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.
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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.
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one of the problems with diagnosing pre-diabetes with the fasting blood test is that you have to go to the doctor or lab to get blood drawn. By that time, a person’s waking glucose level (which can be significantly higher) has come down. Someone with a 96-110 “fasting” level might wake up with 145 or higher. Unless one is obese, the ADA-based system just looks at them and says, “You’re ok” instead of asking “how do you feel in the morning when you wake up?”
I think the best way to test your fasting blood glucose is to do it yourself. You are right, when you do it at the doctor’s or in a lab, your BG may be lower or higher because you haven’t eaten in a while, and much longer by the time you get the test done. Different people react differently to fasting. Some folks will spike higher and higher the longer they go without food because the liver will start to produce glucose as a result of lack of energy intake. Some people will dip low in their BG down to normal or lower during fasting. If you want a very affordable tester and strips that are very close to one of the best, OneTouch Ultra Mini, see my profile. I buy the more affordable tester and strips now that allow me to test very frequently without excess cost.
the doctor after a medical test told me i was at the risk of pre -diabetes, i had the symptom especially of urinating frequently, and i started all the dos and dont as recommended by my doctor.
recently i still urinate a bit more frequently but in two days now my blood sugar level read 78 and 83 respectively.
what is likely to be my problem and the reason for constant urinating
those numbers are very much in normal range. My doctor said Benign Prostrate Enlargement is the typical cause for more frequent urination. He offered a pill for it to help reduce the enlargement so common in men as they get older. I some times take B-complex before bed and it seems to work for some reason. I consume allot of fluids for 3 hours before bed which is not the best idea, but the vitamin B seems to work anyway.
I have actually been having trouble keeping my BG above 70 today! I had to eat candy. I think I am ready to stop glipizide, and then I will be drug free! 🙂
Derik, this is what the Diabetes Summit said the Doctors are afraid of, because too low is very dangerous compared to too high. One doc said they can never be sued for the known progression of high glucose with medications, but the opposite is not true. They said this makes the situation for avoiding helping people with pre-diabetes, since meds can make them too low and have fainting and injury or worse. Given their tool box has only meds, and an upside down food pyramid– we need to pursue alternative methods of control outside of mainstream. These comments in this blog seem to align with the Summit’s conclusion of what to expect. You best follow the plan you found for yourself if it works — I just go for tests since I pay insurance premiums. I spend lots of Whole Foods and some supplements besides. Maybe you heard the new word is Disease management Provider, since healthcare provider is not accurate 🙂
Yeah, my doctor is actually impressed by my exercise and diet, so he has already mentioned taking me off of glipizide. He took me off of metformin a while back because of the horrible and costly side effects. Glipizide is safe but it can make your BG drop too low. I can’t exercise when it gets around 80 on glipizide because I lose a lot of glucose when I do. I may stop the glipizide on my own. Not normally advised, but considering my situation, I think it would be okay. Sent my doc a message today about it.
Its true some meds do things that cause issue if you stop – blood pressure for sure as my friend and wife attest to. I argued with my Doc to quit Statins and he got angry and said just take it– so I got angry and swore never to take it. Like you I changed my diet radically and got better in many ways. So it worries me if we really need Doc’s permission to try to make progress while staying on the med — unless they are really with you on the plan–sounds like your’s may be a good guy trying to work with you. Mine was so happy with the LOW LDL results he could not accept the improvement from diet alone. I had to learn on my own that leg pain issues are normal for statin takers — he just said I was getting old and did not consider the possibility the meds were involved. Enjoy your new life — you are one of the lucky ones who found the cure.
Is your LDL still low without the drugs? That is something I am working on now. My LDL was within range, but my HDL was too low, and out of range. I just need to lose more weight, and I am confident that will happen faster once I am off of metoprolol (beta blocker, slows metabolism). My cardiologist put me on that because I was having tachycardia episodes almost every day while I was on metformin. He is talking about taking me off of that after my next visit.
My LDL is typically 130-135 without any meds eating like you talk about. The LDL and total are not that meaningful anymore — its the Triglyceride/HDL that was shown to predict cardiac issues, i.e. statistics of people who had serious problems also had ratios 4 to 1 (or like 200/50 for example). Since these people with problems never had ratios below 2 to 1, it is now considered very low risk to have Tri/HDL of 100/50, 120/60, 140/70, etc. Thus its the bad triglyceride levels and insufficient HDL that indicates the level of risk is on the rise. You could still have an LDL of 160 and a total of 240 and be very low risk if TRi/HDL was 120/60 for example. Personally I believe my fish oil commitment is working the magic. I get 90/55 on average and sometimes better. Look for good DHA/EPA content and low mercury fish oil. Or try krill oil.
This sounds a lot like the doctor my parents have. My father had a heart attack at 50 (smoker, rarely exercised, and ate a SAD diet). His doctor at the time was great and got him to quit smoking and change his lifestyle. A year later, our family doc died and he was shuffled to his current doctor. Statins were ordered, followed by morphine patches for the incredible leg and back pain that began 6 months later. Then came the anti-depressants for the changes in mood. Now he’s on about 9 different medications and he’s told that it’s because he’s fat (he is) and old (not really). I shake my head when my parents tell me how well they’re doing on their weight watchers diet that encourages cakes made from coke rather than oil and eggs. My mom is “prediabetic”, and always thrilled when the doctor tells her that she’s controlling her blood sugar well (she doesn’t monitor) but I cannot fathom that she is in good control at all. It just makes me sad that a doctor can do this to people.
You have to be tough with doctors. Mine is rarely available, and when I was having multiple ER visits because of tachycardia, I tried to follow up with my doc, but he was booked for over a month. I told him that either he make himself available or I am finding another doctor. He made himself available. I am also the one who is pushing him to take me off the meds, but I am putting the work in to make him agree (lifestyle changes).
Sarah, sorry to hear what your father is going through. When I was on the statin I complained of leg pains and the doctor said its just from getting older. On the Diabetes Summit this past spring (online webcast interviews) they said doctors are addicted to seeing low LDL scores from the statins and can’t see past that one thing. Many respectable Doctors on line are saying the statins just cause more harm, and the proof is out that no body avoided serious heart problems because they were on statins. The only good thing found was for those who had heart attacks already, the statin helped delay the next one. That just says if your plaque is already clogging you up, then keeping the flow of LDL concentration lower can help prevent further clogging. The root problem is still there, plus the side-effects will exist. On the Summit they said normal progression is for amputations which is completely acceptable industry standard, along with open heart surgery etc. They also said the best all around help for lower risk is to eliminate processed carbs/sugary stuff all together and reduce starchy carb vegetables (potatoes), but carrots are not actually high carb unless you eat a bushel. And most people find out that grain foods are a big problem for them, so no breads and minimal rice etc. Wheat is now considered the worst food ever engineered in the lab; and per the book Wheat belly, and others there is no more Wheat from old times – its 100% GMO now, so we just have to make sure not to eat food that has it. Most people get way too much of this– per the Summit, the Food Pyramid is dead wrong on the grains are good for you recommendation on the wall at the Doctors’ offices. Diabetes is a fantastic business since most people can stay ill for 50 years with modern treatments. My Dad made it to 86 when dialysis was next and he decided to pass (no pun intended). He amputations and bypasses wore him out I am sure.
