When Your “normal” Blood Sugar Isn’t Normal (part 1)
In the next two articles we’re going to discuss the concept of “normal” blood sugar. I say concept and put normal in quotation marks because what passes for normal in mainstream medicine turns out to be anything but normal if optimal health and function are what you’re interested in. Here’s the thing. We’ve confused normal with common. Just because something is common, doesn’t mean it’s normal. It’s now becoming common for kids to be overweight and diabetic because they eat nothing but refined flour, high-fructose corn syrup and industrial seed oils. Yet I don’t think anyone (even the ADA) would argue that being fat and metabolically deranged is even remotely close to normal for kids. Or adults, for that matter. In the same way, the guidelines the so-called authorities like the ADA have set for normal blood sugar may be common, but they’re certainly not normal. Unless you think it’s normal for people to develop diabetic complications like neuropathy, retinopathy and cardiovascular disease as they age, and spend the last several years of their lives in hospitals or assisted living facilities. Common, but not normal. In this article I’m going to introduce the three markers we use to measure blood sugar, and tell you what the conventional model thinks is normal for those markers. In the next article, I’m going to show you what the research says is normal for healthy people. And I’m also going to show you that so-called normal blood sugar, as dictated by the ADA, can double your risk of heart disease and lead to all kinds of complications down the road. The 3 ways blood sugar is measured Fasting blood glucose This is still the most common marker used in clinical settings, and is often the only one that gets tested. The fasting blood glucose Continue reading >>
Understanding Your Average Blood Sugar
A1c is an average of all your blood sugars. It does not tell you your blood sugar patterns. Use it only as yet another indicator of how well you’re doing. Glysolated Hemoglobin (or A1c) is a measure of your average blood glucose control over the previous three months. Glucose attaches to hemoglobin the oxygen carrying molecule in red blood cells. The glucose-hemoglobin unit is called glycosolated hemoglobin. As red blood cells live an average of three months, the glycosolated hemoglobin reflects the sugar exposure to the cells over that time. The higher the amount of glucose in the blood, the higher the percentage of hemoglobin molecules that will have glucose attached. Think of the A1c as a long-term blood glucose measure that changes very gradually as red blood cells die and are replaced by new cells. The A1c doesn’t replace self blood-glucose monitoring. Because the A1c is an average of all your blood sugars, it does not tell you your blood sugar patterns. For example, one person with frequent highs and lows can have the same A1c as another person with very stable blood sugars that don’t vary too much. So what’s the point? A1c is yet another indicator of how well you’re doing. An A1c measurement between 4-6% is considered the range that someone without diabetes will have. The American Diabetes Association goal is an A1c less than 7%. Research has shown that an A1c less than 7% lowers risk for complications. The American College of Endocrinology goal is an A1c less than 6.5%. For some people with diabetes an A1c goal of less than 6% is appropriate. Talk with your doctor about your A1c goal. Use this chart to view A1c values and comparable blood glucose values: A1c Estimated Average Glucose mg/dL 5% 97 6% 126 7% 154 8% 183 9% 212 10% 240 11% 269 12% 298 A not Continue reading >>
Translating The A1c Assay Into Estimated Average Glucose Values
Go to: Abstract The A1C assay, expressed as the percent of hemoglobin that is glycated, measures chronic glycemia and is widely used to judge the adequacy of diabetes treatment and adjust therapy. Day-to-day management is guided by self-monitoring of capillary glucose concentrations (milligrams per deciliter or millimoles per liter). We sought to define the mathematical relationship between A1C and average glucose (AG) levels and determine whether A1C could be expressed and reported as AG in the same units as used in self-monitoring. A total of 507 subjects, including 268 patients with type 1 diabetes, 159 with type 2 diabetes, and 80 nondiabetic subjects from 10 international centers, was included in the analyses. A1C levels obtained at the end of 3 months and measured in a central laboratory were compared with the AG levels during the previous 3 months. AG was calculated by combining weighted results from at least 2 days of continuous glucose monitoring performed four times, with seven-point daily self-monitoring of capillary (fingerstick) glucose performed at least 3 days per week. Approximately 2,700 glucose values were obtained by each subject during 3 months. Linear regression analysis between the A1C and AG values provided the tightest correlations (AGmg/dl = 28.7 × A1C − 46.7, R2 = 0.84, P < 0.0001), allowing calculation of an estimated average glucose (eAG) for A1C values. The linear regression equations did not differ significantly across subgroups based on age, sex, diabetes type, race/ethnicity, or smoking status. A1C levels can be expressed as eAG for most patients with type 1 and type 2 diabetes. mg/dl* mmol/l† A1C (%) 5 97 (76–120) 5.4 (4.2–6.7) 6 126 (100–152) 7.0 (5.5–8.5) 7 154 (123–185) 8.6 (6.8–10.3) 8 183 (147–217) 10.2 (8.1–12. Continue reading >>
Is 123 Mg/dl Blood Sugar From A Glucose Test Normal?
