In the next two articles we’re going to discuss the concept of “normal” blood sugar. I say concept and put normal in quotation marks because what passes for normal in mainstream medicine turns out to be anything but normal if optimal health and function are what you’re interested in.
Here’s the thing. We’ve confused normal with common. Just because something is common, doesn’t mean it’s normal. It’s now becoming common for kids to be overweight and diabetic because they eat nothing but refined flour, high-fructose corn syrup and industrial seed oils. Yet I don’t think anyone (even the ADA) would argue that being fat and metabolically deranged is even remotely close to normal for kids. Or adults, for that matter.
In the same way, the guidelines the so-called authorities like the ADA have set for normal blood sugar may be common, but they’re certainly not normal. Unless you think it’s normal for people to develop diabetic complications like neuropathy, retinopathy and cardiovascular disease as they age, and spend the last several years of their lives in hospitals or assisted living facilities. Common, but not normal.
In this article I’m going to introduce the three markers we use to measure blood sugar, and tell you what the conventional model thinks is normal for those markers. In the next article, I’m going to show you what the research says is normal for healthy people. And I’m also going to show you that so-called normal blood sugar, as dictated by the ADA, can double your risk of heart disease and lead to all kinds of complications down the road.
The 3 Ways Blood Sugar Is Measured
Fasting blood glucose
It only tells us how blood sugar behaves in a fasting state. It tells us very little about how your blood sugar responds to the food you eat.
Up until 1998, the ADA defined FBG levels above 140 mg/dL as diabetic. In 1998, in a temporary moment of near-sanity, they lowered it to 126 mg/dL. (Forgive me for being skeptical about their motivations; normally when these targets are lowered, it’s to sell more drugs – not make people healthier.) They also set the upward limit of normal blood sugar at 99 mg/dL. Anything above that – but below 126 mg/dL – is considered “pre-diabetic”, or “impaired glucose tolerance” (IGT).
Oral glucose tolerance test (OGTT)
The OGTT measures first and second stage insulin response to glucose. Here’s how it works. You fast and then you’re given 75 grams of glucose dissolved in water. Then they test your blood sugar one and two hours after. If your blood sugar is >140 mg/dL two hours later, you have pre-diabetes. If it’s >199 mg/dL two hours later, you’ve got full-blown diabetes.
Keep in mind these are completely arbitrary numbers. If your result is 139 mg/dL – just one point below the pre-diabetic cut-off – you’ll be considered “normal”. Of course this is perfectly absurd. Diabetes isn’t like catching a cold. You don’t just wake up one day and say, “I’m not feeling so well. I think I got a bad case of diabetes yesterday.” Like all disease, diabetes—and diabesity—is a process. It goes something like this:
malfunction > disease process > symptoms
Before your blood sugar was 139, it was 135. Before it was 135, it was 130. Etcetera. Would you agree that it’s wise to intervene as early as possible in that progression toward diabetic blood sugar levels, in order to prevent it from happening in the first place? Well, the ADA does not agree. They prefer to wait until you’re almost beyond the point of no return to suggest there’s any problem whatsoever.
[End rant]
The other problem with the OGTT is that it’s completely artificial. I don’t know anyone who drinks a pure solution of 75 grams of glucose. A 32-oz Big Gulp from 7-11 has 96 grams of sugar, but 55% of that is fructose, which produces a different effect on blood sugar. The OGTT can be a brutal test for someone with impaired glucose tolerance, producing intense blood sugar swings far greater than what one would experience from eating carbohydrates.
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Hemoglobin A1c
Hemoglobin A1c, or A1c for short, has become more popular amongst practitioners in the past decade. It’s used to measure blood glucose in large population-based studies because it’s significantly cheaper than the OGTT test.
The higher your blood sugar has been over the past three months, the more likely it is that glucose (sugar) is permanently bonded to hemoglobin.
The problem with the A1c test is that any condition that changes hemoglobin levels will skew the results. Anemia is one such condition, and sub-clinical anemia is incredibly common. I’d say 30-40% of my patients have borderline low hemoglobin levels. If hemoglobin is low, then there’s less of it around to become bonded to glucose. This will cause an artificially low A1c level and won’t be an accurate representation of your average blood sugar over the past three months.
Likewise, dehydration can increase hemoglobin levels and create falsely high A1c results.
