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.
As I mentioned in Part 1 of this article series, there are potential problems with how well these tests are utilized to diagnose diabetes. This is an area that needs further study, but continuous glucose monitoring for the general population may be a better marker.
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, fasting insulin, 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 89 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.
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.
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.
Like what you’re reading? Get my free newsletter, recipes, eBooks, product recommendations, and more!
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.
A continuous glucose monitoring study showed that 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. Diabetic retinopathy is an extremely common (and 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.
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.
Better supplementation. Fewer supplements.
Close the nutrient gap to feel and perform your best.
A daily stack of supplements designed to meet your most critical needs.
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.
That really sounds like prediabetes. You should see your doctor and start addressing it with diet and exercise changes.
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.
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.
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.
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.
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.
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.
Is 6.65 a 5 number?
correction…5 should read %
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.
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?
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.
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.
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.
Go on a ketogenic diet.
I use to do those back home. It use to be so easy for me to get into ketones, but not now, must be my metabolism has changed, I don’t know.
I can’t believe that a ketogenic diet is good for the baby’s development.
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.
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.
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.
Colleen
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.
Susie
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.
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!
http://chriskresser.com/how-to-prevent-diabetes-and-heart-disease-for-16/
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.
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.
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.
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.
TYPO: THE WORD EVERY SHOULD BE EVER
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.
Thanks for catching that Stephen, just updated.
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.
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.
I would suspect meter error in that situation. What meter are you using?
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.