may spur you to find answers in areas you hadn’t thought to explore (e.g. gut biome configuration). Even if you never are able to lower the overall numbers, you will likely get info on individual foods YOU need to avoid that will spike you.

  139. This article is very frustrating. No matter what I do, my blood sugar is always over 100, and my A1C is usually around 5.4. There is simply no way for me to achieve the numbers in this article.(I never in my life had blood sugar numbers this low even when I was like 12 year old) BTW I have no family history of diabetes, I am normal weight and exercise every day and eat a diabetic diet. It all makes no difference at all.

    • I agree, for me, those numbers are an impossible, I will never be in the 80’s when fasting, oh maybe sometimes I am 86, but my “Norma” is in the 90’s.

      I take tons of herbs to keep it down, such as Berberine, which consistently rates better than Metformin, I have no family history of diabetes, am normal weight and exercise most days, and watch my diet. For me, a good A1C is 5.7. Folks can say what they want, but that is my best. My blood pressure is low, and when I had an ultra sound on my carotid arteries a couple years back, the results were “stellar” to quote my doctor.

      So, bottom line, I am not like others, and the numbers I have are good for me. I will add that I have been in these numbers since I was 25, I am now 56. I say stop worrying about what other folks are, worry adds high cortisol, high cortisol equals higher blood sugar. Accept the readings, especially if you are in good health and have always had such numbers. You are not diabetic, neither am I. We just do not fit the bill of others, but hey, that is fine.

      Here!s to individuallity, and good health.

  140. I would like to know what is considered an “ideal” hba1c? A few months ago, mine was a 4.9 and now it’s a 5.1. My doctor said not to worry, but are we trying to get it as low as possible? My fasting glucose is 85. I eat about 150 grams of carbs a day. Not low carb but not exactly high carb either.

  141. Chris, I would love to read Part 3 of this article – what is the title please so that I can find it. And thank you so much for your invaluable information!

  142. Hi Chris,
    My FBG is in 80ss and post meal after an hour is usually 120-130 and 2 hour is between 90-110 but my A1c is always 5.9. I have changed my diet to low carb diet, no sugary sweets or drinks but still my a1c is not moving down even a bit. Is it a concern?.?

    • Hi, I dont think Chris comments on posts much, so I hope you dont mind my thoughts, as I have a similar situation. One possible explanation is long-lived red blood cells , this would explain the higher A1Cs despite lower fasting and non-spiking post prandial numbers. A1C can be like BMI – a general (but not personally specific) screening. 2) You may have a latent reaction that you haven’t ‘caught’ yet (numbers are spiking later than anticipated). This was what was discovered about the ‘low-carb’ Dreamfield pasta – the spike was as high as regular carb pasta, but it was happening later. 3). I am experimenting with a little higher carb diet to see if it actually lowers blood sugar. You may have read that if you are following a low carb diet, you will fail an oral glucose tolerance test, but that eating 100-150 carbs per day for 3 day prior to the test will reverse the physiological insulin resistance (this is a term you can google search for more ideas). 4) I am getting ready to evaluate berberine (‘herbal metformin’) to see what happens and am trying to eat a few more starchy carbs a la Jaminet PHD, as my 23and SNPs suggest I am genetically disposed to higher blood glucose numbers.

      • Which begs the question, why would you want to go on a low carb diet if it’s going to make you insulin resistant….

  143. When i was pregnant i developed gestational diabetes and it never went away. Up until last year my fasting bs levels would be between 115-130 but i was able to keep my numbers under control for the rest of the day i.e. Under 120 after 2 hrs. I have to tell you i am overweight. I weighed 228 pounds. This past year i have been under extreme amounts of stress being a restauranteur so im sure my cortisol levels are totally out of control and in one year i have gained more weight bringing me up to 245 lbs with fasting numbers at 160-180 and i can no longer control my numbers throughout the day. The low carb atkins diet in which ive done before and lost alot of weight rather easily, is not working at all and my reading 2hrs after a meal is still at 140. Im having a hard time understanding first, why i cannot loose weight on atkins, and second why my numbers are so out of whack even when im not taking in the carbs. Cholesterol at last check wasnt too bad at 184 but they did say triglycerides where a bit high and good cholesterol was low. I am not on any meds and never have been except through pregnancy. Please tell me your thoughts. I know i need to lose weight and im trying but all diets seem to be failing.

  144. Just an FYI and N=1 follow up to the whole BS discussion. I hope it will be enlightening to the discussion:
    I have taken my Bayer Contour to the lab when I had my blood drawn in the past and it was very close to their results (i.e. therefore I presume it is accurate). I have been testing/comparing the NovaMax Plus meter (for glucose) because the same meter will do blood ketones and the sticks are reasonable priced vs. what they used to cost and competitors. However, there has been big discrepancies between the 2 meters so this morning I called the company. Overnight fasted glucose. Bayer meter read 82 and NovaMax read 145 (same blood drop). Based on my diet and past testing history, the 82 should be (I hope) correct! They had me do a control solution test on the NovaMax strips which read 119 (so this iswithin their ‘acceptable’ limits which are printed on the meter vial and are about the range of 82-127 I believe). They had me re-test my blood x 2. The first reading was 140 and 2nd was 137. By their standards, this is acceptable. I like this company and they are sending me replacement test strips just in case it was something about this batch (this lot is not from their ‘bad’ strips recall). This is just an example of why it helps to do repeat N-1 testing. I am going to add a 3rd meter to the mix. I believe Dr. Bernstein says Freestyle and Freestyle lite currently the most accurate.

  145. I am a newly diagnosed Type 2 and am trying to control my blood sugar with diet and exercise. So far, I’ve been very successful, but I have a question: Why, when I eat the exact same breakfast two days in a row, does my postprandial glucose fluctuate so much? Yesterday it was 115, today it was 130.

    • Sounds like margin of error in the meter. What you eat up to 24 hours before can also impact the amount of insulin that is ‘stored’ in your pancreas – so that could have a minor effect as well. Have always been grateful I can check BS out of interest (not medication dosing). Think the device manufacturers should be held to a much tighter standard than they are. See Jenny Ruhl’s Blood Sugar 101 book and great on-line info and there is an interesting section in Tim Ferriss 4-hour body where he tests blood sugar (varied by finger, etc). I wouldn’t purchase the book but maybe stop by the library and have a look at that section.

    • Results can also depend on what your fasting blood sugars are. My results vary depending on where my blood sugar are before I start my meals. You can eat the same exact meals and get different results depending on stress levels, time of day, before meal readings, if you are ill. There are so many things that can effect results.

  146. Like ‘veryconfused’, I too, have been looking for the third article to be written as part of the series, ‘Why your “normal” blood sugar isn’t normal’ but don’t see one and can’t find it via the search option. Chris references it at the end of Part 2. Was it ever written? If so, can you provide a link to it, please? Thank you.

  147. I thought there was suppose to be a follow up article for the
    Why your “normal” blood sugar isn’t normal (Part 2) but I can not find it? Help

  148. Hi Folks, I want to ask a question. I have been monitoring my FBS for last couple of years and it remained between 85-87 mg/dl except for once 97 mg/dl (when I was stressed). The more recent FBS was 87 mg/dl which was done in January 2014. My A1C was 4.4 in June 2013. Yesterday I had high pulse ~120 BPM and feeling lightheaded so I went to clinic where these checked my sugar level, it was 153 mg/dl 1 hour after meal and 159 mg/dl 2 hours after meal. Today morning my FBS was 109 mg/dl. I am very surprised and concerned seeing these relatively high number of my readings. Can someone here tell me what is going on with me, or it just might be a temporary thing? To add into a bit more, this week has been extremely stressful and increased my heart beat over 100. Could this is due to this? I would highly appreciate any insight or comment. Thank.

  149. You wrote “If you’re following a low-carb diet, fasting blood sugars in the 90s and even low 100s may not be a problem, provided your A1c and post-meal blood sugars are within the normal range.”

    Does the same rule apply for the A1c levels (6%) for a 25 year old female who exercises five days a week and eats a low-carb diet? In other words, could a high A1c level and a normal fasting blood glucose level be a result of being on a low-carb diet?

  150. I have a question. How come on one day I can eat a spaghetti dinner and never go above 80 and maybe a week later eat the same exact meal and I can go as high as 175 and it takes forever to go down. This happens frequently. My doc is running some saliva tests for cortisol, can this be a culprit?

  151. Thanks Deb G for the info. I will check that book out on the net.

    Yes, my diet has been more or less the American Standard, however, I have also done the Atkins diet with great success regarding blood sugar control. In New Zealand, so many of the foods do NOT have chemicals, so, I am forced to eat better. LOL, it all tastes weird to me, guess I am use to chemicals and not REAL food.

    I can believe that pizza raises the sugar, it sure did mine, that was one of the times it went so high, it took all night to get back to normal, the next day, even though the FBS was OK, it still wanted to go high after I ate. Last night, I had a small Lasagne, I took tow 500 mg of my herbal Berberine and 2 of my herbal sugar control, both help to keep levels lower, and they sure do, at least with me, The first hour, of course, it went to 137, then the 2nd hour, 154, the third, 117, I ate some cashews before the 4th hour and went to bed, not planning on checking the sugar, but, I started to feel very “weird” and my tummy hurt badly, so, I checked it, it was 68. This morning, it was back to 89,

    Mike, I would love to have your readings after I ate, to me, they are outstanding, but, everyone’s body is different. I was told that it is not hypoglycaemia until the readings are in the 50’s.

  152. Hi Deb B

    Thanks for your info. I have not heard of those book before, I will look for them on the “net”. My diet, has been the standard American diet, not as much though over here in New Zealand,. LOL, the food here taste so different, I have been told that is because they do not use as many chemicals. It is actually forcing me to eat better. I did have a pizza on one of those days that my BG went so high, and you are right, it took all night to get it back to normal and the next day, even though the fasting was OK, my BG was still very prome to going higher,.

    Last night, I had some Lasagne, before I ate it, however, I took 2 of my 500 mg berberine caps and another herbal that controls BG with Gymnema Sylvestria. Well, an hour after eating, my BG was 137, the second hour, 154, the third hour 117 and then the 4 th hour 68, I was not going to check the fourth hour as I had eaten some Cashews before bed, but, as I was trying to relax in bed, I got very sick to my tummy and felt weak, so, I decided to check the BG, sure enough, it was 68. This morning, after 7 hours of sleep, my FBS was 89. So, I know for a fact that the herbal products work, I will continue to take them, I had been before, but stopped for a few days and that is when it started to climb.

    I did not know that the BG machines were not too accurate for non-fasting BG’s, I often wondered.

    Mike, I would have been happy with all of your readings, so would my doctor. I would not say it was hypoglycaemia, I have been told it is not that until you reach readings in the 50’s, everyone’s body is different however.

  153. I’ve been feeling ‘off’ for years now. I’ve complained to my doctor who has run the usual blood tests to tell me I’m OK and just need some anti-depressants. I feel I know my body pretty well and I know something is up. I have multiple food allergies which i suspect are throwing my body out of whack in many subtle ways. I’m trying to eliminate foods I’m allergic to like wheat, gluten, rye, barley, eggs, etc. The carb cravings have been overwhelming and I’ve been eating more and more sugar.

    I picked up a glucose meter to see what my blood sugar is doing when I feel good and when I feel bad. Out of curiosity I did my own little OGTT. My blood sugar was 87 before the test and within 15 minutes after I started ingesting my carbs it was 149. I retested in 15 minute increments for the next three hours. The readings were 139, 116, 83 (1 hour mark), 93, 95, 93, 74 (2-hour mark), 77, 75, 77, 77 (3 hour mark). I tested again after 4 and 5 hours and got 78 and 78. I was drinking water during the test, but not large amounts.

    At the 2-hour mark (reading of 74) I started feeling ill, shaky, tired, and hungry. After that I started getting a headache and just felt crummy.

    I guess my question is this, is it normal for blood sugar to peak and drop that quickly within an hour?

    • I am not a doctor, but it sounds like hypoglycemia.
      my doc told me after sufficient testing to eat protein (a slice or two of turkey/chicken/beef etc.) every 2-3 hours and just before bedtime until your FBG is fairly consistent. She doesn’t like to see FBG in the 70’s and really doesn’t mind FBG in the 90’s as long as there is a consistent number and not a pattern of huge spikes. She is also ok with moderate carbs, if it is not a problem.