The “normal” range for A1c for most labs is between 4% and 6%. (A1c is expressed in percentage terms because it’s measuring the percentage of hemoglobin that is bonded to sugar.) Most often I see 5.7% as the cutoff used.
In the next article we’ll put these “normal” levels under the microscope and see how they hold up.
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Hello! I have a few concerns after I did my annual check up last week. My A1C came back with 5.5 and my glucose level was 94 (fasting). I have been getting pretty much the same results in the last 2-3 years. My doctor doesn’t seem to be concerned. While this makes me happy, my own research makes me think that not everything is this pretty. I am 35 yo., healthy, skinny (115 lb 5’4″) and work out 5 times per week. I eat Paleo for the last 2 years (if not familiar, it’s a high fat, no grain type of diet). There are no diabetes in our family at all.
Am I facing diabetes soon? Thoughts? Also, any supplement to balance my sugar levels and insulin resistance maybe?
Thanks!
We have nearly identical scenarios. My glucose values are the same. I haven’t been doing paleo but close. I’m eating more AIP in order to keep my autoimmune issues in remission. I am very active and athletic. I’m very curious what else I can do?! Hopefully someone will chime in with thoughts!
Chromium at 200mcg per day does help regulate blold sugar.
Hi my son has not been well since 3 when we recognised he needed more food than his sister or he would get tearful really tired etc we have had blood sugar readings of 2.4, 2.2 but the Drs told us these were fine but he also had a slightly high corisol level but they said it was because he was stressed but he was asleep in theatre.he has just been in for an overnight 18 hour fast these were his readings from 8am 3.7, 3.4, 2.9, 3.2, then 1/2 hourly 2.9, 3.3, 3.3 then they fed him but when he was at 2.9 he was just laid on bed sweaty eye sight went blurred shaky talking slightly confused his eyes looked glassed couldn’t be bothered and just wanted to go to sleep but the Drs have said this is normal but I know my daughter and myself have gone 2 days with out food and not been in this state but the Drs just say it’s fine and I know he’s not this has been happening regularly since he was 3 and I feed him every 2 hours changed his food to brown bread brown pasta no processed food etc but he is really struggling with wpevery day he is a really talented footballer he had trials with Everton after been spotted but his energy levels let him down pleases help
He also had a severe headache stomach pains and felt really hungry and sick
Brown rice and any pasta raises blood sugar! He may try a protein diet for a while and see how he does! By the way, breads are processed food! Fresh foods such as natural meats, chicken, fish and fresh or frozen vegetables are best!
Thank you. He eats a lot of fruit and veg fresh and he only eats wholemeal bread pasta and rice but doesn’t help when he exercises
Has he gotten off all gluten and dairy? He sounds like u feel when exposed to gluten
No he hasn’t I thought he was lactose intolerant they did a test and they said he was border line and to keep him on it . He has 2 wholemeal ham buns for breakfast goes to school has 2 slices of toast then at 10.45 a bacon bun then dinner with flapjack then he has a wholemeal ham bun on way home as soon as gets home he has carrot cucumber red pepper followed by half a packet of wholemeal spaghetti or wholemeal rice a Pyrex bowl of peas x3 pork chops or gammon then he will have a yoghurt some Jaffa cakes if has sport he will have nuggets and chips from chippy followed by 4 wholemeal slices of toast
Someone I know insists he has a blood sugar level of 615. Yet he doesn’t do anything about it. He functions normally. Is this possible? He says coma comes at 620. I think he is full of hot air. Can someone give me the truth.
My husband was as normal as can be but just not feeling.we thought it was his heart since he has chf.turns out his bloodsugar was 687.the were in shock because he didn’t know he was even diabetic. So it is possible what u were told.
My mother in law is a diabetic and she said she wasn’t feeling well after a family gathering and her chest was feeling heavy and it scared her. The raced to the hospital and her levels were at 600! She can’t seem to keep them down and even….
Yes, your friend needs more education. Most glucose meters will simply indicate “high” for levels around or above 600 mg/dl. When I was diagnosed with T1 DM a blood draw sent to the lab indicated my BG was 850mg/dl. The meter in the doctor’s office couldn’t read that high. Yes, I was conscious and walking, even drove to a pharmacy for my new “diabetic supplies.” Of course I’d been drinking more water than normal; having been peeing every 30 or 40 minutes for several days I knew I needed to avoid becoming dehydrated.