I received a response about the glipzide from my doctor yesterday. He is letting me cut the pills in half now, so I am taking 2.5 mg per day instead of 5 mg. Now I just need to get off of the metoprolol and I am gold! Metoprolol was given because of side effects from the metformin. Metoprolol can cause weight gain, and has decreased my ability to think clearly and to lose weight. It slows your metabolism.
I’m having trouble with my blood glucose. I’m not diabetic or anything but get light-headed a lot. My levels are usually in the mid to low 80’s when I get light-headed and weak. I sometimes skip meals out of not knowing what to eat. I want to eat healthy but am so confused with “complex carbs” “proteins”. Is there a website or something to simply get me started eating right?
“The Diabetes Solution: How to Control Type 2 Diabetes and Reverse Prediabetes Using Simple Diet and Lifestyle Changes” by Jorge E. Rodrigues and Susan Wyler, and “The Johns Hopkins Guide to Diabetes”. Those are two very good books and both contain dietary guidelines. They are geared toward diabetes but everyone should follow these healthy eating habbits.
Also, your BG levels are perfect! Maybe throw some healthy grains or more beans in your diet to give yourself a little more high quality carbs.
And never skip meals! Eat the veggie rainbow, more fish, and more beans (like black beans)! Eat lots of leafy dark greens too, like spinach and kale!
I forgot to mention, if you are experiencing dizziness, you may want to get checked out by your doctor. Low blood pressure and high blood pressure can cause your symptoms. Blood tests are relatively inexpensive with insurance. Go get checked out! Better safe than sorry.
Yeah, went recently. He said maybe anxiety?
I just wanna figure out this eating healthy stuff. It seems confusing having always just eaten whatever. Now that I’m getting older (34) I’m more concerned, since my Dad and grandparents are diabetic.
Thanks for the info.
Diet is pretty simple really. Give up breads and get your fiber from veggies and beans and supplements if you want. Avoid ALL PROCESSED MEATS (deli meats). Avoid beef, pork, and lamb as they contain a chemical that when metabolized creates a carcinogen which has been linked to colorectal cancer. Avoid Every other processed food! Eat whole fruits and veggies, beans, LOTS of leafy greens (spinach, kale, chard, etc.). Eat fresh water fish and chicken a few times per week (chicken without the skin). You can’t go wrong with that diet. And the reason I said avoid bread is because unless you make whole grain bread yourself, they add all sorts of toxins to any processed foods now, including all breads. Drink water only, and occasionally green tea. Stay far away from juice and soda. Juice is super high in calories and sugar, and lacks fiber. Soda is high in sugar, and diet soda introduces carcinogens into your system linked to neurological issues and cancers.
Basically, anything that you can grow, eat. Anything that requires extra processing, stay away, or be very cautious.
Also, minimize or avoid caffeine intake. Caffeine causes the body to go into overdrive, screws glucose control, and causes the body to not be able to absorb nutrients from your meals, essentially causing malnutrition in the worst cases.
Has anyone tried asking about the relative meaning of high-sensitivity C-reactive Protein (CRP) levels with A1C levels? I used good doses of turmeric daily to get CRP down to <.1 which was no value on the history chart. The 3 month prior was = to 0.1, and the 3 month before that was 0.8. Thus Turmeric seems to have completely eliminated inflammation that is measurable by the high-sensitivty technique. The reason to ask is because I thought we worry about pre-diabetes levels as they induce inflammation which kick starts the diseases. So does higher glucose in pre-diabetes range matter if CRP is 0? I got no response from the Doc and I have not seen this mentioned online. If there is interest in the turmeric concoction I can provide the recipe or link. I take 5 teaspoons (using the silverware spoon) of the thick broth after boiling the powder. The organic powder is 8 or 10 bucks from Amazon or Starwest Botanicals.
The turmeric broth lasts a week or 2 in the fridge, so you only boil a small batch 2 or 3 times a month. 1 lb. bag lasts months too. This potion keeps my arthritis pain to almost nothing, and I only warn it also is a colonic detoxifier – no issues, just don’t expect to have constipation. My understand this pretty much eliminates any chances of getting colon cancer- a great thing! No inflammation — no cancer.
I would love to know the recipe for turmeric broth. Thanks
My wife boils about a 3/4 cup of water and stirs in 1/4 cup of organic powder. This makes it easy to spoon out of jar each day to add to other drinks or you can drink a shot glass size (as seen on Dr. Oz.). Ideally you add black pepper which enhances absorption in the intestines to the blood stream. My wife does’t like so I take a small cap of Bioperine (i.e. same thing). What I read is if you skip the black pepper then most of the turmeric will travel to the colon and kick the crap out any inflammation trying to take root down there. I think the bioperine must help since my hsCRP was so low the lab could not measure any inflammation markers in my blood. Plus it seems like the easy way to have a regular colon cleanse at the same time. Friends in southern California go to a juice bar that serves Turmeric shot (in the glass). On TV the other day, Dr. Oz guest doctor (his father in law) says he has the evidence this stuff kills cancer in every organ! Drink up – a half shot a day should do it (I take weekends off unless my arthritis is painful).
I rather take natural remedies than meds that cause severe side effects
We should all be working toward being medication free; however, if your blood glucose is out of control, meds are necessary to quickly bring it into control. I was on metformin until I made lifestyle changes to bring my BG under control. It only took 2 months. My doctor has taken me off of metformin now, and now I take glipizide. He is talking about taking me off of that now too. Diet and exercise are the key. Nothing is as effective as those two combined. Stay well away from refined and starchy foods, as well as fatty meats and deli meats. Start eating more dark leafy greens and a rainbow of veggies, and exercise at least a half hour a day, and when your BG spikes. You will see a dramatic difference in your BG level within days!
Amen Nellie!