  154. Hi, I just found this site and would like to participate. I will give my numbers, etc.

    First, my last A1c was 6.1, the doc said it was Pre-diabetes in January of 2014, OK, I get it that part, but what confuses me is that at home, on my glucometer, all my fastings were “Normal” however, back then, I had not checked after meals, so maybe they were the culprits. Now, I am checking all the time and driving myself crazy. In the morning sometimes fasting is 95 and other times 85, it varies day to day. Usually, after a low carb meal, it drops to the 80’s the first hour and lower the second. On some days, when I am naughty and eat wrong, my b/s sugar is still low, and on other days, I can eat the same thing, and it goes sky high, again, not consistent. Normally, however, since February, my fbs is 90, 1 hour after, 120, 2nd hour, back to 90, but, that changes as well. In February, of 2014, on the 5th, it was horrible. I think I had eaten Lasagne, well, before, my sugars did not change much, but that night, WHAM-O I started at 80 before the meal, I forgot to take it at the one and two hour mark, but did at the 3 hour mark, it was 175, then at four hours, down to 160, then at 5 hours, back to 175. I went to bed, because by that time, it was 2 AM, but when I woke up at 8:00 and took it, it was back to 89!!!! This horrible ordeal has only happened once, but, I have gone up to 178 since, but come down to normal in 2 hours. I don’t know if I was extra stressed that day or what, I am under tons of it, my marriage is not good, my dear dad died 2 years ago and my very best friend died 7 months ago, I live in a strange country, I am from America, but moved to New Zealand last year, and I am soooo unhappy. Anyway, what does confuse me is why the daily differences, even though I may eat the same thing on two different days, my sugars will register differently as well.

    I will say, when I was 24 (I am now 56) I had the horrible 6 hour OGTT done by a Naturopath, my fasting was 94, the first half hour, I sky rocketed up to 198, the hour mark, to 212, the two hour mark, 155, the three hour mark, 113, the four hour mark, 55, and the fifth and sixth hour, 76. I was told I was hypoglycemic. I tried another test 6 years later, but I broke out in hives due to fear and the readings were wrong, this one, however, was only insulin level and again, was told I was Insulin Resistent.

    Most of my A1c’s have been around 5.5, 5.7, and 6.0, I have not had that many however.

    I do know that in the past, I have never drank much water, so maybe this accounts for some of the higher levels, also, when I exercise, it goes lower. But, I have another question, when I exercise, it goes to “normal,” but then, about a half hour later, rises again, but then goes down, why would this be? UGH.

    Anyway, that is my story, I am sure my stress is off the charts, I have just sent in the “all day saliva” tests to see where my cortisol levels are as well as other hormones as I am post-menopausal. I am doing this long distance as I do not trust the doctors here in NZ, it is tedious doing the mailing, but well worth having my same Naturopath of 7 years.

    A positive note, I am now exercising daily, either via taking 45 minute walks with my dogs, or doing the vigorous, 45 minute indoor walking with my Leslie Sansone DVD, I feel so good afterwards and my bs sure shows it. I am trying to eat better as well, I need to lower my cholersterol and LDL as well. My blood pressure is outstanding, it is always 110/75.

    • Hello Susan, My heart goes out to you in your isolation, but I applaud your bravery in taking the steps to tackle this issue. Nor sure what your ‘past’ eating history is (Standard American Diet?). If you haven’t already, I would highly recommend Jenny Ruhl’s Blood Sugar 101 book. It will explain many of the vagaries of BS monitoring. Much of the information is also available on her web site (the book is just a bit more logical in its lay out). Tim Ferriss actually did some interesting experiments with his glucometer in 4-hour body. Basically showed the huge variations based on finger used, many things you would not expect. Bottom line, be glad you don’t have to use these devices to administer insulin, they have a very high ‘legally’ allowable accuracy range. Yes, stress, infections, what you ate 24 hours previous can all impact your BS. It is more a matter of generally tracking and seeing patterns and making correlations with what is going on in your life. BTW – have have seen it anecdotally reported that pizza will elevate BG highest and keep it there longest. The components of lasagna (gluten/wheat flour, cheese and tomato sauce) would perhaps be very similar. Good luck!

  155. Thanks Chris for the great information. I just started testing my fasting blood glucose and it was high (97) but for past few weeks I have been eating very low carb and felt slight relief after reading this post. So, if and when I eat carbs, my FBG would go down? As your post states, I don’t value what is considered “normal”, I too subscribe to the importance of optimal health.
    I haven’t had my Hemoglobin A1C tested in awhile, so I can’t comment about that number right now.

    I am still confused as to whether or not low carb creating insulin resistance is good or not? Can please you clarify this for me? Don’t I want to increase my insulin sensitivity? and am I preventing my body from burning fat?

    Also, I just listened to a podcast from Kiefer about carb re-loading and it makes sense about eating carbs at the right time, what are your thoughts about low GI not being as important or conventional wisdom says?
    Thank you.

  156. Hi Chris. I have been reading your stuff for years now, but rarely tried to pose any questions to you because I appreciate how massively busy you are.

    But now, I have a problem that is really freaking me out and I have tried to read all I can from the smarter nutritional thinkers about it and still feel like something has happened which I don’t understand. I think you might be the most likely person to have some insight.

    I have suddenly started to see big postprandial blood glucose spikes (138, when 88 is more my usual) that hang around for several hours even when I have only eaten some fish and green veggies cooked in coconut oil. I am also seeing much bigger spikes after exercising.

    My fasting glucose is also sitting much higher than usual (100 compared to my usual 64-72). I am still generating ketone bodies in the low nutritional ketosis range ( I measure this with a blood ketone device).

    I read your views and those of hyperlipid about temporary insulin resistance on low carb diets, and decided I would try introducing more carbs in the form of sweet potato to see whether that regulated things again and kickstarted my insulin sensitivity. But it has not, and after a few days on sweet potatoes in the evenings, I have had rubbish sleep and feel high as a kite, and have higher glucose readings than I have ever seen in my life, even compared to when I was a big grain and sugar treat consumer. I am starting to feel a bit scared.

    I am 42, fit and highly active, not overweight at all, otherwise healthy, eat ancestrally all the time and have done for several years, and for the past year on the low carb side of things because I find my brain tends to work better and that it tends to keep my energy more stable. Suddenly everything has changed….

    I am not sure which way to go, up the carbs even more, or stay right off them? My instincts and appetite seem to be telling me to fast on fat, but this seems risky if the problem has been caused in the first place by being too low carb.

    The only thing that has really changed in the last week is that I increased my heavy weight lifting, going from once to twice a week.

    Any suggestions?

    • I destroyed my insulin sensitivity going low carb. After 6 months on a low carb diet with refeeds I started seeing fasting glucose above 110 and post-prandial 160. I quit testing after and hba1c test came back 4.9, but it was still very scary and I don’t even know what my numbers are now.

    • Hi Alison. Have you seen any changes since this last post? I wonder about this as well (my story is similar). I read/listen to MANY nutrition sources and from what I can tell – we are still keeping insulin low (key to anti-aging and many other health metrics). So measuring blood sugar is a ‘proxy’ for insulin. Have you had your insulin measured via lab test ever? That said, some of the strategies I have read are: once a week carb day (SAFE starches, not junk food) and do not combine with fat. This would also achieve a protein fast, which is also an anti-aging/autophagy strategy. Some members of the Calorie Restriction Society have excellent blood sugar success with high carb diets (high fiber, low glycemic carbs like fibrous veg, barley). They are able to be in ketosis a large part of the day, but it is through ‘narrow eating window’ and being in a fasted state for many hours through the night (I do not recall their insulin numbers, tho – but blood sugars are fantastically low). Have you read the writings of Dr. Ron Rosedale? May help give you comfort/additional insight. Keeping blood sugar low should work for the majority, however, we are all biochemically unique. Biggest question: how do you feel? I have been experimenting with resistant starch (unmodified potato), but need to get serious about tracking blood sugar impact (it is reported to lower it), also there are some plant based compounds that may help (I have one brand ordered). I want to test/track in an n=1 manner that I can positively say what works for me (and therefore what might work for someone else), but right now I can’t. Hope that gives you a few other areas to consider that maybe you hadn’t. D

  157. It sounds like cortisol. Cortisol will raise your glucose, and strenuous workouts can raise your cortisol. I would look at your intensity and scale back a bit.

  158. I’ve recently started working out. With a very low carb diet, (+/- 35/day) I have my FBS between 82-95 and rarely are the posts above 115. 1 hour after workout, and still fasting, it will raise to 150. Current A1c = 5.6, 1000mg Metformin 2X daily. Any suggestions to moderate this?

  159. Hi, my son is 5 and recently had some tests done (all fasting.) His glucose was 73 (range 65-99), A1C 5.4 (range 4.8-5.6), BUT what concerns me is that his insulin was 0.9 (range 2.6-24.9), and C-peptide 0.5 (range 1.1-4.4). We’ve always noticed that he has extreme mood swings related to food. I did a couple of prick tests on his finger when he was having these episodes and his glucose level was 50 once and also low the other time. I haven’t measured his glucose levels any other time, but his pediatrician said it’s normal because he doesn’t have elevated fasting glucose levels. Do you think the levels are normal or I should seek a second opinion? Thanks for your help!

    • Hi Laura.

      CK is no longer posting on this thread.

      50 is hypoglycemic territory. keeping protein in your son’s diet every 2-3 hours will help keep it more stable and not dip so low.
      This is what my practictioner told me, when I was having drops, but not as low as 50, it did stable me quite a bit.
      Also, eating a bit of protein just before bedtime.

      Can anyone else offer some thoughts?

      • What causes a person to go hypoglycemic? I’ve had numbers in the high 40s and low 50s and I thought the meter was malfunctioning.

        • Margaret – I don’t know the scientific cause, but not eating often and diet contributes to it, try keeping protein in your system every 2-3 hours and right before bedtime.
          This may help the drops.

  160. I used to be hypoglycemic and eating a paleo diet improved my symptoms. I used to have nocturnal hypoglycemia eating the SAD, like 40 the whole night.
    Now I’ve been checking at every single night I have numbers like 100 at 2am. Every single night. But when I wake up it’s always 70 or in the low 70′s.
    It seems like there is a dysregulation but I don’t know why or what can I do to improve it. Can you help me and give me your opinion on why this happens?
    Thank you very much and keep up the good work.
    Greetings from Spain

    • as someone else mentioned in the comments, your liver may need some help. Perhaps you could try drinking lemon water throughout the day (1/2 lemon squeezed into a glass of water upon waking up and more throughout the day) or taking a liver supporting herbal supplement such as milk thistle, dandelion or burdock root (get these in pill or tincture form at your local health store or online).

      try these for a few weeks and see if your numbers improve.

  161. My fasting blood glucose is 110, last year it was 120. My A1C is totally in the normal range. My doctor said my anxiety can raise my FBG levels. I am slightly overweight and enjoy a drink or two every night. I have gone back on the treadmill and stopped the drinks. Also, watching my diet very carefully. Do you think I have taken the proper steps?

  162. My over 12 hours fasting glucose results are almost always rather high, mostly 97, 98 or even 99.
    But my post meal glucose readings barely go up, doesn’t matter if tested 45 minutes, 1 hour or 2 h after a meal, my post meal glucose readings are almost always just a few points higher than the fasting readings, so mostly only 100 or 101.
    Do I need to worry about my rather high fasting glucose results?
    Isn’t 81 or less the optimal fasting glucose reading?
    Or don’t I need to worry about higher fasting glucose results because my post meal glucose readings are well below 120?
    I follow a low carb vegan diet since years (I never eat junkfood), can low carb dieting cause higher fasting glucose results?

    FYI: I’m not a diabetic and I don’t take any medications

  163. My fasting glucose is always in the 70’s or low 80’s and I eat mostly carbs lol. I guess being male, running and 145 pounds helps.

  164. Well, don,t know if this will help someone, but just in case. I am not diabetic, neither pre-diabetic, my husband is diabetic and I use his glucose meter to monitor myself too. Well, like 2 years ago I bought iodine pills because I read that iodine will low the risk for breast cancer. I started to take 1 pill daily of 150mcg iodine each, a few days after I started to develop hypoglycemia, no matter what I eat or in what amount, hypoglycemia didn,t improve I remember I was eating 3 bars of cookies n, cream chocolate from hershey with no avail, I was eating bread, french fries, candies with no avail, dizzyness what still there and my glucose didn,t went up of 68 doing this but it didn,t went down of 60 either, my FBG was always below 70 but never below 60, the only thing that worked was eating 2 full spoon of white sugar. I didn,t know why that happened to me, but after I quit taking those iodine pills hypoglycemia episodes also stopped. I read recently that iodine increase sensivity for insulin and some doctors are using it in type 2 diabetic ppl so this way those ppl don,t need to use medication.