Hello everyone,
I was wondering if someone could help me. I was diagnosed on Tuesday with type 2 diabetes. Today I decided to look at my blood and urine test results. According to my results and the WHO and Canadian diabetes association I don’t think I have type 2 diabetes, I think I am pre-diabetic. I want to know if I am at any disadvantage if I keep the diagnosis and don’t bring it up to my doctor? and I want to know if I am right and I am only pre-diabetic. I will list my results below
July 16th- blood glucose after 12 hour fast = 6.1 ( thats when they called and asked me to do a tolerance test)
– no protein in urin and no glucose in urin
July 19th- Blood glucose after 12 hr fast=7.2
Blood glucose after 2hr and the glucose=11.0
Ac1 taken on the same day = 5.9%
I am overweight with a BMI > 40, I think I have PCOS. I have never had any symptoms associated with diabetes ( although I do know many people are asymptomatic)
I am under the impression that if a fasting blood glucose is in the diabetic range it has to be taken on 2 separate occasions and both need to be in the diabetic range ( for me one occasion was-7.1- and one occasions was not-6.1)
Also if a doctor just wants to use the glucose tolerance test the result should be above 11.0 and not = 11.0 ( and i think the test should be done twice just to make sure-but this is just my opinion and not one set by WHO or the Canadian Diabetes Association)
I will still be making significant changes to my life through diet and exercise so the only think that will change is my outlook on life.
Thanks for your help
Hi Kayla, your fasting blood sugar levels are on the border, but you OGTT is diabetic. A truly normal result would have seen you back down in the 5s or 6s at 2 hrs. So for your benefit make some serious changes to what you eat and you could stop your diabetes progressing further. Your test results are a warning and a wake up call. Good Luck.
Thanks for the Reply! I had started to make changes 2 weeks before my tests and I am continuing with those changes.
I have been testing my blood sugar before meals and after as well as doing a test every morning after fasting for 10-12 hours. I have not had a reading above 6.6. The only time I was at 6.6 was this afternoon 2 hours after lunch, all I had was a small tortilla for carbs, then we went for a 20 min walk about 15 min after I ate. All my other readings including fasting have been between 4.0-6.0 which is considered normal.
Does anyone else get totally normal readings at home, but when they drink the glucose have very high readings? Could it be because I normally eat a low carb diet, also they gave me the 100ml glucose drink (not sure if that makes a difference)?
How long have you been low carb, and how low carb have you gone – 50g or less a day? If you’ve been low carb for a long time, then it could affect your ability to cope with a huge glucose hit. However, I’ve been low carb for about 3 yrs and a glucose hit doesn’t affect me at all, but carbs do (work that one out). The fact that you get good results while eating low carb, is probably the result of eating low carb, i.e. doesn’t mean you’re not diabetic. So, I would continue with what you are doing, LC, and try to get the extra weight off and you could well find that your are fine. Use the results as a big wake up call and get your life back on track. Good luck.
Kayla I believe these three books will/could be most instrumental in helping you get your body in balance thereby allowing you to maintain a very healthy lifestyle.
Reversing Diabetes $13.99; The Seven Pillars of Health $12.99 & Get Fit & Live $9.40 all books written by Dr. Don Colbert you can also go to his website http://www.doncolbert.com
For the record its never “about being skinny but always about being nutritionally healthy” as skinny & overweight people both can be malnourished & not making good use of daily exercise of at least 30:min of aerobic combined with resistance training to keep your body an effective fuel burning & usage person. Those two non regulated factors can be the culprits behind most degredation of the human body.
Good luck to you & all who are trying to understand our ever changing food source!
I would just change my diet…no processed foods! No breads, pasta, potatoes, candy, cake or ice-cream! Eat simply! Eggs, butter, fresh meats, chicken and fish, baked, broiled not fried or breaded! All fresh vegetables, except corn, Lima beans, peas, potatoes, these have a high glycemic! Berries are best! Don’t overdo fruits! They contain sugars! Stay away from diabetic meds until you see how a nice clean diet does for you! You will also drop weight eating this way! Also a nice brisk walk drops your glucose by 25 points in just 10 minutes! It’s amazing how the body reacts when you do the right things for it! Oh, and no cereals! They are candy in a box!
if you are overweight and have pcos you have doubled your chances of developing diabetes.