Everyone interested in Glucose measurements and their relative status in terms of having any degree of diabetes should explore thediabetessummit.com
That summit took place a few months ago. These Doctors and Practitioners pretty much said the general Doctors we are all seeing do not have the answers- the answers are a work in progress they are all doing there part in finding out. The most profound statement made was that most Doctors have no training in diabetes and just follow the protocol of their organization or mainline. The horrific part is that they have to wait for us get to that point of very high numbers and start us the normal array of treatments, which takes us down the path towards amputations etc. The statement was made “this is the normal course FDA expects of diabetes patients and therefore the prescriptions will take us there”. The Summit is trying to charter a new course that helps us heal and prevent the complications considered normal in diabetes. Except for Metformin, all the drugs have hideous side effects to deteriorate our health; so much so that the people suggest not taking any medications at all, and trying a few novel things — which really translates to the low carb dieting for step 1. they said everyone improves with that.
Chris,
If someone is having abnormal blood sugars and your doctor isn’t listening to you about it what would be my options? I feel like the only way my doctor will listen to me is if I pay out of pocket for an OGTT and then show her the results. I honestly don’t want to do an OGTT because when I did the one hour screen it made me queasy.
The obvious answer is to find a new doctor. When you say abnormel, how did you find out? You must have some results from some tests. As I studied the subject, many do not recommend OGTT test as it does not reflect a real life situation and makes people sick. Why don’t you purchase a blood glucose meter, the strips can be purchased cheapl on the internet. Start checking your blood regularly, morning (fasting) and then after the meals, 1 and 2 hours. After a week or two you will have enough material to show your doctor how your sugar is doing. You can find out about your blood sugar from regularly monitoring your levels. You do not need OGTT to find out if you have or don’t diabetes.
Marty,
I was recently hospitalized and I had blood sugars of 133, 160, 140, 135, 125, 125. They were taking my blood sugars during my hospital stay because my blood sugar was high (136) when I was admitted to the hospital. The 136 on admission plus the 133 are diagnostic for diabetes for a Fasting Blood Sugar. When I was discharged I was on a diabetic diet. My PCP won’t accept I have diabetes because I think its that I don’t have the 200+ readings.
I had my wife in the hospital also, ER, they were taking her blood sugar, most of the time it was higher, she did not have any diabetes for sure. I would not rely on the hospital measurmenta at all. You say you had 136 on admission. WHen did you eat, what did you eat. Such a number out of context means nothing.
My suggestion is to take deep breath, buy a glucose meter and start monitoring your sugar for at least two weeks. Fasting in the morning, then usually 1 and 2 hours after the meals and before going to bed. I disagree with your doctor who wants to see 200 to take action. If after two weeks your numbers indicate prediabetes or something similar you need to take action into your own hands and find a new doctor.
Five years ago I had ‘pre-diabetes’, and was overweight. The doctor wanted me to start taking some medication right away. I studied a lot about diabetes and first decided to lose weight, start exercising and eat healthy, no soda, cookies etc. Now I have normal weight, still eat healthy and there is not even a hint I have a problem with sugar. I don;t use any special diet, just eat healthy, maintain weight and exercise.
Marty,
The 136 reading upon admission that I was talking to you about was that 6 am in the morning so it was an FBG. Some of those other readings were FBG as well. So anyway you slice it I’m not normal and according to the standard Chris mentioned that he would use I failed them.
Breanna, what you say sounds correct. Recently this year a “Diabetes Summit” was held on-line with about 40 subject matter experts all working with patients in various means. The entire series is for sale. I listened to most of them and I would say this summit is saying the regular Medicinal approach is not put into effect until the subject is in pretty bad shape, or many years into the problem development. People in the pre-diabetes condition are basically sent home with an upside food pyramid chart and exercise recommendations. The concluding remarks were indicating this is very sad — and we need to get help to get the Glucose down to normal as soon as possible before the meds for Type-2 just make the patient worse off. Your data sounds like you are in this state along with millions of us. I think they said “millions” if I’m not mistaken. The normal healthcare options don’t provide solutions yet, thus the “Diabetes Summit” approach is very special. I’ll admit I have tried the plant/herb, sea-weed powders, and vitamin/supplements on the market for Glucose lowering and just have yet to identify a winner. I do have my blood test records however and can say the Statin meds for lowering cholesterol also whacked my Glucose down to normal; however I got sicker and fatter and had more pain walking and stopped taking that in favor of a green smoothie /low carb / healthy fat & protein diet. My Glucose got higher than originally but the Triglyceride to HDL ratio dropped below 2.0 which is the new gold standard for Lipid fat tests over the LDL & total cholesterol scores. Plus I feel great with lots of energy. So what do the pre-diabetes / barely diabetes numbers really mean? I recommend the Summit videos if you have the time and a $100 or so to invest. Your questions however are just the beginning as the topic has no quick black and white answers. Honestly I was more discouraged after. But I have entered a mission phase of life to learn more and get more data on all facets of blood tests and foods. If you can make a hobby out it, then its rewarding to share and discuss with others in family and work situations.
Glenn,
She still won’t diagnose me with either diabetes or prediabetes. I don’t know what I should do now. Any suggestions?
Breanna, your numbers mentioned would not trigger a verdict for Type 2, and for Pre it seems you have to have an A1C of 6 at least. I can’t recall if you had that result. I test that every 3 months now to know for sure. my FBG is always Pre but A1C is always below 6, so my PCP says its OK. That is the standard response it seems. Did you get a home monitor? I got him to prescribe it so at least i can collect data when i try a change. I think that and getting A1C every 3 months is all you can do. Unless yu can afford an Alternative assistance Dr. program. Eating veggies and healthy fats are the biggest aids to lower Glucose of course.
Glenn,
Yes, I have been testing at home. My numbers range from 110 to 144 just fasting. Based on the those fasting numbers I would definitely qualify as prediabetic. I think its ridiculous I cannot get a diagnosis because my doctor is old fashioned. I’m going to print out all the readings for her to see and maybe that will change her mind.
Breanne, you can try — I have not been able to get my Dr. to talk at all, but he has been amenable to my requests for many other blood tests to compare (CRP, Calcium, Vit D, Testosterone, typical CBC -Complete Blood Count ). Only glucose is not cooperating well. I asked for Insulin test last week and he said it is not used anymore because the home scores are more useful. I asked for Homocysteine and he said they quit that 8 years as it is debunked. My feeling is the Dr.’s are trained to prescribe meds for good solid disease situations, and are not comfortable discussing what we are learning online from others. that is my take and I accept for the coverage I have this is my best bet for costs out of pocket. Plus I buy allot of Kindle books to learn from. You may end up in the same boat if your Dr. freezes like mine, or just poo-poos what we think. Maybe you can convince your Dr. to dig a little more for advise. Hope she helps you.
Just know that being injured or ill will spike your blood sugar, sometimes quite high. I believe it is you body’s way of providing the needed energy for recovery and repair.
Glucose is not the only test for heart health risk. You can look at the Anti-inflammatory Diet, Dr. Weil’s website has for instance. In his link for it, ” Elevated C-reactive Protein (CRP)” it says “If this test shows that CRP is less than 1.0 mg per liter of blood, the risk of heart disease is considered low; if it is between 1.0 and 3.0, the risk is average; if it is above 3.0, the risk is deemed high.”