  165. My A1c is 5.9. The doctor says my fasting Blood sugar was 98 one year and 110 mg/dl the next. But I bought a Contour glucometer and measured my blood sugar after meals. Spaghetti dinner was a peak of 122. After 1 hr. it was 111. So my meal spikes are real low but my Fasting is sort of high and my A1C is high. Could both my fasting and A1C be due to other factors?

  166. Hello,
    I’m hoping someone can help me understand if I’m testing within normal range for my diet. I eat mostly dark greens, nuts, seeds and chicken, I use good fats liberally like coconut oil and I consumer flaxseed and take 2 PB8 a day. My BS was 114 a few hours after a meal, 152 an hour after a meal and 114 fasting. Chris says very low carb can bring higher results that could still be considered normal. The only sugar in my diet is Stevia w/coffee.

  167. Lynne I have the same phenomenon happening and I think he said it is likely a cortisol issue. Perhaps he can expound upon that?

  168. Hi Chris,

    Is it possible for my 1 hour post dinner reading to be lower than my 2 hour? For example, i ate around 100g of carbs for dinner and a protein. My 1 hour post eating was 97 and 2 hours later 109! Why would the second figure be much higher than the 1 hour figure? Does this mean I have imparied glucose tolerance?

    • The 2 hr reading being higher than the first can simply mean that it took a long time to digest. Most likely to happen when you eat a high fat meal. Look up the ‘pizza effect’. The numbers you listed though could very well be within the margin of error for the meter anyways.

    • Yes, The meter can vary. To determine the amount of variation. Take several readings, say 4 in a row, when your blood sugar is stable like before breakfast. This will give you an idea of the variability of the meter. I can get a 10 mg/dl difference by taking a sample on the opposite hand!

      • I think these meters cannot be trusted. I tested myself before a fasting test at the lab. At home it was 100. Went to the lab, had the blood drawn, then tested with my meter 2 minutes later, and it was 110. When I got my results, it was only 84.

        • Hi Margaret,

          May I know what glucose meter decide you are using? I am using the Aviva Accuchek one and it is pretty close. My fasting one day was 61mg/dL at home and when I tested it at the lab it was 66md/dL. So not too bad a difference I think and I am pretty happy with the accuracy so far.

  169. Almost 15 years ago I had Graves Disease and they nuked my thyroid. Since then my TSH levels swing from hyper to hypo-thyroidism on a regular basis making it nearly impossible to maintain a stable metabolism. I have had a single breath calorimetry which measured me at 1700 kcal/day although my weight is 360 lbs. With every bout of hypothyroidism (over the 3 months between testing), I will gain weight. I have managed to lose 60 pounds, but it has taken a great deal of hard work over a long period of time. My lipids are generally good, mostly normal, a little high in triglycerides but not scary. My blood sugar is getting worse and worse and does not seem to have anything to do with the foods I eat. Over the past 9 months I have been hypothyroid, hyperthyroid and hypothyroid again. The diabetes meds I am taking are antagonistic to the thyroid medications I’m taking. I feel these two diseases are at odds with each other. I really need some help and some advice, especially as to what kinds of food I should eat. Currently I focus on green vegetables, colorful starches (red potatoes), and lean meats. I don’t know what more I can do. Thanks.

  170. I am Type 2, although I’ve never been obese and my endocrinologist thinks I may be a Monogenic (MODY) diabetic. I have become resistant to pills so am on insulin for both basal and bolus injections.

    I learned a long time ago that my HA1C doesn’t equate to my Fructasomine which also doesn’t equate to my average blood sugar readings. My blood sugars before and after meals & insulin can be quite high and my daily sugars can vary wildly. I am insulin resistant. Even the fastest acting insulin can take three hours to take effect.

    But my latest HA1C is 5.1. LDL is a low 42. Triglicerides 71, HDL 53 and overall cholesterol 109. Alt 19 and very, very slightly anemic.

    I’ve given up on the usefulness of the HA1C test, as when I test my sugars 6 times a day at various times those numbers always average 140 or higher. Since it takes so long for insulin to kick in, I try to inject very early before meals, but also can’t risk hypoglycemia at work or driving. When I’m hypOglycemic, it’s usually at bedtime.

    Any thoughts?

  171. Hi Chris, Thanks for the informative article, My wife was diagnosed GDM (Gestational Diabetes Mellitus) during third pregnancy (completed March-2013). After that fasting and random blood sugar comes to normal levels.She had OGTT test done after 3 months and the reading were in normal ranges specified. Two month ago, she checked fasting blood sugar at home using one of handheld glucometer and had readings in range of 120-135 mg/dl. along with random test readings (2 hours) always comes lesser than fasting test results. She started a very strict diet plan but fasting readings fluctuates in the same range with random once again comes lesser than fasting results. She just had glucose fasting, random and HBA1C test done at a reputed laboratory and readings are as under
    Fasting (approx. 12 hours) = 125 mg/dl
    Random (two hours) = 105 mg/dl.
    HBA1C = 5.2 %.

    We haven’t see any Doctor yet and I want to have your opinion on these readings i.e. is she is diabetic or what? also comment why fating sugar levels are higher than random sugar levels. My wife is 33 years old and very active.

  172. Dear Chris,
    I am wondering if you can help me. At 44, I delivered my first baby and developed gestational diabetes with my pregnancy. I was on bed rest towards the end and had to take quick and long lasting insulin. After my C section, they checked my sugars and told me they were back to normal.
    However, 6 months later, I am still checking as my first a1c at 2 months was 5.6. It then came down to 5.2. I am very thin, 108 at 5″4, and exercise by walking every day, usually 45 minutes to an hour at a fast pace and pushing a stroller. My waking sugars range from high 80’s to sometimes high 90’s. Two hours after meals, usually below 100, but sometimes in the low 100’s or teens.

    I do not have diabetes in my family, and try very hard to watch my carb intake. I do not enjoy animal protein, but find that chicken especially keeps the sugars low. I often find myself very hungry mid morning and mid afternoon.

    I tested my a1c today, 6 months after delivery, and was disappointed to see 5.9!

    Any thoughts as to my chances of now having type 2? The clinic I see here told me to stop checking and come back in a few months.

    Thank you

    • Hi Susie, Like you I also developed gestational diabetes. I developed it in two pregnancies. I was somewhat surprised by my diagnosis since I’d never had any major issues with my weight. My blood sugars returned to normal after delivery but later became elevated. I couldn’t understand because I simply did not fit what I thought was the criteria for diabetes. I researched “thin diabetics” and found a well of information on diabetic “myths”. Thin people can and do develop diabetes. Also research insulin resistance. I also was told to stop checking my blood sugars so frequently but I still check because it gives me an idea as how different foods effect my blood sugars. I hope this helps.

      • Thank you so much for writing back. I am truly confused by the numbers I am seeing. This morning my fasting was 100, where as yesterday it was 86. I have now starting checking my one hour sugars after meals, and so far, they are in the low 100’s. However, I have not really tried to carb overload to really test it. I notice that an hour after rising, the numbers go back down to the 80’s. It’s the first one of the morning that seems high.
        My greatest fear is that I am already doing damage to my heart, eyes, and nerves. My baby girl already has an “old” mom, I just want to stay so healthy for her sake as well as my own.

        Do you take anything? What foods seem to elevate your numbers?
        Thanks again!

        • Yep, I take 500mg of metformin twice a day. During my pregnancies I managed my blood sugars really well with diet and exercise without any meds. I would suggest seeing a Endocrinologist and having a Glucose Tolerance Test done. This is a good way to find out if your insulin is impaired. If you’ve ever had a GTT done then you already know that it is no day at the beach consuming such a sweet liquid substance that can bring you to your knees. The GTT was the way I learned that I had developed type 2 diabetes. After one hour my blood sugars went to 205. The foods that I’ve found to have the biggest effect on my blood sugars are starches. White rice, potatoes, bread. I’ve switched to brown rice which I don’t particularly care for but it has less impact on my blood sugars. I tried the whole wheat bread, but I just couldn’t eat it, so I now eat honeywheat. I love fruit but I also have to eat it in moderation. I’ve learned that for me portion size, types of carbs and timing is key to managing my blood sugars. I need a small snack before bed or my morning fasting blood sugars will be elevated. According to my doctor going too long without food can sometimes cause your body to think it is starving and thus causing the liver to produce more glucose resulting in high morning fasting glucose. When your insulin is impaired it may not be able to handle the extra glucose produced by the liver. I try not to eat my snack after 10:00 because I want a true fasting (8-10 hours after a meal) in the morning. Take your time and choose a good Endocrinologist, bring a list of questions with all your concerns. Bring your monitor with you. Be prepared to go through a battery of test including having your thyroid checked. If meds are suggested ask if they are necessary to manage your blood sugars and make sure you are satisfied with the medical advice. I hope this is helpful

    • Susie, Knowledge Sponge is right, thin people do get diabetes. Besides, there are many obese people without diabetes.

      I’ve read it may take about 10-15 years for women with gestational diabetes to develop full blown diabetes, after their pregnancy. It may also manifest itself with the onset of menopause.

      I’d advise you to test 1 hour after meals if you want to find out whether your glucose/carb metabolism is impaired. In early diabetes, when fasting and 2-hour levels are still normal, the 1st hour reading may reveal the problem. For more detail, you may read about the two phases of insulin release after meals. If the 1st phase is broken, you will have a high 1-hour reading, like above 140. In fact, the “fully normal” people’s glucose rarely goes over 120 even an hour after carbohydrate-rich meals.

      Take care 🙂

      • Thanks so much for your response. I started checking yesterday the sugar levels one hour after meals, and they were in the low 100’s to teens. That said, I did not really carb overload, just a normal meal.

        I do understand that thin people get diabetes, I was just surprised, as I do not really fit the profile…no family history, and always a normal weight…very healthy. I have read and understand that 50 % of gestational diabetes patients go on to develop Type 2 within a few years. I guess was just hoping to prevent or keep it at bay as long as possible. I really miss being able to eat normally and with more spontaneity. I have also been a vegetarian most of my adult life. But I am finding that the grains, rice, beans, etc, seem to elevate my sugars, where chicken and cheese, eggs, beef, do not. I also have a terrible sweet tooth.

        Any thoughts on medication, or maybe switching doctors? I feel that an A1C jump from 5.2 to 5.9 in a month is a red flag. Do you think the at home tests are truly accurate? I am also experiencing a great deal of stress at home.

        For the most par, my sugars seemed to be under control, with the exception of the waking/fastings, which lately have been in the 90’s…sometime low, sometimes close to or at 100.

        Thank you for your time!!

        • Dear Susie, I agree with you that a 0.7% jump in your A1c is not something to be ignored.

          I’m not sure you can prevent diabetes, but you can control it. As you’ve rightly found out, carbohydrates elevate your blood sugar levels, while proteins and/or fat do not (though they may, a little bit).

          Was your A1c tested with a home test kit? As far as I know, at home A1c tests are not too off, while glucose meters are allowed to be up to 20% off.

          Susie, with the numbers you’ve posted, I highly doubt you’re doing any damage to your heart, eyes, and nerves. I’m not a doctor, but my opinion is you need no medication, at least as long as your readings are as great as you’ve reported them to be. Now to find out why your A1c has jumped to 5.9%… Stress may have contributed to it, especially if you tend to snack often, when stressed. Just an idea.

  173. Hi Chris,
    I am a female, 22 years old, from Portugal.
    I was a bit overweight when I was a kid and diagnosed with hashimoto’s at the age of 14. My TSH was extremely high and I of course was a depressed kid.
    During my teenage years that follow I became anorexic. I didn’t stopped eating at all, actually I ate every 3h..but just granola bars and everything that was low-fat. I lost nearly 17kg.
    When I cured myself (did theraphy, gained weight, my period came back etc) and reintroduced carbs, I experienced reactive hypoglycemia. It’s like a plague. One hour after eating my blood sugar was 50. The doctors advice was to eat carbs every 2h … you can imagine what happend next.. I got stuck in a cycle where every 10 minutes to 1h my blood sugar was 35. Sometimes riight after eating. Being this young I had no idea why this was happening… I though I was going to die from this. I could never leave my house without something with sugar in my purse and I passed out in supermakerts, school, coffee, shopping center… My doctor prescribed me anti depressants and refused to understand that RH is real. Anyway, I did a 21 days sugar detox which seemed to be solving my reactive hypoglycemia, and started supplementing with Omega 3 and Chromium. (which I think was crucial). Of course now I am still afraid of this happening again,specially because I couldn’t and still can’t find a doctor in my country who can help me understand what was happening. Reading your posts and doing my own research is what is helping… Do you think I still need to do cortisol/adrenal tests? Perhaps I still have low DHEA? In Portugal is hard to find someone who can do them but I will do whatever I need to do to guarentee I will no longer be through such pain again.
    sorry for my english! and for being scared and confused…..I’m afraid it can all come back…… I almost died. And I’m going to go to college again and wanna make sure I can have a life again. Please give me some advice or at least suggest all tests I shoud do…

    Thank you so much and sorry for the long text and taking your time!