I am a Type 2 And has managed my diabetes by diet control over the last 20 years. Recently, it has spiked significantly. In checking shortly after eating, the readings can be 285 and the other night was over 600. Question: should I be concerned with high spikes 30 minutes after eating of 300, if within another few minutes it starts to drop once I begin to exercise? thank you!
Hi Amber, what had you been eating to cause the spike? If you’re already on a low-carb diet then I would be concerned about those sorts of spikes, you probably need to start on medication. If you are not already low carb and those spikes were the result of eating a high carb meal, then you have your answer – cut the carbs. You do not want to be spiking that high.
Sorry my machine was playing up, the reply was to Kalie.
Sorry my machine was playing up, the reply was to Kalie.
Three months ago my A1C was like 6.5. Three months later my A!C is 11.5. Yesterday I was fine and today I am a diabetic. I tested my blood with the kit the gave me, early in the afternoon it was 293, later that day I tested it again and it was 246. I guess I am lucky its going down very slowly. Why would my blood sugar level be pre and then jump to full blown. My doctors were having a hard time with that. Let me know what you think. Thank you.
If your diet has remained much the same and you’re not eating loads of carbs, then it seems highly likely that you may be LADA, in other late onset type 1. It would be sensible to get a urine ketone test kit, test your blood sugar levels 2 hours after a meal and if they are high, test your urine too. If you have ketones then it would be as well to get in touch with your doctor fairly quickly.
My fasting sugar level after 12 hours is 95mg/do. And random sugar level after almost 3 to 4 hours of eating is 116mg/dl. Is this normal ? Am I pre-diabetic?
Alina, one model of diabetes has us all somewhere on a continuum between perfect panceatic health and total beta cell failure. With that in mind my non-professional opinion is that you’re closer to diabetes than not. Whether you’re diabetic/prediabetic or not, you, and practically everyone, would benefit from shifting carbohydrates consumed from simple (refined) to complex (natural), and from getting more exercise so our insulin is used more effectively.
I am 44 and have a gluten allergy. I’ve recently lost 25 pounds by eating healthy and exercising, putting my weight at 136 on my 5’3″ frame.
I’ve been feeling sleepy and headachy in the afternoons and borrowed a glucometer. I ate 2 hours ago and my blood sugar was 88. I ate a sandwich (gluten free bread) and some raisins and 1/4 of an avacado. I also ate one fun sized hershey bar.
Here’s my question…am I hypoglycemic? is 88 too low? Thank you!
Hello, below 70 is considered low.
Can anyone please help me. I’ve been trying to get figures for blood sugar distribution in the “normal” (i.e. those without diabetes or pre-diabetes) population. I want to know what percentage of people have average blood sugars in the 51-60 range, the 61-70 range, the 71-80 range, the 81-90 range, the 91-100 range. Ideally, I would like this not just for our “European” cultures, but also for those still following their “re-MacDonalds” eating patterns (eg, people from Japan, maybe even Okinawa). Can anyone help?
I’d also really love to know what percentage of people have a reading of less than 72 (which my diabetes nurse calls “hypoglycaemic” in any one week.
From an article on another website, about 95% of non-diabetics fall in the 4.7% to 5.7% A1C. (about 85-115) This I assume would be for people who aren’t on a low-carb diet. Below 70 is considered hypoglycemic so it’s unlikely that many would be living healthy lives in those ranges.
Hi Chris,
I’ve been diabetic for 15 years now and for most of that time I never really took care of myself, I would however have my eyes check annually and no issues there. But about 4 months ago, I just started getting headaches, felling dizzy and as if I wanted to faint. When I went to the hospital, it was because my sugars were at 338. That’s when I decided to make a change, however when I went to the doctor he checked my A1c levels and they were at 12, I’m pretty sure they were that high since I was diagnosed. However, after I made the changes I went back to the doctor 3 months later and lost 25 pounds and my A1c levels are 5.7 and my sugars average 117 over 90 days. I take no medications and am doing this on diet and exercise alone. I have had my eyes check and other than some floaters I have no issues with my eyes. My concerns are that my vision was not blurry once my sugars started dropping but now that they are consistently normal, my vision is blurry, will it take time to set in before my vision is normal again? Also, now if my sugar goes over 150 I start getting headaches, feeling dizzy and faint but it never happened to me for 15 years when my sugar was high, will that also go away? Is my body just getting used to me being on the right track? I’m just concerned if these symptoms will ever go away.