What is the connection? Well diabetes is known for heart failure risk, but all the complications of diabetes are associated with high inflammation. High inflammation is now known as the root source of most disease formation–you could say inflamed tissues are the incubation areas for the development of disease locations in the body. Since I have perpetual pre-diabetes numbers I have been examining other risk factors. CRP seems to offer one of the best collaborative assessment factors for heart disease risk, so you don’t have to use old fashion Fasting Glucose alone. My research has uncovered that High Glucose initiates inflammation issues in any of the organs. So I do my best to stick to low inflammation foods and supplements. Minutes ago I got my new HMO reading of <0.1. I was 0.8 in January this year. That was bad, but per Dr. Weil's link still low risk of heart disease. When it comes to Glucose tests, there seems to be no clear cut answers out there. So no one should worry until they collect a variety of bad indicators for risk. Of course inflammation cannot be a good thing unless your body is dealing with a short term issue that it will recovered and healed back to healthy status.
And everyone should have a coronary calcium scan. Watch the documentary, “The Widowmaker”.
Derik, you make a good point. We get an invitation every year for a mobile unit that does this test for about $125. I have not invested that way, but I invest in in K-2 MK7 (Vitamin K2 from Natto). This has allot of press for moving calcium to where it belongs and even removing arterial calcium. It is “required” for people taking Vitamin D in does of 5000iu or more which I do. I maintain a blood level of 70 to 80 which is high optimum. But ideally the Healthcare insurance would give the artery calcium test — since they “care” if we have a developing concern, right? I think they only care about giving meds if you are justified with the correct high number; which the population is encroaching in greater percentages.
3 months ago, my doctor told me I was prediabetic with an A1C of 5.7 and glucose reading of 110. At the time, I was eating nothing but junk and fast food in large amounts. I wasn’t surprised. I completely changed my diet. Since, my fasting blood levels in the morning are between 66-72. Most of the day I range in the 70s and at 1 and 2 hours post prandial, I am in the 80s and 90s. Never went over 105 post prandial. I got my most recent labs back and A1C was down to 5.3, fasting glucose was 65. Last night, I ate a baked sweet potato roasted in coconut oil, 4 oz of baked chicken and some cheese. 45 minutes later, level was 185. 1 hour 195. and 2 hour 175. As you can see, these levels were not normal for me. Should I assume I have diabetes?
You might try again without the Sweet Potato- a good volume of carbohydrate with a low glycemic index takes longer to get processed- it stands to reason the glucose might be higher than you want. The fact that your numbers improved so dramatically after changing your eating suggests you are far from having diabetes, or even pre- for that matter.
Thank you for your response. I retried the sweet potato last night, but this time, only ate 1/2 and steamed instead of baking (because I read baking it can almost double the GI). 45 minutes after 95, 1 hour 98, 2 hour 102. I guess the reason I freaked out and assumed the high numbers from the night before were indications of diabetes, is because everything I read says a normal person with a high carb meal won’t go over 140 and mine were well over that. I can’t seem to find any explanation as to why it would have been that high
I have normal glucose but do check it occasionally. it does happen that I get a weird number once in a while. I retry again and it gets back to normal. So it is advisable to always repeat the test if the number is out of the ordinary. There should not be much difference between 1/2 and 1 potato. So you sugar seem to be normal.
I recently tried the concept of high fiber to see if I can improve my A1C and Fasting numbers. I hunted down the highest fiber foods and picked the big winners to try. It turns out these are high carbohydrate foods — I found black beans and a flax cereal that had massive fiber ratios and near 0 sugar. I ate a bowl with glee and waited an hour. My reading was 165, compared to my highest number ever of 130 with my low carb diet. Did some reading and reassessed the total carbohydrate of the food–answer was total carbs trumps high fiber when it comes to controlling sugar spikes. I returned the flax seed cereal to Whole Foods for my money back, and I accept small amounts of black beans as OK. I have had Pre-diabetes numbers for nearly 30 years and recent years on low carb, high verge & greens, rationed fruits and quality protein sources leaves me with higher A1C as Chris said above is expected (i.e. low carb dieters experience higher glucose levels). Its a mystery still. I suppose a more serious aerobic activity would be a good experiment next.
My Dr. told me I was insulin resistant 3 yrs ago, and put me on Metformin . My tri-glycerides/cholesterol etc are always mid range. HBA1C is 5.00; FBG 95, and Insulin 15. I eat a low carb diet; BMI 24.5; exercise every day;very active. After 3 yrs on Metformin FBS was increasing to 100-105, but as I decreased the Metformin to 1gm /day instead of 2g/day my FBG has decreased to around 90 but insulin back at 15, whereas with the 2 gm Metformin it was 5!Very confused-any comments please? Thank-you.
Tina, I know I am insulin resistant and can tell after a piece of bread or small amount of pasta. My fasting glucose is 110 to 115, and with the low carb diet averages 114. I asked my Dr. for metformin “to try” as I read it is quite safe and has no side effect issues other than in the belly at first (no biggie at all). He refused saying it will hide the problem and I’ll not make life style changes. I think that is dumb since extra circulating glucose is just not doing any good over the long term of months and years. He did provide me the home monitoring kit however so I can keep an eye on changes as I try something new. I have no data on insulin levels to help in this discussion, but surely if you can optimize the metformin to keep your fasting marker down to normal, then you are doing great for yourself. This endeavor is pretty much trial & error until we each find our unique technique to manage blood glucose – hopefully you are checking the post meals and adjusting diet so those don’t get much over 120 to 140. From what I read, this is more important than the daily fasting number staying normal.
I had horrible side effects with metformin, mostly anxiety and tachycardia. Since being off, I have controlled my BG with glipized, exercise, and a good diet rich in leafy greens and black beans. I started with a BG of 375 when eating unhealthily, and now I maintain 70 through 100 most of the time just on glipizide. I have a lot of info on how I do it if anyone is interested. Most of it is diet and exercise. Drugs don’t even come close to being as efficient as diet and exercise.
Derik, have you researched glipized for long term safeness? I have not heard of it so I will so I am aware of it. I have been on kale and spinach smoothies for 5 years now and have had everything get better about my health except the BG is a little higher. I also barely eat any carbs but fruit and veggies (easy on fruit as they say too). I can’t jog due to a bad hip so I do gym but have not seen improvement-so I am trying to increase frequency and intensity. I wonder if you stopped the med if the diet and exercise alone will work?