    • Me either! It was bad news for my mental and physical health, and in fact *worsened* my IR. The mian thing I changed when I went back to eating good carbs was that I massively decreased my PUFA intake. I don’t eat pork and avoid vegetable oil and poultry skin like the plague…

  174. “One caveat here is that very low-carb diets will produce elevated fasting blood glucose levels. Why? Because low-carb diets induce insulin resistance.”

    This seems to militate AGAINST a low carb diet, as insulin resistance is BAD, correct?

    I was on VLC (30 g or less a day with a weekly refeed) for about 5 months. During that time, my fasting glucose was around 96. Prior to this, low 80s had always the norm for me. Since going off the diet 3 months ago, my levels are still elevated. I think by going low carb I’ve destroyed my body’s ability to process carbs.

  175. I am new to this so exuse me if I have missed something but wouldn’t intermitent fasting produce the same effects on your insulin resistents as a no carb diet?

  176. Hi. I am Registered Dietitian. One of my friend developed gestational diabetes even though there is no family history of diabetes or GD. She controlled her sugars by diet and exercise during pregnancy. Now she is pre diabetic where only her OGTT is 154. Her fasting and HbA1c are normal. Y is tat so ? How can she control her sugars and post pone diabetes.

  177. hi, I would like to know if insomia and anxiety can cause high BS. I have to take sleeping pills to sleep, but only get 4 hours a night. I take anxiety meds, but still have anxiety. Have racing heart rate. My FBS is 95-100 and after a small snack of one bite bagle and 2 sips tea it was 137. in evening it went to 156. Help…..

    • Aany type of stress on the body can raise BG numbers. IT just vareid as to what extent. I know when I have a cold they shoot up quite a bit higher than ususal.

  178. Hi. Just ran across your article. I’ve had some confusing numbers pop up in regards to my blood sugar. Last fall I had some lab work done at the doctors. Fasting sugar was one of the things tested. And it came out at 79. A pretty healthy number. Just recently, I bought a home glucose meter out of my own curiosity and because I’ve been having some symptoms that could possibly point in that direction such as peeing more often some days (although that could just be from anxiety and green tea) and feeling tired (although I don’t sleep very well). I tested my own fasting glucose. One morning it was 99, 107 the next, and 104 the third day. I only tested post high carb meal one day where I ate a bagel. One hour after it was 125 and 111 at two hours, 110 at three hours. So those numbers were pretty well within normal range, but my FBG seem to be high. I called my doctor to tell her about it, but she doesn’t seem to be concerned about it as long as it’s not over 110. But I am concerned. I don’t exactly fit the bill for pre diabetes. I’m not over weight (118 lbs). My blood pressure is always fine. Last fall my cholesterol was healthy (170). I exercise three times a week. And my diet isn’t horrible. I don’t eat enough vegetables, but I reserve soda and dessert only for special occasions. I did go from an active factory job to a sedentary desk job last summer (couple months before the FBS of 79), but like I said, I try to get to the gym three times a week. I’m only 27. My grandparents on my mothers side had diabetes, one from poor lifestyle choices and obesity, the other didn’t get it till in his 70’s. But neither of my parents or any of my siblings have it. So what do you make of this? Should I be worried? Could anxiety or insomnia be causing my FBS to be too high? Or perhaps my home meter isn’t very accurate?

  179. Now, i’m worried. I had a prediabetes test done several months ago and my FBG was 91 mg/dL and my A1c was 5.6. I’ve been testing my blood sugar levels with a True2Go meter and my FBG is below 90 and, in some cases, is as low as 70. My post-meal blood glucose is usually below 130 45 minutes to an hour later. But, a breakfast of two reggs on a white roll, accompanied by some white potato and bell peppers, brought my blood glucaose level to 149 after 45 minutes. I immediately did another test with the same blood drop and got 142. But, 15 minutes after that test, my blood glucose was 123 and, an hour after that, it was 108. Should I worry? Am I headed towards diabetes in ten years?

    • John, when my doc diagnosed me with prediabetes, my FBG was 78, but the A1C was more revealing. It was 5.9. It took me about 2 years to get it down to 5.5, but I’m still not satisified as that is an average BG of 112. My goal is to get the A1C below 5. My AM fasting is always quite low. My post prandials are pretty good because I follow a low carb diet. You may do well by reading The Diabetes Solution by Dr. Richard Bernstein…very informative.

      Your post meal readings are just too dangerous, in my opinion. I would ditch white breads and potatoes and perhaps follow a more low carb diet, as Dr. Bernstein advocates.

      Keep in mind that the test strips that are available today are just flat out not accurate.
      It really sucks, but until the multitudes complain, nothing may be done about it.

      May I also suggest checking out http://www.bloodsugar101.com
      You will learn alot. Good luck!

      • Sharon,

        If the test strips aren’t accurate then what is? I’m so lost with all this information. When I was diagnosed 3 months ago the test strips were showing 280 but now since I have cut out bread, sugar and pasta my levels are consistently 88-110 so what do you suggest to test your levels?


        • Craig, I know it’s all very frustrating. The last I heard from Dr. Bernstein’s podcast is that the Aviva strips, the old version, are the best ones and can be purchased from Canadian pharmacies and they are pricey. You can write to him and see if they came up with any solutions yet.
          You can write to them [email protected]

          I got so disgusted with testing, I just eat right and don’t test often.The accuracy is really for people who are dependent on insulin and it’s imperative that they get the most accurate reading.

          I just get strips from my father (who is diabetic and Medicare sends him strips) and I use those.

          Take a listen to Bernstein’s podcast the last Wednesday of every month. I believe there is one coming up tomorrow. Read his book, it’s well worth it. The Diabetes Solution.

      • Thanks, Sharon. It’s a great webpage. There’s so much contradictory stuff on the web that I don’t know what to believe. But, Blood Sugar 101 looks pretty good.

  180. Over the last few months I have developed some alarming symptoms. My toes are numb and my entire hands go numb off and on. I have intense leg and foot pain that burns so bad, I cannot sleep at night. Most recently, I have had intense thirst and non-stop urination throughout the night and day. In general, I feel horrible with fatigue, back pain, headaches and an unexplained ravenous appetite. I am about 40 lbs overweight and most of it is in my belly. I have extremely high cholestorol along with a hypothyroid issue. I’m beginning to feel like a hypochondriac. The kicker is…. my bloodwork is all normal and my doctor is not concerned. She prescribed Lyrica for the pain, but I cannot dismiss these symptoms. What could possibly be causing this? Does anyone else have this problem?

    • Carrie, what do you mean your bloodworm is all normal? What tests did you get and do you have copies of the results? What tests did you do for thyroid function? What do you do for your hypothyroidism? It sounds to me like you need a new doctor who understands the intricacies of thyroid related issues, and who will be able to assess whether you are taking the right medication, particularly if what you take now is thyroxine.What does your diet consist of generally?

  181. Hi Chris: thank for your article, it is very informative.
    I am 54 male, now 83 kg ( and guess about 8 kg over normal weight for my height; have lost 2 Kg in last 2 months). For last few years I have had all kinds of tests done, including blood work, MRI etc for feeling light headed, headaches, disoriented giddy feeling, ringing in ears, seeing spots etc etc. Litany of issues. Have had cardiac workup done as well

    Everybody looked at my blood work, Pre-fasting around 100, post around 140 and said I was in range, need to lose weight, get fit. And everybody says Sugars are not the problem.

    This did not compute.

    Finally got to India last month and had insulin levels and sugar checked every half hour, and low and behold, PP jumped from 100 to 160 in half hour, 190 in 1 hour, and then settled to around 140 in 2 hours.

    The spikes are killing me. Very unsettling. Sometimes cannot even walk, and feel very unsteady. I can feel my right eye veins start to hurt and throb. Other times are better

    I am on half tablet of Metformin (500Mg) twice daily ( was on 500MG twice daily, doctor said cut the dose over last 2 days; seems to improved tolerance for spikes). Also take Blood pressure medicine for 30 years; and multivits, cinnamon, omega 3.

    I have started watching diet, and working out. Will improve.

    Anymore need to be own Advocate and find out what is wrong and how to solve it

    1) are there any other tests I need to do to pinpoint issues or find out about beta cells etc, get to bottom of issues
    2) anything else I can do to reduce to fasting sugars to below 100???

    Best Regards,

  182. Hi,

    I was losing weight, thirsty and peeing a lot so I went to the doc and she had me take a blood test. The test came back that my FBG was 330 and my A1C was 12.6. The doc immediately said I had diabetes and told me to eat no salt, sugar or pasta. I did that and within 2 weeks I brought my FBG down to 98 – 118 range and continue for over a month to be around 83 to 110.

    I have been trying different foods to see what spikes my levels and so far nothing spikes my levels. Is it possible that I’m pre-diabetic and not full blown diabetic?

    Thanks for the very informative information.


  183. Is it normal for blood glucose to go to 59 one hour post a meal of pasta? 90 minutes at 96.

    I am highly active and not overweight. However, over the last 8 months I have put on 10lbs without reason. If anything, I have cut my carbs to low and increased my activity. 90 minutes cardio some days. 3-4 days per week of boot camp on top of the cardio.

    I am now on 1000mg of metformin.

    Super confused

  184. Hi Chris

    Would a pregnant women who eats a low carb diet with 1 hour post meals blood sugar range from 94-110, but a fasting blood sugar at 94 be considered to have gestational diabetes?

  185. Hi Chris, Thanks for the informative article. I did what you recommended and got a monitor to see what was happening to my blood sugar levels. Here are a few of my results

    (eating a footlong sandwhich)
    Fasting: 87
    pre-meal: 82
    1 hr: 149
    2 hr: 124
    3 hr: 101

    (eating chipotle chicken and rice bowl)
    1 HR: 143
    2 HR: 104
    3hr: 93

    I was wondering what your thoughts are on this. It seems that your article and the research it cites tend to say that small spikes up to 140 can be normal, but even at the 2 hr mark it is till hovering around 120. However the other meal I had, theres the spike of 140 at 1 hr, but at 2 hr it is way below 120. So I’m a little perplexed at what this numbers might mean, but I guess it really depends on how much carbs you are eating at that particular meal. Any thoughts would be greatly appreciated

    • I forgot to mention that I do have several risk factors. I am 25 yo, my BMI is 29, my a1c was 5.6%, and both my grandmothers have diabetes. Does the results above suggest that I might be pre-diabetic?

  186. Hello Chris,
    I liked your article. I am 7 weeks postpartum. I was diagnosed GDM at 28th week of pregnancy. My fasting was always normal. I was only on diet and exercise control and managed my blood sugars v well. At 6 week post partum my fasting is normal but 2 hr OGTT is 154 mg/dl and hbA1c is 5.9. I do not have family history of Diabetes. What could have made me pre-diabetic ? I am again on diet and exercise control.

  187. I am confused a little and maybe you could help me. I took the OGTT and my results were FBG 73, one hr 47, 2 hr 57. This test was murder and my body has not been right since. However, I do understand now that I have experienced these low levels before. I have since bought a meter and if I eat a high carb meal I will see my #’s at 196 one hour after then 112 @ 2nd hr. I have also seen 162 2 hrs after eating. I have low numbers in my diary as well 54, 47.. I am not overweight nor have I ever been obese. I was an athletic kid but the strange thing is I remember throughout my 37 yrs of life frequent urination, inability to drink alcohol, sensitivities to medicine, food additives, restless leg syndrome and extreme fatigue ( sleeping entire days as a kid and have recently started to do the same). My Mother and Brother have hypothyroidism and similar urination trouble. My Brother was going to get checked for hypoglycemia but his endocrinologist said she doesn’t believe in it. I will admit after checking with my meter, it’s more accurate to check that way. My hypoglycemia symptoms will come as my bg is declining. I have an appointment with endocrinology and of course my TSH is normal. We all know how accurate that test is. Anyway, your thoughts or suggestions would be appreciated. Also, the high numbers I quoted were found when I wanted to test myself with carbs to see why if I eat potatoes I get pain in my back by my kidneys. I hate that pain so the numbers are lower since I eat low carb. Makes me wonder what they were when I was eating the way I was before with more carbs and chocolate with lots of tea. Oh my, I can’t even tollerate one cup of tea now.
    Sorry this was so long. I am frustrated and have had some horrible experiences with Dr’s in the last year. I am eager for someone who will examine, the big picture.Thanks.