You should get eyes checked that sounds like diabetic retinopothy. I should know I have it.Been a diabetic for 22 years.
Trust me it will not be that way for long. I have lost over 75 lbs. Eat healthy, and exercise. My A1c levels are still 6.0-6.3. Although my fasting glucose is 74-85. Go figure.
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I recently had two fasting blood draws done last week. The first result for fasting blood sugar was 179 and the second result was 170. My fasting A1C was at 6.0 taking at the same time the 179 result. I’m 24 years old and about 105lbs. Im just concerned and my PCP doesn’t seem to be because my A1C is normal and my hemoglobin levels are “normal”.
This happened to me too. Daily upon waking blood sugar level 176 plus but a1c came back lower
I’m panicked. Can I ask you a question? My 31 year old son had his first seizure Saturday (6-6-15) and we have no clue why. List of possibilities:
Overheated (we do not think so)
Prior dehydration issues
Low blood glucose (82 one hr after lunch)
My question: my mother was a diabetic and my sons dad is a diabetic. My youngest son suffers from low blood glucose which they say is pré-diabetic. I have been taking his readings since the seizure and they are consistently in the 80’s all the time even after eating. Could it be possible the blackout and seizure was sugar related? We have appointments this week with neurologist, cardiologist, and ENT (he now suffers from a crushed nose after the seizure and fall). Thank you, Debbie
My 10 year old daughter came out with A1c of 7.1 and insulin total of 3.37 glucose of 130 fasting . Can somebody tell me if she’s diabetic or pre diabetic. Her doctor said it was normal but I know they are higher than normal. Are children normal ranges different from adults. Please help me I’m lost and worried sick
Hi, I’m new to all this , I’m type2 diabetic 54yrs young.
My morning blood test was 6.2 ate a good breakfast eggs toms mushrooms and sausage, tea and little milk . Then I feel really lightheaded and really crappy , when I test my blood sugar it is5.6.whenever I go below 6 this happens why?
hi my name is Melissa and I have recently been tested for diabetes, and they told me that my blood was fine. well however I don’t understand cause every morning I take my blood sugar, and it ranges from 83-154 so far, ive been taking it for three days and every morning it higher. is this normal or should I have more tests done.
I had my A1c tested 3 months ago and it was 5.6 I was taking Chromium for the past 3 months 800-1000 mg a day, I monitored my blood glucose with a kit. Reading were usually normal. Then the the numbers got low even after meals. I stopped taking the Chromium, Things seemed to normal out a bit. Now though they are dropping from a 115-125 after eating to as low as 80 after sometimes even 20 minutes of moderate exercise.
Is this normal?
A normal blood sugar 80-100 after 2 hours of eating it should not be any more than 140,if it is then you have a issue, after exercising 80 is just fine, if you are worried about you can talk to your health care provider after all I am just a 17 year old diabetic.
I had a fasting blood test done week ago and my doctor told me my blood sugar level is 4.5 and he has advised me to go on low fat diet as he said I could end up with diabetes is that true
Oh my goodness. No. Just the opposite – you need to lower the carbs and increase the fat. The low fat advice is because diabetics tend to have more cardiovascular disease. The evidence now is that inflammation may be the more important factor and it is primarily carbs/sugar drives inflammation. Also, it is important that you take in healthy fats, not the industrial processed stuff. For great info on that go to http://www.dietdoctor.com, click on “Health” and then click on “How to Reverse YourDiabetes Type 2”. I think you’ll find links to other useful sites.
Hi, I recently had my labs done and my fasting A1c came back at 6.2 and my Glucose came back at 107. Am I diabetic? Would it be safe to add Gymnema Sylvestre to my daily supplements? My father and his mother were both diabetic and I don’t want to go down that route. Also, I’m a little confused about whether I’m leaning more toward hypoglycemic or diabetes or either! My doctor was not much help, just to say that I was a little high but not too bad. Please help!
You are wonderfully normal! You are not diabetic! They did lower the glucose level from 125 to 90. But that’s just so everyone can be termed diabetics! Keep up doing what u r doing!