Glipizide works by helping your body to produce more insulin. I guess it’s kind of like wine or grain alcohol, where it causes the body to over produce insulin (I would never suggest you start abusing alcohol to alleviate diabetes 2, but 1 serving per day could help). I have had no side-effects from glipizide, But it enjoys the same side effects as metformin, though it works differently. So there is a chance, but neither have life threatening side effects, except when tested by some university in Britain, they found metformin to highly associated with heart attacks of some sort. I have seen nothing like that about glipizide. I think it has to do with the dosage. Typically metformin is given in a minimum of 1000 mg per day. I had problems with 2000 mg per day (a LOT of very costly problems with anxiety and potential hear attacks). Even when they lowered me back to 1000 mg per day, I was feeling paranoid and nervous all day. It was debilitating. My doctor finally took me completely off of metformin. I control my BG mostly by diet and exercise now. And I stay around normal levels (70 through 90).
Oh, and to answer your question about stopping the meds. Never do that without your doctor’s approval, but I recently ran out of glipizide. I tested frequently with a low cost tester (see the link on my name) and was able to stay within normal range because after every meal I would run/walk stairs. Just work large muscles for 15 minutes or so, and you’re gold! It’s not easy and does require work. Also focus on many many many many leafy greens along with your normal diet!
Sounds like you are ready to stop the med and see how it goes — I think you sound like you were border line pre-diabetes and from what I have gotten out of many sources this is almost never given a prescription. I leaned on my Dr. to just let me try metformin a month or so and see what happens, but he finds a way to weasel out of it. I was think 750 a day only. I figure the constant 115+ from dinner till dawn, then 120 and finally down to 110 by afternoon cannot be good long term. You found some answers you can manage. I take 1/2 to 3/4 blender full of greens I drink breakfast, lunch. I could add more after I blend it and there is space. I will start trying that- thanks !
I was, and am, definitely diabetic. If I eat a piece of while bread, or a small mini snickers, etc. I launch to over 140 unless I have had under 60 grams carbs for the day. It’s not normal!
My first episode of tachycardia (a big symptom of high BG) in my life was back on April 16th of this year. When they took my BG (the first test they did) it registered at 375 mg/dL. I am definitely diabetic, but I believe in most people, depending on the cause, it can be reversed through lifestyle changes. If it is a malfunctioning liver or pancreas, or other organs causing the lack of or inefficient use of insulin, then I doubt it can be reversed. Every diabetic should have a liver function test and a test of the pancreas function.
I’m not convinced a diabetes tendency can be reversed, but that it is controlled through diet. I once read a lifetime of high sugar damages the insulin mechanism permanently. I was raised on high sugar processed foods and my wife of fish and vegetables and fruit in the Philippines province. She can eat high carb all day, while I can barely have a bite.
I am completely convinced the condition can be reversed depending on what’s causing it. If it is just insulin resistance due to fatty build up in the cells, then it can definitely be reversed and I think that was what was causing mine. I am on half my dose of glipizide now and even if I eat a small piece of candy (a mini snickers) which I only do to test out my theory, my spikes are completely normal. I go from 80 to 110 within an hour and then back to around 80. Losing weight is a HUGE must for ALL type 2 diabetics. If your pancreas or liver is malfunctioning, then yeah I would agree, there probably isn’t a way to reverse the condition.
I have a low A1c, but a high AM fasting score which falls down to “normal” for me by ten AM or noon, and stays down until sleep. Good 2 hour after meal scores.
There much be some technique(s) to interrupt the growth of glucose level during sleep, perhaps consuming a chunk of cheese just before sleep or even getting up at 3 AM to do a walk. Clearly fasting testing measures an internal meal of converted fat, and I want to control that part of my 24 hours, also.
Can you recommend a way to control glucose level during sleep hours when daylight eating is under control?
I have the same High FBG every morning. Seems to match the description for Dawn Syndrome. As I sustain a low carb diet my triglyceride level is low and makes me believe I consume body fat for fuel as a baseline, plus the fact I don’t get hungary like carb eaters do. That sounds like your description I think. I have tested myself over all conditions and times and notice a consistent 110 +/- 10 and an A1c computation of 5.5 which translates to 114. Thus my data is telling me that my body is regulating the nominal range without lows and without highs, and stays in this narrow range. My morning value is 115 smack dab in the middle which is terrible per the FbG requirement for normal. I too am looking for evidence this is a good thing, or do I need to try to get to normal. I gave up on FBG and at best can try to get the A1C to shrink, and continue to learn about low carb eating effects on blood glucose and any risks. Bottom line, I simply cannot justify high carb intake and sugar induced inflammationi issues, while low carb feels so good and I know my body has to convert its own sugar needs. I just wish that average was under 5.3 so its in the ideal range suggested by Chris.
Dale and Glen, interesting information. I, too, have troubles with high FBS in the morning. I have not monitored by blood sugar the rest of the day although I have done two hour post-prandial. I am basically a low carb eater but I also have serious sleep issues with waking at 3:00-4:00 am and not being able to get back to sleep. Dawn phenomenon? Somoygi effect? Don’t know, guess I will have to check my 2:00-3:00 am to see if it is the Dawn phenomenon or eat some nuts or cheese before I go to bed to see if is the Somogyi. More biohacking is in order!
Natalie and Dale, having to get up and do something at night seems too radical for the long run. It won’t hurt to try and see if a fat-healthy food does modify the morning BG result. If it does then you are compelled to wake up which may not be the best if you are otherwise able to get a good night’s sleep. I will confess, after 6 months now, the dawn effect has not budged at all for me. Though I fasted till 10 am to get a blood test and the FG was way way down to 101 by then. At 6am it will be 115 — today it was 121. That is supposed to be the 2hour after spaghetti dinner number 🙁 I do not understand this “phenomena”. If you discover something to help please share.
Hi..my readings are
June 18 FBG: 131
June 19 FBG: 117
June 20 around 2hrs after meals: 113
June 21 FBG: 117
what do this numbers mean? am i pre-diabetic? i’m not getting my A1C test yet..im alarmed bec my mother was already diabetic since 2012..
Hey Reymelito, there’s no substitute for actually visiting a doctor, but I recently learned a lot about blood sugar readings so here’s how I understand it.
Fasting blood sugar is your blood sugar when you haven’t eaten anything. It’s usually taken in the morning after you wake up and before you eat, because being asleep for the night is usually the longest time you go without food, so your body is in the fasting state and blood sugar is at its most stable/lowest point.
Fed blood sugar comes after you eat, when your blood sugar will be at its highest point because you ate something and that percolated into your system through your stomach to give you energy. The thing is, you’re testing your fingertips. It takes a little time for the blood sugar to get from your stomach to your blood and from there to your fingertips properly. And how fast this happens depends on your system and on the food you ate. If you drank a sugary soda or juice, it’s gonna spike up fast and go down fast. IF you ate some beans, it’s gonna take a while to go up.