  188. I was at the hospital a couple weeks back and mentioned to a nurse that I think I might have pre-diabetes or even type 2 diabetes, as my one hour blood sugar level after thanksgiving dinner was 250 mg/dl. She laughed and said that hers ‘probably hit 300’ and said not to worry about it. It’s stuff like this that makes me not want to use doctors for anything. Many are clueless, granted this was just a nurse and I know the medical industry is very compartmentalized with lots of ‘specialists’ that are just good at one or two things.

    I control my blood sugar levels with salads and high omega 9 dressing to go with it which has replaced lo mean (chinese pasta) that I used to eat. I found out about this blood sugar spike myself, since my fasting sugar readings at the yearly health screenings were always in the 90’s which is ‘normal’

    Sad thing is, these post meal blood sugar spikes have likely been going on for years, without my realizing it, looking back at past fasting numbers. My a1c was at 5.6% when I tested it, so it’s not super advanced by any means. Usually my blood sugar does not rise above 110 now with my meals, and will be lowest in the evening, where I can find it down in the 80’s.

    First mistake of the medical industry.. using 100 as a good fasting number, it should be set under 90. Second mistake, not testing post meal levels or encouraging people to do so on their own. It’s actually very easy to self monitor for diabetes but I never see this brought up in the mainstream media, nor is the connection between high blood sugar and heart problems due to inflammation ever brought up.

    Seems to me reasonable to assume that undiagnosed type 2 diabetic conditions could be more at fault for heart attacks than saturated fat, since people who eat saturated fats usually eat a lot of things like potatoes and french fries, and have a high level of omega 6’s in their diet, which are arguably bad in excess.

    • forgot to add, other than suffering from anxiety/stress issues I’m fairly healthy. I’m hoping reducing the anxiety/cortisol levels through lifestyle changes will reduce the insulin resistance.

      My cholesterol is tested at 130, triglicerides I forget the exact number, I’m pretty sure they were in the 60’s. My HDL higher than LDL. 6 foot, 170 lbs, don’t drink, do jog in 4-5 mile stretches. Blood pressure usually from 118/78 to 124/78. Don’t drink or smoke. No family history of anything medical issues on either side of the family, they all live to be very old, even when they are overweight they still hit 80 years old.

      My one failing are lifestyle habits that maintain my stressful personality type, which has gotten up to panic attack levels since November. Stress kills. The medical industry likes to blame it on a whole list of things but are reluctant to approach one’s mental state which can be hard to fix but can be done, with discipline.

  189. I’m trying to put these all together:
    A1C: 6.1
    CRP: 3.4
    Fasting blood sugar: 6.5-6.9 (117-124)
    Following a low carb diet for 1.5 years (50-80gms carbs per day)
    Anemic (106 the last test)
    Low iron for 12 years (heavy menstrual)
    Post-meal blood sugar: 7.5 (135)
    Over weight. Mostly belly fat
    Female age 49

    Started metformin 2 weeks ago at my insistence. Went up from 250mg to 500 two days ago because I have seen no change.
    The doctors here have no clue. But I have no where to get help. I’m sure you don’t want to diagnose over the message board but could you point me in the right direction?

  190. I was diagnosed with Type 2 in January (2012) and this article has been incredibly valuable to me, in terms of setting personal goals, and aiming for truly good health, as opposed to just stalling serious illness. Aiming for the markers mentioned in this piece, as opposed to the benchmarks set by so many other diabetes forums and sites, I regularly have a BG level of 120 or so two hours after a meal, and have brought my A1C down from an 8.3 in January, to 5.7 just last week. The amazing thing is that it hasn’t actually been difficult – more a matter of paying attention to how my body reacts to both food and activity, and making informed choices. Thanks for this valuable resource.

  191. Hi Chris
    i recently test my fasting blood sugar and the result was 116. This morning i drink a milk shake and test it 11/2 hour ( One and half hour) later and the result is 119. can u please give me some advice, i am over weight also.

    thank you

  192. Dear chris many thanks for ur efforts towards diabetes .ur blogs reallys helps those who have many concerns abt diabetes .i am on of them ,,,i am 35 years old male
    i was diagnoses only once with FBS 122 and total cholestrol 215.however my HDl ,LDL and trig was fine ,,after a week my FBS was 99 and my 2hours after posmmeal sugar never corss 125 its always stays between 110 and 125 ,,and now my total cholestrol is under 200 … i m using two machines at home one is bayer contour wich always showing my fbs below 100 and accu check above 100 to 105 ,, my AC1result is 5.1 my Dr said its ok nothing to worry about , i m very concerned and afraid if sometime diabetes gonna catch me , my question is am i at risk of having diabetes ? what does one time spike ? i have no family history of diabetes , i m not over wieght and doing regular excericse .i m not friend of sodas and fast foods .please reply .

  193. Hi Chris,

    My husband had recent health chech up. Here are the nos
    FBG:117 mg/dl
    post pradial (2hrs): 81mg/dl

    He is identified with slightly enlarged liver and has high tryglycerides (335mg/dl). Does this indicate anything alarming? He has high BP and takes medication for that.
    Please advice me. me

  194. My fasting blood sugar is 72. Should I be concerned about it being too low? Is this an indicator of a sort of pre-hypoglycemia? Or am I completely ok?

  195. Hi Chris,

    I was wondering if you could help me understand the connection between the adrenals and blood glucose in my situation.

    I never used to monitor blood glucose until going on Hydrocortisone due to depleted adrenals that would not respond to any other supplements. My main symptom before going off of it was continued night wakings, up for hours at a time, usually presenting with hunger or adrenaline. I just weaned off of the Hydrocortisone after being on it for approximately 10 months. I gained quite a bit of weight on it, and had other symptoms, like increased systemic candida, that prompted me to go off.

    Since being off – I am now waking in the middle of the night with that same gnawing pain in my stomach (despite a high protein, high fat snack before bed), and often eating some Goraw sunflower seeds throughout the night, as I wake frequently. My blood glucose is usually around 100, slightly under or over. I also have had higher fasting readings since weaning.

    This is extremely puzzling to me – and I know there is a connection with cortisol. Do you think this points to high cortisol or low? I eat paleo/GAPS, and it almost seems as though I started having issues when I went grain free.

    Thanks so much for any advice!

  196. Endocrinologists say her numbers do not make sense and are at a loss at this point. Would love an opinion on where to go from here.

    11y/o female with unexplained weight gain for past 6 years.

    Fasting OGTT with 75 gram glucose drink: ( This was done twice due to high insulin levels, with similar results )

    Fasting specimen 66
    1 hour specimen 102
    2 hour specimen 107

    Insulin Response to Glucose:
    Fasting Specimen 23
    1 hour specimen 215
    2 hour specimen >300

    Leptin 42.5 (high)

    C-Peptide 3.09 (normal)

    Glycosylated Hemoglobin A1C 5.4 (normal)

    Lots of bloodwork, everything else basically normal. Strange that C-peptide is normal, but insulin is outrageous. She is on NO medications and no exogenous insulin.

    Also had negative MRI of pancreas.

    Thanks for looking and for your thoughts.

    • I’ve been in a similar situation since age 16 (23 now). I’ve seen two endocrinologists so far, on top of five different general practitioners and none of them could give me answers beyond “its diabetes but not diabetes”, which explains and means absolutely nothing. It is extremely frustrating.

      My fasting insulin is/was (?) an average of 24 mU/L (optimal is 6 mU/L).

      My fasting glucose is anywhere from 87 to 104 (average 89) mg/dL

      Insulin C-Peptide 2.5 ng/mL (normal)

      A1C always normal (never over 5.5%, currently around 4%)

      oGGT 220 mg/dL at 2 hours
      bona fide diabetic range, but I’m not actually diabetic. I continued the test myself until 5 hours where I then experienced a sudden drop to 77 and then 72. I did experience hypoglycemia at those levels.

      24 hour Cortisol 117 mgc/24hr (over 50-70 mcg is officially hypercortisolism by most reference ranges; Kaiser’s cut-off is far too generous at 125 which is why it was not explored further).

      None of these results make sense together. They are not supposed to be possible. Especially not the C-Peptide and Insulin level discrepancy because Proinsulin is supposed to split into a perfect 1:1 ratio into actual Insulin and C-Peptide (C-Peptide is basically just a byproduct or waste in the Insulin manufacturing process). I’ve not been able to find anything anywhere about what could or does cause this to be imbalanced… I’ve been searching for six years. As far as the internet is concerned, there is no explanation (though its probably in some obscure textbook somewhere that costs too much money for the lay-person to reference…). One possible theory out there is that this COULD be the result of ‘impotent insulin’, but I have my personal reservations about that. It wouldn’t be interesting enough to get a diagnoses even if it was (extremely expensive too I bet, “experimental” something not covered by insurance and all that).

      Point is, I also cannot get a definitive diagnoses and they’re not interested in helping me either (they’re not even looking/testing anymore). My pediatrician actually told me I was perfectly fine even despite his running the same metabolic panel that the first endocrinologist did. She pegged it as ‘syndrome x’ but it actually is not (it is but it is NOT the primary cause of everything else, it is a secondary condition). However, at least it was a start… even if it is now a dead-end.

      Very strangely, after I’d followed the advice of Mayo Clinic with the MED or Mediterranean ‘diet’ (the alleged “cure” for this) in just two months of that, I encountered my first and severe hypoglycemic episode (before that I’d only ever had very slight hypoglycemia). The significant change I made for that? Replacing my carbohydrates from white flour to wheat and whole grain. It was severe enough that I lost sensation over my entire body (it started in my liver area and then rapidly spread everywhere else – it had to have been an extreme amount of insulin flooding out of my pancreas) and then I also had an absentee seizure. A movie was on one minute and it was infomercials the next. I slept for over 24 hours after this attack and I felt absolutely fried, like every nerve in my body was shot (I felt toxic actually; like I was intoxicated but I really wasn’t. I don’t even like aspirin). I know my insulin was sky-high because I could smell it and taste it, not just feel it.

      I know I’ve had whatever this thing is since I was at least 12 years old (that is when the rapid weight gain began as well as some of the lesser symptoms) and I still don’t have an answer. I wish I could help you but I just wanted you to know there is an explanation for this. Keep pushing it and advocating for your daughter. I wish my mom would have done that for me… maybe I’d have the answer if she would have. Too late now. I’m not a cute kid anymore… they don’t care about adults.

      Diet and exercise failed. This is NOT ‘lifestyle’ related. It is something else.

      You know what… even having high Cortisol AND Insulin is not supposed to be possible, let alone mismatching levels of Insulin and C-Peptide. Cortisol is the anti-Insulin and Insulin is the anti-Cortisol. It is always supposed to be one over the other, never both like this.

      However, it seems entirely possible that this is a liver-related problem in the first place. Look into the new information about that. Something to do with the FOX06 gene. There is also now strong indication that ‘hepatokines’ (liver hormones) are involved in causing insulin resistance (and therefore the myriad of other later progressions, e.g. actual type 2 diabetes). So its not the pancreas, but the liver that is the problem… no wonder they’re not making progress with diabetes and other diabetes-like disease processes. The nimrods are looking at the wrong and non-causative organ! How embarrassing.

      I hope you and your daughter get the right diagnosis soon. Sorry I can’t help more.

  197. Oh, one more question. If you’re on a VLC diet, are your PP target values the same as everybody else’s? My PP readings are rarely over 120 (unless I eat too much fruit or dessert during my night meal). (Incidentally, I’ve also noticed that if I eat too many carbs, my readings are usually lower after a long meal than a short one.) For my first meal of the day (during which I have very few carbs), my PP readings are almost always below 110 and quite often below 100 as well. OTOH, my PP readings rarely in the 80s–should they be? If so, why?

    • The PP targets are the same; it’s the VLC diet that is probably keeping you from exceeding them (that’s the point of VLC in people with insulin resistance). As long as you’re under the targets, statistically speaking you are not at greater risk for future blood sugar complications.

  198. This is a fascinating article. I had never heard of the “dawn effect” before, but it describes some of what I’ve observed with my own readings.