Don’t listen to Sandra,
Pre diabetic fasting glucose is 100-125 At 126 fasting glucose is considered diabetic.
many times drs may order A1C testing but there are things that can impede on those test and give false low or false highs. Things including blood transfusions, anemia and so forth.
Get your read advise from an MD.
The 125 is “Diabetic” is a little weird. Of course this means you see your Doctor every 3 months, labs, dieticians, it all equals money. You can live to 100 with a glucose level of 125. Really 99 and I am pre-diabetic? No, Dr’s + accountants+ low indicator #’s = more money for everyone but you. That doesn’t mean you shouldn’t watch what you eat, its just that your probably doing a lot of “right” things already.
Hi Chris,
I am a 28 year old female and have no family history of diabetes. However, I am always extremely weak and nauseated in the morning or after any length of time fasting. Over the last two week I have felt my blood sugars fall extremely fast leaving me dizzy,hungry,sick to my stomach, irritable and weak while shaking. I finally decided to go to the doctor because I couldn’t maintain a set point any longer. She said my symptoms would say I am hypoglycemic which has no treatment. She said nothing about me would say diabetes. I asked her to run an A1C at the suggestion of my A&P professor so she did. I had an A1C of 5.5 which she said was perfectly normal and had no indication of diabetes. She also threw into the mix that my hypothyroidism could be the cause of my blood sugar levels. I am at a loss! I would love to hear your thoughts!
Christy, I’ve noticed more and more theses days that doctors don’t treat people…they treat test results…when they catch them. Recently, I have discovered Bio-hacking thru a website about adding healthy nutrients to your morning coffee/tea ….it’s called Bullet proof coffee. The site has associated pods casts with a never ending wealth of health and scientific information on how to hack our biology to heal ourselves. It’s a bit of work but I’m already seeing results in two months after being “sick” for years.
I’ve been doing bulletproof coffee for a month. I’ve lost 12 lbs. without trying. It’s a delicious way to have your coffee. It also gives you more energy! Just tell friends to look up http://www.bulletproofcoffeediet.com. Glad you discovered it and are doing so well! Keep at it! Hugs, Sandy
I am 60 years old, overweight and diabetic. I’ve had this disease since I was a teenager. I have gone to the classes and received the certificates. I was a very “educated” diabetic. My disease was bad and getting worse every year. A1c 14.7 fasting blood sugar well over 300.
What I was to learn is that my diabetes education led me to a path that only worsened the disease. Much of what I “knew” was based on what has proved to be bad science, influence peddling and marketing sleight of hand. It was almost the exact opposite of the path I had now follow: one that is a miracle in my judgement.
I did a great deal of research to come up with the lifestyle changes I have now implemented. Did they work for me? A1c is down to 6.1 and still falling. Insulin is down from 300units per day of Lantus/Humalog. I have lost 30 pounds and still dropping. Many issues with inflammation and blurry vision gone.
There is a free documentary on NETFLIX called “Fed Up” that focused on childhood obesity. There many ideas that will frighten you but if they urge you to keep looking for answers, that would be wonderful.
I would suggest the information at dietdoctor.com is robust and was very helpful to me. It was also free. After i had very successfully put many of the principles I discovered there I practice I joined the community but felt that $9.00 a month was a fair price for changing and likely extending my life.
Good luck. I hope this information is life changing for you as well.
Sorry about the omission but my insulin requirement is now zero!
your blood sugar drops like a stone because you are raising it too high.
A low carb, high fat or Ketogenic way of eating will prevent that.
Gluten (a protein in wheat, barley, rye) is worse than sugar for spiking blood sugars. No room for pasta or bread-y things on keto.
You are speaking truth to power! We are partners.
Hi Chris,
I am an Indian with 48 old (weight 103kg and height 6″feet)and last few years I am monitering my bg regularely. Nw a days my fasting BG is around @110 (100-110) and shoots up to 280-300 after 2 hours of meal( breakfast) and it is purely related to what I eat(amount of carbohydrate). After Luch But it comes back in range (120) after 2 hours(means total after 4hours). What is the cause of it? What action would you suggest ? Please advice
Exercise at least 30 min per day. Cut down on soda, chips and other sugary drinks and/or foods. I found exercise is doing the trick for me more then the food and watching the carbs.