So when you start testing your blood sugar you want to test at a couple times. I tested a lot when I started so I’d know how I reacted to different things, like almonds or cauliflower or fake sugar ice cream. If I really want to know what my blood sugar is doing with a new food I test half an hour after I started eating, then again at one hour after, and at two hours. That gives me a general idea of how my blood sugar is reacting, if it’s going up too far or staying high too long.
Now, the first thing in the morning test. You’re saying your fasting blood glucose is over 100 first thing in the morning – you might want to do two tests, because there’s a thing that can happen. Your body does a whole lot of stuff to wake your brain up first thing, and one of the things it sometimes does with some folks is it dumps sugar into your system like a wake up call to get your brain going. So I’d test first thing, then wait an hour before you eat anything, and test again to see if your blood sugar went down a bit. Because fasting blood glucose is usually down below a hundred and fed blood glucose is usually up above a hundred but not usually higher than 120 or so (140 if you ate a ton of candy.)
If you’re seriously worried – eat less sugar and more cheese as a snack, ditch white rice and pasta and replace them with sweet potatoes and lentils, stop drinking soda and fruit juice, start eating greens like broccoli and kale with your lunch and dinner, and TALK to your doctor.
bookwench, I actually tested in the middle of the night, first wake up, then 1/2, and 1 hour later before eating or any coffee. I really expected a variation, but it was negligible for me. The idea for the wake up sugar rush seems plausible — maybe it is true for many people- they should try it since if they are low before the wakeup they can relax about the issue.
My age is 30 years.My blood sugar level was 167mg/dl when I took blood test 4 months back. after that , I did started exercise and followed diet about 2 months and my blood sugar levels are never crossed more than 125 even after meal. I stopped doing exercises nearly 45 days back .But the problem is I lost my weight nearly 7 kgs with in 3 months (81 KGs- 74 KGs).Today I went for GTT test and results are FBS : 113 mg/dl and after 2 hours GTT(had 75g glucose solution) is : 123 mg/dl, and HbA1c is : 5.7% ..I don’t know whether I am prediabetic or diabetic and don’t know meaning of the results. kindly suggest me ..Thank You.
If a patient came to you with their meter having an average of 125 mg/dl from 33 readings would you diagnosis them as diabetic?
From what I have researched, that may be prediabetic. Still it is just as serious and should be addressed immediately through diet and exercise.
I have had a problem for years with certain sugary or starchy foods. If I eat them, occasionally I will get a drunk feeling and need to go to sleep for several hours. This need is nearly irresistible. I feel hung over when I wake up. I had an abnormal 2 hour glocose test when I was pregnant a long time ago, my extended test was normal. My fasting sugar in always 98 on Atkins with few carbs, like 20. I had to go on Atkins when I began to feel sleepy and tired all the time with digestive issues starting last August. My PCP assures me that all my labs were ok. My brother and grandmother are type 2 dm and I have a daughter with PCOS andanother child with NASH. Both see endocrinology but I am not sure I need to. I feel like my doctors FNP doesn’t take me seriously and seeing him is like gaining an audience with the pope.
Getting drunk on carbs is actually a thing: http://www.bbc.com/future/story/20150305-the-man-who-gets-drunk-on-chips
I have been monitoring my glucose out of curiosity for about a year now. Prompted by they crappy way I felt when I ate sugary/heavy carb loads. I noticed that my fasting numbers were never under 90 (which is strange because a few years ago they were normally around 75 on routine blood work, sometimes 60 which is kinda low). And the most alarming part was that after I ate normal unhealthy food (breads, chinese food) I shot up to 160-225. The 225 reading was the highest and happened a handful of times. I freaked. I started to tell myself I had full blown diabetes. I requested blood work to be done over the course of this year, fasting were 95, 98. A1C was 5.2-5.6 which I thought the 5.6 was high but was told it was normal. I recently was referred to an endocrinologist after my PCP felt like he couldn’t do enough to reassure me. I explained my concerns and I was reassured by this endocrinologist that I was not diabetic not even pre-diabetic despite my high home meter readings. The doctor even laughed a bit which I did not appreciate. This experience just proved to me that doctors don’t truly care for their patients. Its only when your dying or close to dying when they finally can say ok I’ll share my “knowledge” with you, here, take some pharmaceutical drugs. I feel the changes in my body. I am a really thin person, there is no weight to lose but there is so much room in my life to eat healthier and take care of myself. Its truly in your hands. I’ve realized more than ever, as people it is so necessary to become self-reliant especially when it comes to your health.
If I were you, I would buy a glucose meter and start monitoring my glucose regularly to see if these are aberrations only. You may have a problem, because in a healthy person, a glucose reading 2 hrs after meal should be below 120, and 1 hr after the meal below 140. If you are over these numbers, I would find another doctor.
Sara, sadly your conclusion seems to be spot on – my personal experience is that the Doctors are not concerned when we are basically darn healthy compared to others they have on the agenda for the day. Many of us are interested in feeling vibrant and hoping for longevity without the pain and agony of our parents. So we are pushing the envelope as we get information and, dare I say, annoying the Doctors who don’t have the time or whatever to learn all this stuff. I use email with my doctor to squeeze out any bit of knowledge he has. It seems funny how he mostly avoids the question. But at least he will agree or disagree to a new blood test request and give a reason if he does not want to add the test to my list. I think you are right, we must take responsibility for ourselves–it truly is challenging since the Web is loaded with info, and it takes a big commitment to find the nuggets of knowledge that seem worthy of trying. Plus how much have I spent on books? yikes. Sharing in the blog adds allot towards understanding what we otherwise cannot get feedback. Friends and family have too much mis-information, and trying to advise them is more often only hurting the relationship (since change is seldom welcomed unless we want to make it ourselves). thanks for sharing !
Sometimes my post meal reading is higher two hours than at one hour,does anyone have an explanation?
hey! 🙂 ok, so blood sugar doesn’t just spike in response to any old food, right? There’s a couple things to consider in blood sugar levels.
First, sugar itself. Eat sugar, get a super big spike super fast, then a crash when your blood sugar goes way down. It’s big and dramatic and kids love it but it’s pretty horrible for you long term.
Second, carbs. Get a spike- bigger and faster for simple carbs, slower and lower but still an increase for complex carbs. If you’re gonna eat carbs and not excercise try and skip the white potatoes and white rice, they’re super fast energy that goes away super fast or packs on pounds. The only thing worse for you is straight up candy. Complex carbs take your body a while to pull apart to get to the good bits, so the impact is less and the spike is more spread out and less damaging. You can still overdo it though.
Third, protein. You get a sort of bump from protein. It’s not a spike but protein will push your blood sugar up a teensy bit and leave it there a while because it takes your body ages to digest protein, and you get the blood sugar results while it’s digesting.