    Concerning “2 hour” post-prandial readings, I’ve read that if your meal lasts less than 30 min., you should start timing “2 hours” from when you begin your meal. However, if your meal lasts longer than 30 min., you should take your blood-sugar reading 1 1/2 hours after the end of your meal. I’ve also read that the target for your reading should really be < 110.

    I have a question. Does anybody know if it's common for one's body chemistry to change as you reach middle age? When I was younger, I ate a high-carb diet with relative impunity and had normal weight. When I was 30, for instance, I had a FBG of 84. However, once I reached my mid-30s, my weight just started creeping up and up. Until then, I usually weighed in the low 140s. But then my weight started to get as high as 153. Unfortunately, I don't know what my blood-sugar readings were then. About a year later, I completely changed my diet and switched to the "Weston A. Price" diet. It wasn't a low-carb diet per se, but rather a healthy moderate-carb diet with more protein and fat, and no processed foods. On that diet, I ended up losing nearly 20 pounds. However, even though my weight was in the 130s, when I had my FBG taken a couple years later, it was 105! I don't remember what my HA1c was, but I believe it was pretty high as well. Anyway, I changed to a strict low-carb diet after that, and my readings got better, and my fasting insulin was even less than 2.0! Currently, I usually don't consume more than about 30-40 grams of carbs a day.

    But what I'd really like to know is why my body seemed to lose the ability to tolerate a lot of carbs in my mid-30s. Has that happened to anybody else? Why would my FBG be 84 when I was 30 and on a high-carb diet (with lots of white sugar and sometimes fast food), and then 105 when I was 38 and on a healthy, moderate-carb diet (with no white flour or sugar or fast food), and weighed less 5-10 lb. less at 38 than I did at 30? I shudder to think what my FBG was when I was about 35 and weighed as much as 153.

  199. Hi Chris,

    I wonder if you can help/comment – I am T2 & was wondering if one should skip breakfast when experiencing high waking blood sugar readings? The reason I ask, is that I am worried by eating breakfast with high readings, this would only elevate the readings much higher? If one should skip breakfast, how long should one wait before eating anything?

    Another thing I would like to mention & am wondering if anyone else has experienced is that I can somewhat control eating during the day or eat very little but get very intense hunger prangs during the night – I have been eating my main meal later & later – now at any time between 23:30- 00:30 but a couple of hours later, I still get hunger pangs & cravings? I find myself getting top a few times during the night as I have a huge urge to snack? What is going on?

    Many Thanks!

  200. Dear Chris, my question is a bit different. I really want to know if “normal” can be different for different people. I’ll try keep my back story short; I was diagnosed as T2 in 2001. I first tried the doctor recommended route of metformin and regular testing with little to no diet modification. That unsurprisingly (I know now) didn’t work. I did my own research and eventually went on the induction phase of Atkin’s diet (never got off phase one because it was working so well for me, lol!) Got pregnant after years of trying, and then had to go high carb again due to money issues. After my first pregnancy, my blood sugars actually looked normal according to every test. I stayed relatively low carb, having gotten ALL sugar and most non veggie carbs out of my diet. Got pregnant again. My blood sugar numbers still looked good and my doctor asked me if I was SURE I was diabetic. (I don’t have daily numbers to reference, sorry.) While staying relatively low carb, I do not get the symptoms of high blood sugar – such as sleepiness after eating, nausea, and frequent headaches. Nor do I “crash.” Most importantly, my cycles stay normal!
    During my second pregnancy, I had my first case of gout – complete with high uric acid levels, but normal blood sugar levels. It resolved itself with no drugs in a very short period of time.
    Fast forward to this year. Over the last 1-2 years, I have slowly allowed more and more carbs into my diet. I feel it is important to mention that I am a food nazi. I insist on eating and feeding my children a nutrient dense, mostly organic, mostly low carb diet. All our fruits and veggies are organic. As for these carbs, even they wouldn’t be considered much to most people. A sandwich for lunch on authentic sourdough about half of the time, and a pasta dish using organic noodles about 2-3 days a week. (On foodstamps, I have to save money somewhere, and even organic pasta is so much cheaper than meat…) I make a LOT of homemade soup. I make it from scratch starting with the bone broth and then adding the rest as I go. It tends to have a lot of noodles as fillers too though. Otherwise, meat and veggies for dinner.
    Lastly, when scrutinizing my diet, I realized that about 6 months ago, I somehow got addicted to a homemade lemonade drink of organic lemon juice, water, and organic unrefined sugar.
    I still have no symptoms of high blood sugar, my cycles are still regular, and I even got pregnant again, which is something I generally cannot do unless VLC (almost no carb). Then I miscarried AND got my second episode of gout. So, I decided to have my blood checked for A1C and uric acid. (I would have been surprised by high uric acid since I tend to be moderate with my protein intake too.) My uric acid was normal, but my A1C was 7%!!!!
    I had long ago stopped testing my after meals blood sugar because for a long time, it was within “normal” levels, and I knew the warning signs for high levels. I got a new meter, and started testing a TON. I tested first thing in the morning and 1-2 hours after every meal. At first, my average was between 170 and 200 (this was on June 1st ’12. That prompted me to cut ALL carbs and sugar from my diet, and as the month has progressed, my average levels have slowly fallen – or perhaps quickly depending on perspective – to an average of 130 to 150 with odd days like today where it hovered around 170 for no real reason.
    I will give one day’s readings so that you can see that I am not spiking after meals and am having reduced numbers after meals.
    6-13-12 First reading after waking up – 138 at 10:35am. Ate cottage cheese with sunflower seeds and had cup of black tea with cream. (NO sugar, just cream.) Ran errands and couldn’t test until 3:05pm. 146. Ate hotdogs w/o bun but with dab organic ketchup and mustard. Drank another cup of tea with cream. Tested at 8:17pm 111. (I actually think this was probably a mis-reading.) Immediately had a snack of organic sugar free peanut butter on lettuce and tested at 9:41pm. 143. (I want to see how different foods make my blood sugar react.) This shows how my glucose levels actually stay within a few points of each reading throughout the day, except for the abnormally low (for me right now) reading when I had gone a little over 5 hours without food. (It seems to be easier for me to remember to test right before I eat than after, BUT I do test as often as possible to get a good range of numbers.)
    A different day, when the numbers were all higher. Woke up and tested at 9:39am, 152. Ate an utterly no carb breakfast of hotdogs. (We were at my MIL’s and that was pretty much all she had!) 178 at 1:07pm, No idea why!. Decided to have tea with cream. 133 at 2:44pm. Went home and deep fried a whole chicken in tallow (that I rendered myself). Ate around 4:30, tested at 5:39, 135. Around 9, decided to eat a basic salad (no croutons! A sprinkling of sunflower seeds instead) with homemade red wine vinegar and organic olive oil vinaigrette. (No sugar in it.) Tested at 10:16, 156. Had nothing, tested at 12:19, 130. Next morning, woke up at 150, shrugs.
    More importantly, I feel fine. My gout cleared up once my average fell below 170 (remember it was between 170 and 200 when my gout flared up), and I see it going down a point or two on average each day. My blood pressure is normal, and blood tests show no other abnormalities. I know I already am diabetic, but since you stress that it’s the post meal numbers that are the most important. For the past 19 days, my 1-2 hour post meal numbers have consistently been between 5-10 points higher, so no spiking. Wouldn’t – if high numbers really do so much damage – wouldn’t there be SOME indication of it? I’m not trying to get out of being low carb, I really like it, but if my numbers really are bad, then why don’t I feel bad? Why don’t I have some sort of symptoms?

  201. Hi,

    I recently had a fasting blood glucose of 111 at the docs. He stated that he is going to put me on insulin if it doesn’t lower. I am constantly on a low carb diet and my home glucose test always reads 98 or 99 . Please advise.

  202. Is it possible to take certain nutritional supplements to control blood sugars in addition to exercise for life, instead of taking oral medication? My A1c is 6.3 and if I eat sweets it can spike as high as 230. I’m 42.

  203. Chris, I have been reading this whole post and find it quite interesting. however, I do seek yoir opinion. I kust had my yearly physical And my fasting blood sugar was 101. Now diabetes runs on both sides of my family, however, I am slightly over weight but I do exercise 250 minutes a week or more, so I am losing weight, an I cook all my meals, never .eat eat fast food so I am wondering what I am doing wrong. That is the highest it has been for a physical

  204. I believe i have coritsol issues. I am type 1.5 diabetic (with declining beta cell function) and have been doing paleo for appx 9 months – which has gotten me off of insulin completely. I workout in early mornings and have noticed my fasting blood sugars have crept up when i wake to the 140s and can even feel something happening a few hours before i wake. Eating a snack at bedtime seems to make my blood sugar numbers go higher at waking. What is the typical treatment to balance out cortisol?

  205. My fasting numbers were mostly in the 80’s and then started creeping up to 90’s and a few in low 100’s.
    I realized I had not been drinking much water so I made sure I was having at least 6-8 glasses a day. And the last few days I have had fasting numbers of 82, 83, 88 and 84. Do you think my drinking of water has anything to do with this as I have not made in other changes that I am aware of.


  206. My son has a problem with very low blood sugar levels. Once he eats he has to eat every hour and a half. His glucose drops to 60’s and he becomes lightheaded, hands tremble, eyes bother him. Been to several doctors and they are not sure if it is reactive hypoglycemia

  207. I have been hearing , from various sources, including a naturopathic cardiologist here in Phoenix, that Stevia is not a good idea. I’ve been using green powder and liquid Stevia for more than 10 years and I was wondering what the final verdict may be.
    Chris, would you kindly view this article and it’s comments and give me your opinion. Thanks!


  208. Chris, do you have any tips for driving down the A1C numbers?
    If anyone knows what would help, I’d appreciate the input.

  209. Hi Chris,

    As I was diagnosed with diabetes type 2 just few days ago, I was surfing the internet looking for some answers and came across this interesting blog. I now have much better understanding of why and how it happens that your blood sugar rises as well as what to do to prevent it.

    I did a thorough medical exam in Germany last week and while I’ve occasionally had high blood pressure and was eventually diagnosed by hypertension, my blood sugar tests were always good. I’m 39 and am not overweight (h: 1.70m, w: 64 kg) and I exercise 5 times a week. In Germany, I did gastroscopy, colonoscopy, CT of abdomen and ultrasound of heart and blood vessels. I also did full blood examination. The only problems are gastritis and slightly fatty liver. All the rest is perfect. On Saturday morning, before I left the hospital (I stayed there for three days) I had OGTT with following results: FBG – 60 mg, 1h – 280, 2h – 113. Based on this the doctor concluded I have diabetes type 2 (and maybe even type 1 so she order some more tests to be done). I was then released and sent home with a bag full of medication. I was also given a glucometer to measure my blood sugar every day one hour after meal for 10 days. And today is a second day that I measured it 1 hour after lunch and it was 91 mg – yesterday it was 89 mg. N.B. I still haven’t taken the medication and just continued eating what I normally eat as I wanted to see what my results would be.

    Chris, I would very much appreciate if you could tell me what you think about all this. Can diabetes be diagnosed after one such test?

    Thank you in advance and many regards from Holland.


  210. Thanks Lynn. I have read Stephan’s blog before and I have seen this article.
    You are right…worry is not good. I guess I would call it more concern and confusion..lol.
    I will test again in a few months and see what happens then. My biggest goal is to drive down that A1C.

  211. I get what you are saying Sharon, I really do. However my reading tells me that optimal is less than 10 and perfect is less than 5. Dr. Mercola’s views on extremely low insulin levels are incorrect in my view.

    Also, bear in mind, that worrying about getting things perfect can be even more detrimental than insulin levels of 15. JMO.

    Check out this well balanced article:

    • Lynn, my insulin, 3 yrs ago was <2. About a year later, it was 3.2.
      Now it jumps to 5.3??
      According to Dr. Mercola and other experts, a healthy fasting insulin should be between 2 and 4.

  212. Hi Chris,

    I’m hoping you can answer this question for me. I had an GTT done and the results baffled me. My 1 hour result (180’s) was actually lower than my 2 hour result (200’s). Is this a normal occurrence? I thought blood sugars drop over time not rise.

  213. Just got my latest bloodwork and I must say, I’m baffled. First, I did test my fasting sugar at home before the AM test. It was 83 and the lab test read 83 which means I have a good meter.
    I was so proud that my A1C went down to 5.5. It was originally 5.9, the went to 5.8, then 5.7.
    I was also happy to see my Triglycerides on the regular lab test was 48, way down from 75 last September. With that all being said, I was kind of shocked to find my fasting insulin was 5.3! I know it has always been between 2 and 4 (optimal?).
    I should mention that I also took the NMR Lipscience profile and my Insulin Resistance score was 3, which is excellent. Their lab values were different as my Tris read 36 with them. They seem to have different overall cholesterol readings than LabCorp. They claim my HDL was 88 and LabCorp has me at 103. Either way, I’m thrilled.

    Chris, any reason why the fasting insulin would be so out of whack? I do follow a pretty low carb diet.

    • I forgot to mention that my post prandials are always under 100 except if I do the occasional sweet potato. Then it can soar over 120.

      • Your numbers seem great Sharon (good job)! Will be interesting to see Chris’ reply on Insulin.
        Lab error? I’m sure you have heard Chris’ KResser and Masterjohn speak about how unreliable the lipoprotein tests are, maybe Insulin as well? Once I was firmly low carb/paleo, I found I could no longer tolerate occasional cottage cheese and/or greek yogurt (even tho no added sugars). They are insulinogenic, thus Im thinking that they increased my insulin, and since my BS was pretty low, caused too great a drop. I would pretty much pass out/fall asleep until my glucagon kicked in (10-15 minutes). I’ve only had Insulin tested once and it was below their detection marker (2 I think). Art DeVany says his is as well. Do you eat much dairy or more than 6-8 oz. protein per day?

        • Thanks, Deb! Yes, the first thing I thought was lab error, but that is like thinking the dryer shrunk your jeans when you actually have gotten fat..lol.

          Yes, I have heard Chris’s info about the unreliability of the NMR test, but I thought I would go for it anyway just to see how I progressed from last time. I’m crossing my fingers that my insurance will pay for it. They did last time, but I’m just not sure about this time.

          I have been having some dairy all along and never saw my insulin this high. I do use mostly goat products (Kefir, yogurt and cheeses). Goat dairy does not have casein which from my research claims it is safe over cow’s dairy. I do take in quite a bit of protein. I also use Whey Concentrate Powder before and after workouts. According to my size, I need about 56 grams of protein per day. I do pump iron also and I’m trying to keep and gain muscle. The goat dairy and the protein never raise my post prandial sugars very high, so I am not sure that is the issue. I would think my BS would be raised upon eating them.

          Here is an interesting tidbit…Dr. Richard Bernstein (diabetes doctor) claims that people who eat nuts cannot lower their A1C. Hmm…I eat nuts (way too many) and I seemed to have lowered it.
          Berstein says NOT to eat nuts at all. He’s ok with dairy. Ugh..it can make you crazy with all the different input and opinions. Dr. Cass Ingram who wrote Natural Cures for Diabetes also is against nuts but says dairy is fine. I’m trying to cut back on nuts, even though it’s very Paleo. They are so expensive. Goat dairy is expensive too, but I am not sure I want to give that up yet. I wouldn’t mind giving up dairy and sticking with nuts, but I am not sure what is the healthiest thing to do. Nuts are pretty high carb, in case you don’t know. If I give up both, I think I will have to seek out other fats to keep me satiated. Drink gobs of coconut oil? LOL

  214. Ps I think I understand your viewpoint as to why this particular reason for insulin resistance is the result of an efficiently working fuel system when eating a very low carb diet, however I’m just wondering whether being ‘healthy’ might make one more sensitive to the damage carbohydrates can potentially inflict, not simply from the perspective of blood test results. Does that make any sense?

    • Dan M, I see it’s been over a year now, but I’m hoping Chris can somehow chime in on your two comments here. I would love to know his thoughts.

      • Go for it Luke. I have to say that I have long since moved past this way of eating and would no longer consider it to be healthy.

  215. Thanks for the reply Chris. So can I ask, in your opinion, does that mean that one becomes more susceptible to the negative health effects of insulin resistance or excessive glucose in the blood if one was to intermittently eat carbohydrate rich meals, whilst eating a predominantly ketogenic diet for the majority of the time?

  216. Dear Chris, thanks for the great blog and the wonderfully informative and entertaining podcast. I wanted to ask a question in relation to the caveat you mentioned regarding an elevated fasting glucose for low carb dieters. I was just wondering if the resultant decreased sensitivity that goes along with this process could mean that one might notice larger fluctuations in post meal blood glucose after a meal that includes a proportion of carbohydrates like potato or rice, if one does not include such ingredients regularly. I hope i’ve explained what I mean reasonably clearly and that it’s not a question that has already been answered.

    Thanks again, Dan.

    • Great question – looking forward to more info on this as well (I have read +10 higher on low carb post-prandials) but hope this Chris has time to address this).

    • Dan: yes, that can absolutely happen. Which is why I recommend that people eat 150g/d of carbs for at least 5-7 days before taking an OGTT if they have to do that for some reason. Otherwise, it will be artificially high.

  217. This morning really scared me. My fasting blood sugar was 197. The highest it has been before today is 130 but usually around 110-115. I ate breakfast and 2 hours later it was 171. Two hours after lunch it was 156. I have been testring steadily everyday for the last month 1/2 and only twice has my reading been over 160 and those were 1 hour post meal readking. I am on 500mg of Metformin a day. Should it be increased? Can menstral cycles play a role in rising blood sugar. I am at a lose right now,

  218. Hey Deb,
    Tell me more about a high starch diet? I’m confused isn’t carb and starch the same?

    Smiling your way!


    • Hi, Did you mean me (Deb B)? A great majority of people manage T2 (or pre-diabetes) with a low carb diet (generally 50ish grams per day range). If you are INSULIN RESISTANT – that is generally conceptualized that your body cannot tolerate carbs. However, there is also a certain % (Mary Vernon thinks its 10-15% of the population) that can do the high carb levels and still have wonderful A1c and Blood sugars (I think it tends to be the younger and more athletic types). Typically in “Paleo world” and Paul Jaminet Perfect Health Diet – “starches” are the pure chains of glucose (white rice, yams, potatoes – i.e. they are avoiding the fructose) vs. a carb would also included fruit (more of a blend of fructose and glucose) and I think grains are (Maltose)? a monosaccharide – but with the long gluten protein structure which causes issues for many. I should look it up for 100% certainly, but am experimenting with cold thermogenisis and rush to get into Lake Michigan for a few minutes!
      Your blood numbers all seem good, but seems something is off metabolically for you to feel that way. I think Chris asks people about thyroid numbers. Also, would you consider some raw animal products (like salmon roe)?

  219. Wow, very informative and enjoyable information.
    Had blood work done in January routine although it had been over ten years since I had this done. I’m a 52 year old extremely/athletic female, 5’3 114lbs. I had been feeling awful for quite some time, experiencing blurred vision, mood swings, and general fatigue ( hard for me to say, I push through fatigue quite well). I felt like I had a magnet attached to my body and the earth was metal. Chalked it up to menopause. Continued to work out but found myself on the couch way too often. I also had huge cravings for sugar, all forms and lot’s of it which was unusual. Still exhausted.1

    Blood work results were perfect, with the exception of (A1C 5.9). Huge history of diabetics in the family both type 1, and type 2 so I though I’d better get on it.
    Fasting running (ten day average of 74) 1 hour post meal mostly around (85) two hours well below 100.
    I’ve basically cut out all refined sugar with the exception of a drizzle of pure maple syrup in my morning tea. I am a strict lacto ovo vegetarian have been this way well over 25 years. I miss having a piece of cake once in a while.
    Will do another A1C test on mid April.
    The most prevalent thing I’ve noted is a bit lower than normal reading some fasting below 70, and post meal low 80’s.

    I have great insurance but was told I didn’t need to see a doctor because I am not diabetic, but pre diabetic. jeeze. how does one avoid becoming pill dependent?

    Thank you,

  220. Elizabeth – Bear in mind that A1C is not the most accurate test. Kris actually wrote an article about this. You are better off testing your fasting and 1 hour post meal blood sugar numbers, to see where you are really at.

    I don’t count anymore, but 250-300 carbs comes from a lot of 1% milk in my tea throughout the day, my GF bread or buckwheat cereal in the morning, pasta/potato/rice at lunch, and soup, GF bread/crackers at supper. I also sometimes have a piece of fruit in between meals, not that often though, maybe twice a week.

    Sharon – LC seems to work wonderfully for some people. However, if your glucose and insulin levels are rising on it and you feel like crap, it may be a sign that it is not for you. I ignored my body’s signals for years!! I’ll never be married to a theory again.

    I’d be very careful about the nuts though, they contain a lot of PUFAs.

    Also bear in mind that your initial blood sugar reaction to starches is likely to change over time. My BG numbers were way higher when I first reintroduced carbs.

    I think that your friend’s hubby should do what makes him feel best and what helps his numbers. We are all different, and what helps him may harm someone else.

  221. Chris, my friend’s husband was just diagnosed with full blown diabetes. She told me his doctor told him he must go on a low carb diet but what is strange is that he said he can only eat non or low fat dairy, absolutely no coconut oil or fats. He said that diabetes is caused by sugar and fats and not what most people think.
    Is this guy for real? High(good) fat, moderate protein, low carb is what I thought was the diet to follow.
    Where would he get such misinformation?

  222. Hi Deb b

    I don’t count anymore, but last time I checked I averaged 250-300 carbs a day.

    I get my carbs from potatoes, rice,rice pasta, gluten free bread, bananas and some other fruits. I strictly avoid gluten.

    • Thanks – interesting how people can be so biochemically different! Glad you kept investigating and found a way of eating that lowered your numbers.

  223. Sharon – Dr. B is wrong and I am proof positive. We are ALL different, but I had a fasting insulin level of 33 (extremely insulin resistant) after four years of low carbing and after a switch to a high starch, low PUFA WOE my insulin fell to 4.7. Optimal is less than 10 and perfect is less than 5. My HOMA score was also <1.

    Finally, my fasting glucose now averages 75-84 and 2 hour PP also 75-84. It rarely ever goes above 100. Whereas on low carb, it was always late 90s fasting and 2 hours PP was 120.

    Elizabeth – Sounds like you have become insulin resistant and that your thyroid function has decreased on LC. The exact same thing happened to me. I was already hypo, but LC just made it worse. The body often increases RT3 in response to weight loss/low carb intake and some people become insulin resistant on LC.

    • Lynn- I was already on a real foods diet when I went primarily Paleo/Primal, LC/VLC. I included raw milk/cheese/yogurt. I didn’t lose any weight ditching grains, potatoes or fruit. Low-thyroid symptoms increased.
      Since the A1c result the doc advised to eat meat and veggies only, I told him that was primarily what I ate and he said this is the only way to bring the A1c down, so keep doing it.
      Against his advice I have added carbs back in, I have no idea how much, but my temps are rising from 95.-96.4 to 97.- 98. I feel as if I have more energy. I’m still gluten free, but have added back rice, potatoes, carrots, dates, honey in my green tea, organic popcorn popped in coconut oil (a splurge). But in the back of my mind I’m wondering if I’m raising my A1c. My blood glucose level from the same doc visit was 113, but that was non-fasting.
      Also, while on Paleo/Primal I developed LPR, it may all be coincidental – I dont know.

      What does 250-300 grams of starch/carbs look like in proportions?

    • Wow, Lynn, now I’m really confused!
      Should we low carb or not low carb?
      My fasting sugars are usually in the 70s, sometimes low 80s and my PP is usually under 100 .
      I stopped the starches and my only indulgence is too many nuts.
      May I ask what WOE and HOMA stands for?
      According to Dr. Joe Mercola, fasting insulin should be between 2 and 4.
      When I had it checked last year it was 3. I’m going for another full panel of tests next week and I’m anxious to see where I stand.

    • Lynn – I realize it has been a year since you wrote this, but I liked your response to Elizabeth. I believe I have increased rT3 in response to LC diet, and I believe I have become insulin resistant as well. I am self-testing currently for more info. I would like to ask, what did you do to resolve your issues? Did you go on thyroid medicine and/or metformin, or were you able to treat nutritionally?

      • I have gone back on a good amount of carbs…clueless as to how much. I have gained at least 15lbs.
        I’m still on a real foods diet. I have added back spelt or einkorn grains with few splurges on organic spelt pretzels or sprouted corn chips.
        I’m tired of thinking about what is right or wrong in the diet world. I eat real food, but try not to over think it any longer. I feel much less stressed.
        My hair is growing back in. I do not have a lot of the thyroid symptoms anymore, I do get cold hands and feet from time to time.
        My rT3 I have not had checked lately.
        While on lc I was heavy on nuts, those I eat sparingly now.
        My blood sugar is still prediabetes level for the most part, so I’m taking cinnamon and chromium supplement. It seems to help a lot in keeping my fbg and pp under the target numbers.