Fourth, get. Fat takes forever to digest and barely nudges your blood sugar at all.
So if you ate a big meal with a sugar rush up frond and a starch rush after and a complex carb bump and then a big protein finish.. . Your blood sugar might go up and stay up for a while.
How many daily carbs per day does Chris consider a low carb diet?
It is not neccessarilly the number of carbs only, but the quality of carbs that counts. Stay away from starchy and refined foods like white bread or whit rice. If you have white rice, mix high fiber beans in with them to slow the digestion of the carbs. Eat carbs containing high proteins and fiber like black beans, and eat more plant based foods, especially dark leafy greens.
That does not answer the question – what does CHRIS consider a low carb diet? In my book, anything below 50 g a day is low carb – and that would exclude unrefined carbs as well as refined carbs. That’s the way I eat and works for me. But is that what Chris considers low carb? I dunno.
Thank-you, Mandy. I am asking how many carbs/day do you have to stay below in order to be considered a low carb diet in Chris’ opinion. There are many thoughts on what it means to be eating a low-carb diet. I already eat only whole foods–no processed, sugar only from fruits (and I try to eat only berries, limited other fruits, and only eat fruit with a protein or fat), very very limited grains and not only a daily basis, good quality protein (very limited beef), healthy fats (coconut oil, olive oil, hemp oil, etc.), and a variety of vegetables (try to watch the number of starchy veggies) but probably need to eat more yet my FBS is in the high 90’s or low 100’s which seems way too high for my diet–that’s why I am asking the question on carbs and I am also interested on how much higher than the 85-90 mg/dl that a low carb diet will make your FBS run.
It’s different for everyone and it’s different for every food. You can’t just arbitrarily count carbs, which is why I said it’s the quality of the carbs that counts. If I eat a helping of black beans (not canned) that, let’s say for argument sake, contain 25 grams of carbs, because of the high fiber and protein in the beans, it won’t spike my blood sugar. On the other hand, if I eat a tablespoon of sugar containing 25 grams of carbs, it will get instantly converted to glucose and cause a faster rise in my blood glucose level. I would say get anywhere from 40 to 60 grams of quality carbs per meal. Quality carbs does not mean white bread (or even wheat really), sugar, juice, etc. It means high fiber carbs with protein.
I don’t just arbitrarily count carbs, and each of us has different issues, depending on your own metabolic damage… but carbs are the culprit for blood sugar, in my opinion (and that of many doing research in this field).40-60 g of carbs per meal! That would throw my blood sugar right out. Trial and error has taught me that I need to keep to about 30g a day to keep my blood sugar at a nice healthy level. If you can do it on 40g per meal, wow, lucky old you!. Beans affect my blood sugar as does any starchy veg at all, no matter how ‘healthy’ the carb is. I eat a handful of Cape gooseberries for dessert once every couple of weeks – and see a minor impact in my BS in consequence, but hah, you gotta sin sometimes!
I didn’t want to argue against the ADA because I figured everyone would come to the same conclusion. The ADA will kill you. Their diet promotes maintaining a BG above 140 which will damage, over time, every organ, nerve, muscle, eyeball to the point you will be disabled or die. My dad has followed their diet for 15 years and cannot control his BG. I followed a low-carb/quality carb diet for 3 months, and I can maintain mine. Don’t follow the ADA diet, it is suicide!
I agree, it really depends on the person. If I have 50 grams of carbs, and they are high fiber and/or high protein carbs, I only spike to around 120. That is perfectly normal. However, if your body doesn’t produce enough insulin, or you are overweight and your cells are too full of fat to accept the insulin (insulin resistance) then your carb intake will vary.
Thank-you for the responses. Derik, 40-60 grams of carb per meal would make me gain weight instantly. I can eat that an occasional day but I, too, am like Mandy. 30 or so grams of carbs a day is all I can handle which is why I can have a few berries with my breakfast a few times a week, beans very occasionally, and I must watch my consumption of starchy vegetables. However, none of this answers my original question which is how many carbs per day does Chris Kresser consider a low carb diet.
I have prediabetes .since the diagnosis I lost 20 lb
My fasting glucose has been between 92 to 105
But my post brandial glucose are between 102 and 125 only in one occasion my postbrandial glucose was 137.
I eat carbohydrates but those with low glycemic load like avocado ,nuts , berries , tomatoes ,lentils chickpeas ,green beans ,cabbage etc. proteins and low saturate fats .
I concern my fasting glucose still elevated
Should I change my diet or add something
I am not in any medication yet , do I need to start metformin?
For how long have had these numbers? How often do you check them? What is your A1C? The diagnosis needs to be confirmed by checking these values twice and I think at least a couple of months apart. Many years ago I had similar values and the doctor wanted me to start with medication right away. I turned down his offer and started to exercise regularly, also lost weight and after 6-8 months my values returned to normal and has stayed there since then. I don’t count any calories, carbs, etc. Exercise, keep your weight optimal and (unless there are some other issues) you will be fine. Check your sugar regularly so you can see the trend. With the numbers you have right now I would certainly not take any medication.
Sara, I have very similar numbers and diet to you (a little worse on the FG). I wanted to try Metformin to see if I could get FG down below 100. My doctor refused. I went to the lab the other day and got 105. He argues metformin will make an artificial change, and won’t take the effort for lifestyle. Though he never wants to hear about dietary changes so he may think I drive thru fast food. The only fast food I get is from whole foods market pre-made food like raw kale with quinoa salad. I would suggest you are not yet a candidate for metformin either. You ought to get the hsCRP test and make sure you have no inflammation. My goal is to find out if hs (CRP) is <.1 (i.e. they cannot get a reading unless it is .1 or more), then does FG of 100 to 110 even matter at all? So far I find nothing to support that, but plenty to say high inflammation is the root cause of all disease. So it makes sense no inflammation would mean no disease, and therefore FG would "don't care". Maybe in 10 years or so they will identify the relationship. Everyone should find out if they have a high CRP since it means disease is forming and you need to stop it. I always read that inflammation in the artery precedes calcification and LDL sticking to it. So no inflammation then no clogs and no heart issues — which leaves Glucose levels up for discussion. I always read Glucose causes inflammation, where buggy things grow and feed on the sugars. So it makes sense if that is happening the hsCRP will detect some inflammation. I always read and hear that Turmeric stops inflammation and can stop or prevent cancerous cell growth. Some would argue these connections cannot be publicized or the health care industry could crumble — they will say turmeric cannot be patented so there is no money in it. What if it did eliminate the hysteria of high FG numbers of 100 to 110 or more?