        My huge success is no longer being a slave to my diet… and not over thinking it. This has been a blessing not only for me, but also my husband who doesn’t always have to hear, “I can’t eat that!!” I had to work on my mind when first eating the “evil” foods. To me, this is a much more healthy way of life.
        Freedom to eat and enjoy life without tons of guilt is a blessing, I’m glad I made the choice move away from lc.

      • Hi Maddie

        I have been on Glucophage for 12 years: well before I developed an insulin level of 33, also during the time that my insulin levels became optimised. I am on Gluc because of my PCOS. I am also on T3 only because I have thyroid resistance caused by Hashimotos.

        My diet hasn’t affected my thyroid, but low carb or high sugar intake puts my glucose and/or insulin in the wrong direction. So I still eat gluten free. good carb and low sugar.

  224. Late to the party – any idea what would cause a 5.9 a1c, elevated rt3, low thyroid symptoms while on a low carb diet for over a year? Makes no sense to me. Thanks!

  225. I just listened to a podcast from Dr. Richard Bernstein (The Diabetes Solution).
    He’s far from natural, but pretty informative.
    Someone presented the question to him about “safe starches” and mentioned The Perfect Health Diet.
    He said there is no way that eating starches will improve insulin resistance. The only thing that will do it is losing belly fat, strenuous exercise, muscle building, taking Metformin.
    He said if it’s too good to be true..don’t believe it.
    Chris, once again, another opinion is out there.
    What are your thoughts on Dr. Bernstein’s methods and philosophies?

    • I agree with him on some things, but not on others. In any event, with questions about starch or carbohydrates the answer varies depending on who’s asking. A diabetic will have different needs than a non-diabetic.

      • Well, all I know is that I did the “potato test” where I tested my fasting sugars (81) then ate one white potato. One hour later sugars tested at 142! Yikes! 2 hrs. later I tested at 88.

        I read that if you are a low carber, you can minus 10 from the post prandial number. Still, I must say that I freaked out a little but felt better to see the 2hr PP at 88.

        Any thoughts?

  226. Hi Chris,
    I am just reading your article here since I am still trying to make sense of a 2 hours glucose tolerance test I had last Sept. My Dr just said, all your numbers are normal, no big deal, but refused to explain them to me. They were all the same number, which really threw me off since I thought blood sugars went up then down. I am trying to make sense of this, and I took my own fasting blood sugar this am and it was 95, so this is back on my mind.

    2 hour results as follows, all arm stick test, except at 95 minutes:
    fasting 89
    drank glucose
    After 1 hour 89
    After 95 mins (I had them test since I felt slightly dizzy–this was finger stick) 104
    After 2 hours 87

    I always thought it was odd the numbers are nearly the same except it went back up? after an hour?
    I have always thought I had blood sugar issues, but I was told I am normal.

    Brief history, I had gestational diabetes diagnosed with only one baby, before him, I had a 10 pounder (only 1 point over what was considered abnormal on my test with him, I believe it was 141), then an 11 pounder when I changed Drs who went totally with the test, and said I did not need to watch my diet. I had smaller babies 8 lbs 4 ozs when I was on a diabetic type diet, which I did on Drs orders since I had gestational diabetes before, he said “just do the diet, I’m not testing” I have had 9 babies, the last 2 we induced and even 10 days early my last one was 8 lbs 14 ozs.

    Also, both my grandmothers had type-2 diabetes and one of my uncles does. Neither parent does and no one else that I know of, but both of them are fairly healthy and not overweight.

    Soooo…..am I normal? or should I find a new Dr?
    Oh, and I am not terribly large, although my BMI is 31.6

  227. Thank you so much for this article! It had the information I needed. I was extremely frustrated that my last two analyses showed increased BS levels of 110 and 112 after I went on a low carb diet! Never had high BS before that. I started a low carb diet about 5 months ago to help my daughter who has been diagnosed with polycistic ovarian disease, and both BS tests I’ve had since then have been higher than normal. The HGB a1C levels have been staedy at ~ 5.5 over the past three years. The same was true for my daughter, who also had a BS level of 100 at the last test. Needles to say both of us were concerned and upset by the results.
    My question is: is it OK to continue to low carb diet even with the higher BS, or should I increase the carb content of our diets?

  228. Hey Chris,

    I started feeling rough a few months ago and have been struggling ever since. The first time I checked my BG was maybe a week into feeling bad and it was 60. It’s never been below 60 for me. It will always go back up and not get too low. Usually it seems like my BG drops into the 60s after 1 hour or 1 hour and a half. Sometimes I remember in the mornings it would drop into the 60s like 40 minutes after eating breakfast. I started eating 3 eggs with cheese on wheat bread for bfeast. So I thought this may be why I feel bad was because my BG was getting low. My fasting was always 71-73 basically maybe 74 or 70 but never in the 60s so I think that’s probably good even tho I seem to feel a little off in the mornings like dizzy or something so I always eat bfeast before anything else. I also went to a Endo. and he told me my blood sugar levels looked normal and that 60s is probably normal for me and didn’t care to much and said I would just get better. What happened was I was in China for 4 months and at that 4 month mark I started feeling crappy and didn’t know why. So I had to come back to America cause I couldn’t hardly walk when this all hit me. I’m not sure if I just have bad Anxiety or if it’s just hypo causing this. I’ve been on a good diet for about 3 months now. This all started in mid November of 2011.
    I did start feeling better tho about 2 months after this all started. I felt pretty normal for 2 weeks. I thought I was getting better. Now I’m started to kinda slip back into this again but not as bad as it was in China. I felt I would die in China. Now I just feel lightheaded and weak sometimes or something like that. I haven’t really gotten sweaty no blurred vision, no hunger pains or anything. Usually just dizzy, heart rate goes up a little, feels like I may faint. So Idk if it’s all anxiety or what. I do seem to feel a lot better when I can control my anxiety but 60s just seemed low to me but maybe it’s not. I’m 6’2 and way 177 now. I did get pretty skinny in China. I lost a lot of wait because I was always riding a bike and walking every where. Also they eat lots of rice and noodles. I probably didn’t eat well enough. I weiged 160 I think in China. And people said I looked pretty skinny and could see my bones in my face and things. My Endo. here in America said he thinks I just got malnurished and since I’ve gained my weight back I should just get better. He also said to try to just stop eating every 2 hours and try to get back to eating 3 meals a day maybe with a night snack. But I haven’t really been able to do that I feel too bad I guess to do that. I don’t want to take the chance yet. He also did some blood test on me. I think one was called a cortisyn stem test. They injected me with something that did something to my adrenalin and checked my cortisol levels. They injected me at 10am I think then checked my blood at 10:30am and my level was 25 something then and at 11:00am they checked again and it was 30 something my cortisol levels. I saw in my medical record the normal range is between 6-22 or something like that but my Endos. nurse called me back and said all my blood work looked perfectly normal and my BG levels were pretty much normal. So I hope this isn’t too long just worried why if seems hard to control when I’m eating right. Who knows maybe it is all just anxiety but that seems hard to believe when my BG drops into the 60s so fast and when I eat I feel better. I used to check my BG a lot but haven’t now for probably a month. Checking it just gave me anxiety and made my feelings worse. Thanks for the help!


  229. I”m an overweight RN who eats a MOSTLY paleo/low carb diet. I have been feeling ‘strange’ lately, frequent urination, thirst, etc.

    Just got a glucometer, thought I’d do some testing on myself.

    My FASTING BS was 139 this morning – terrible. But my POST PRANDIAL blood sugars are running 100-130.

    What the hell do I take away from THAT?

  230. i have a very big worry. my a1c level is 6.7 and my fbs levels are all with in normal range of 75 and 77 when i do check them. random checking through the day is about 80. my pharmacist told me that there was nothing to worry about. i am however of african decent and dont know if this influences my a1c in anyway. i would be grateful if u kindly get back to me

    • Hi nana. I hope Chris will also jump in here, but when I saw your post, I just HAD to comment.

      The pharmacist who told you there was “nothing to worry about” is absolutely wrong, in my opinion, as well as the opinion of many other medical professionals and the American Diabetes Association (who isn’t even in the cutting-edge when it comes to diagnostic criteria…)

      For many people who become diabetic (studies are showing this is particularly true for middle-aged women) the fasting blood sugar level is the very LAST measurement to become abnormal.

      There’s an excellent write-up here: http://www.phlaunt.com/diabetes/14046621.php – read particularly the section just over half-way down the page with the heading “Why Fasting Blood Sugar Levels are Often the Last to Deteriorate” — it explains it quite well.

      A HbA1c of 6.7% is now ABOVE what the ADA’s latest recommendations are for diagnosing diabetes. As of the most recent standards, the ADA is stating >6.5% meets the definition of diabetes. (American Diabetes Association. Standards of Medical Care in Diabetes 2010.)

      What this means to you is according to current diagnostic criteria, you ARE diabetic. It’s quite likely you have very high post-prandial (after-meal) readings, but not high fasting levels yet. You can still reverse this in the early stages – but you likely need to address things ASAP.

    • Nana: it really depends. A1c is not a particularly reliable marker in individuals because it depends on the assumption that everyone’s red blood cells survive an average of 90 days, which we now know is not true. If your fasting glucose is in the mid-70s, and your post-meal (one-hour after and two-hour after meals) blood sugars are below 120, it’s possible your red blood cells live longer than the average, and you have a falsely high A1c reading. I’ve written about that here: http://chriskresser.com/why-hemoglobin-a1c-is-not-a-reliable-marker

      On the other hand, if you’re having dramatic blood sugar spikes throughout the day that are raising your average blood sugar, and that is showing up in elevated A1c, it’s definitely an issue.

  231. Hello Chris,

    Thank you for this website, you do an excellent job at educating diabetics and nondiabetics about diabetes. Why is there so little said about thin people who have been diagnosed with type 2 diabetes? I come from a family with a strong history of diabetes. Some of them were thin people.
    Thin diabetics are often recommended to begin low carb and low calorie diets when many of us are already at or below a reasonable weight. The result is we often end up looking and feeling deprived. How can we maintain a sensible weight and have good blood sugars?
    Also, I was testing my blood sugars 3 to 4 times daily (fasting and 3 post-prandial). This routine kept me (which can get expensive) very informed about how portion size, GI, and even the time of day I ate certain foods would affect my blood sugars. My doctor told me testing this often is not necessary and testing once daily would be sufficient. I was a little suprised to hear this news, I had always assumed testing frequently is one of the diabetic’s greatest weapons. It’s sort of like having the enemy’s strategy book. Could you please tell me your opinion on blood glucose testing?

  232. Hi Chris,

    I posted early about my daughter with no answer to it. I love the input you give and am at my wits end at this point. Please respond to this one and tell me what you think…

    My daughter had BG of 350 at age 2 ish. and once more at that time it was 200. After that she was fine. She is now 8 and has been having periodic high fasting sugars of anywhere from 90 – 140. Not always and i can’t really predict when she will have issue. But we can usually tell when she is having the issues because of her behavior and attitude. Then we will test her and watch. During the day its kind of high after meals during those times. Nothing scary. 120 – 140. This will go on for a few days to a week and then go kind of low normals. 80 after meals FBG of 60 – 70. Twice in a row she has had an A1C of 5.7% and after giving her a GTT her 1 hour was 200 and 2 hours was 108. The 2 hour was great.

    Yesterday we finally got in to see the Pediatric Endo. He said that none of this is indicative of anything and that having a bad emotional day can lead to sugars of 350 or whatever. He said that I am just being nervous and that she is 100% fine. An A1C is no signs of anything, and that fasting blood sugars less than 200 are just fine. So, now I am pretty confused. I kind of don’t trust him. Really?? FBG can be 140 and he doesn’t consider this a problem? Now, while I dont’ believe she has diabetes and I am not trying to borrow trouble I would like to know what is causing the off sugars. She is a small girl so none of this is weight related. He also said NOTHING except diabetes causes high blood sugars in a person. Is that true? There are no other conditions that would lead to high blood sugars? He wanted her to go get a blood draw for a FBG test this morning. I didn’t do it because I know right now it would be normal anyway. I don’t need him treating me like a nervous silly mother.

    Now, I am really not sure what to do. Second opinion with a different Endo.? Or visit a naturopath? Or just continue being strict with her diet and hope that this truly is her noraml.


    • It definitely sounds as if she has some insulin resistance and blood sugar issues. Unfortunately, it’s