On the CRP – mine has always been too low to measure and my HDL has always been very high and LDL low normal. No high Blood pressure either and really only slightly overweight and low triglycerides also. Yet I had an H1C of 6 and doctor was convinced I had heart disease due to it and also put diagnosis as pre-diabetes and metabolic syndrome (I have NO signs of that other than the glucose) I had a cardiac calcium scan and had ZERO calcification (at age 66) which surprised him. He now says I have teflon arteries and I told him that I don’t think anything can stick without inflammation – he said that is a good theory – whatever that meant. I did get the A1C down to 5.5 with a very low carb diet though.
Hi, I was diagnosed with gestational diabetes during my pregnancy. I was able to control it with diet and exercise. I recently deliver the baby and my random blood glucose level was normal (around 90) tested at the hospital. My OB told me to continue testing my blood sugar at home until the next visit. He did not tell me the range or anything to look at. Can you tell me if these numbers indicates whether I have diabetes or prediabetic? I am a little worried that I would develop Type 2 diabetes after pregnancy. Here are my #:
Fasting BG: 70-83
1 hr post meal: 96-150 (I am usually under 120 during breakfast and lunch, in which I do not consume rice. I am usually in the higher ends, passing 120 during dinner, in which I eat small amount of Jasmine white rice)
2 hr post meal: 90-100
random BG (3 hr post meal or so): 85-90
Thank you
Your fasting and 2 hr are perfectly under the level Chris suggests so you don’t have anything to worry about. You can keep checking though to see how things go and if they ever change.
Hi
I have been unwell for a number of months, no energy waking every day with headaches. Nausea and vomiting at least once a week and my eyesight at times seems very blurred like I’m under water. A friend took my blood sugar one day and it was 11.1 which my friend whose a diabetic insisted wasn’t normal. The following day I took it again and it was 11.7. Since then because I’ve been worrying I have been taking them more regularly. I have had blood sugars of 15.3, & one at 24.5 but generally they are are between 9.4 & 13 and remain high up to three hours after food. Lately I have been having lows of 3.5, 3.1, & 2.7 after light exercise. When this happens the back of my head hurts and I feel sick and dizzy and extremely weak, I do start to feel better after I have eaten something. I also wake between 3 & 4 every morning drenched in sweat and very restless. I have had a HbA1c test which was 5.5 and my doctor insists there is nothing wrong. I don’t really real any different when the blood sugars are high but when they go low it’s horrible. My doctor is refusing me any more tests and I’m getting desperate because it’s affecting my quality of life feeling so ill all the time. Could the HbA1c test have been wrong and if the test measures the average then surely the low blood sugars would bring down my average?
You had an a1c of 5.5% or in different units? You definitely need to find another physician.
Hi: I presume these are metric units? If so, you sugar is too high, you need to see another doctor. 11.1 mmol/L = 200mg/dl. Normal level are in the main article, but 2 hrs after the meal should be below 120 mg/dl and 1 hour 140 or less. After the exercise your number are very low. That’s probably why your average 5.5% is OK. It is an average. Again if these are metric units and you gave the correct numbers. 24 mmoL=ca 400 md/dl that’s dangerously high, this is causing your eyes problem and probably other organs are also being damaged. Also levels between 9-13 are too high. You need to find a new doctor right away if my interpretations of your numbers are correct.
Hi, yes they are metric units which is the measurement we use here in the UK. I feel like I’m going mad! Thanks for your response, I’m getting a bit desperate because I feel so poorly all the time. There are a couple of things that are puzzling me. My fasting blood sugar is almost always between 4.5 & 5.6 (100mg/dl ) usually the higher end which I believe is completely normal. I’ve only ever had one high reading for fasting and that was 15.3. From everything I’ve read it would be unlikely that I have diabetes because my fasting BS is always in the normal range, am I understanding that right? Also I’m not on any medication and from everything I read BS would only drop that low in a diabetic if you were on medication? For example I can be doing some light gardening for a couple of hours and I start to feel nauseous and I feel very hot and sweaty and my head hurts and I’m absolutely exhausted. I usually eat a slice of toast or some biscuits and lay down, after about half an hour I’m fine again. During these times my BS is nearly always below 4 and as low as 2.5 but sometimes I get the symptoms with readings of 5.2 although if I ignore them they keep dropping. When I told my doctor he said the readings are normal and nothing to worry about, he told me to stop taken readings because it was the cause of me worrying. He also said the high readings are normal and people who are not diabetic very often have BS this high after eating and as long as they return to normal there is nothing wrong. I am so confused because everything I’ve read states a normal healthy person will never go over 7.8 (140 mg/dl) and will always return to normal within a very short space of time regardless of what they eat. This morning I had two slices of wholemeal toast and a small glass of orange juice for breakfast. Before breakfast my fasting BS was 5.4, exactly 1 hour later they were 9.5 and 1.5 hours later they were 6.3, so coming down again. Is this what is meant by a short space of time? I would normally eat cereal for breakfast and my readings are usually around 12.2 and stay up much longer and don’t start to fall until after two hours. I could switch to eating toast but if there’s absolutely nothing wrong with me as my doctor insists then there’s surely no reason to watch what I’m eating, because these are normal levels. I’m currently seeing a rheumatologist for another problem. The palms of my hands turned bright red and feel numb and sensitive to hot and cold temperatures. I have unexplained muscle wasting in my forearms, wrists and hands, to the point were I have developed hyper mobile thumbs which are extremely painful. Over the passed 12 months the pain and muscle wasting is increasing and he hasn’t come up with a reason why it’s happening, I’m concerned this could be peripheral neuropathy caused by the high blood sugars. I really am at a loss as to what is happening and I’m terrified to mention diabetes to my doctor because he makes me feel like a hypochondriac! Any help or similar experience would be appreciated. One final question, I am confused by the term plasma and whole blood reading. Do blood glucose monitors read plasma or whole blood?
Karen, the foods you mention are all grain based (cereal, toast, biscuits). You may be gluten sensitive and developing an autoimmune condition. Look into the autoimmune protocol diet, read Sarah Ballantyne’s book The Paleo Approach. Best of luck.
Karen, it could be the high sugar rush from toast and orange juice are related in causing some of your other symptoms. I don’t think your symptoms are common for pre-diabetes or type 2. I have lived with someone who had the hot flashes daily which sounds a little like your description. It could be that whatever is causing your bad symptoms is also fluctuating your BS. The foods you mention are generally known to spike BS quite beyond any normal recommended levels. You could experiment with cutting out those and other grains too. If you have some fruit and add garden greens in a good blender you could give it a try and see if your symptoms improve. The “Beauty Detox Diet” by Kimberly Snyder has tremendous suggestions that will help get your body back on a normal track without meds, unless you have some serious underlying problem that needs medical treatment. It sounds like your Dr. does not think that yet, so may as well give it a go, like the best selling author has discovered in her global studies of peoples all over the world.