Here we will look at a 123 mg/dL blood sugar level from a Glucose test result and tell you what it may mean. Is 123 mg/dL blood sugar good or bad? Note that blood sugar tests should be done multiple times and the 123 mg/dL blood sugar level should be an average of those numbers. (function(){var aa="function"==typeof Object.create?Object.create:function(a){var b=function(){};b.prototype=a;return new b},m;if("function"==typeof Object.setPrototypeOf)m=Object.setPrototypeOf;else{var n;a:{var ba={a:!0},ca={};try{ca.__proto__=ba;n=ca.a;break a}catch(a){}n=!1}m=n?function(a,b){a.__proto__=b;if(a.__proto__!==b)throw new TypeError(a+" is not extensible");return a}:null} var da=m,p=this,ea=function(a){var b=typeof a;if("object"==b)if(a){if(a instanceof Array)return"array";if(a instanceof Object)return b;var c=Object.prototype.toString.call(a);if("[object Window]"==c)return"object";if("[object Array]"==c||"number"==typeof a.length&&"undefined"!=typeof a.splice&&"undefined"!=typeof a.propertyIsEnumerable&&!a.propertyIsEnumerable("splice"))return"array";if("[object Function]"==c||"undefined"!=typeof a.call&&"undefined"!=typeof a.propertyIsEnumerable&&!a.propertyIsEnumerable("call"))return"function"}else return"null"; else if("function"==b&&"undefined"==typeof a.call)return"object";return b},ha=function(a,b){var c=Array.prototype.slice.call(arguments,1);return function(){var b=c.slice();b.push.apply(b,arguments);return a.apply(this,b)}},ia=Date.now||function(){return+new Date};var ja=Array.prototype.forEach?function(a,b){Array.prototype.forEach.call(a,b,void 0)}:function(a,b){for(var c=a.length,d="string"==typeof a?a.split(""):a,e=0;e
Why The A1c Test Is Important
The A1c is a blood test, done in a lab, that shows what your average blood sugar has been for the past 3 months. Other names for this test are glycosylated hemoglobin, glycohemoglobin, hemoglobin A1c, and HbA1c. How the A1c Test Works The glucose that the body doesn't store or use for energy stays in the blood and attaches to red blood cells, which live in the bloodstream for about 4 months. The lab test measures the amount of glucose attached to the red blood cells. The amount is the A1c and is shown as a percentage. Your A1c number can give you and your health care team a good idea of how well you've controlled your blood sugar over the previous 2 to 3 months. When you get your A1c result from a Kaiser Permanente lab, you'll also see another number called the estimated Average Glucose, or eAG. Understanding the eAG Your estimated Average Glucose (eAG) number is calculated from the result of your A1c test. Like the A1c, the eAG shows what your average blood sugars have been over the previous 2 to 3 months. Instead of a percentage, the eAG is in the same units (mg/dl) as your blood glucose meter. The chart shows the relationship between the A1c percentage and the eAG. If A1c % is: Your eAG is: 6 126 6.5 140 7 154 7.5 169 8 183 8.5 197 9 212 9.5 226 10 240 10.5 255 11 269 11.5 283 12 298 What the Numbers Mean The A1c and eAG reflect your average blood sugar over a period of time. These numbers help you and your doctor see how well your treatment plan is working. The higher your A1c and eAG numbers are, the higher your chances for having long-term health problems caused by consistently high blood sugar levels. These problems include heart attacks, strokes, kidney failure, vision problems, and numbness in your legs or feet. The lower your A1c and eAG numbers, the lower you Continue reading >>
This Calculator Uses The 2007 Adag Formula To Estimate A1c And Average Blood Glucose Equivalents.
Enter a value into one of the fields below then press convert. A1c Value: Average Blood Glucose mg/dl or mmol/L Continue reading >>
Blood Glucose — Know Your Number!
When it comes to blood sugar, the closer you can keep it to the normal range of 80 to 89 mg/dL the better. For years I have been warning that blood sugars even in the 90 to 100 range show that you are becoming insulin resistant and on your way to diabetes. A recent study done on 47,000 Kaiser Permanente patients validated this observation. The study, published in the American Journal of Medicine found that blood sugar, blood glucose (BG) levels in the 95-99 range more than doubled a person’s risk of becoming diabetic. In fact, for every point over 85 mg/dL the risk of becoming diabetic increased 6%, even when they controlled for other factors.1 Accordingly, the study noted that there was more incidence of cardiovascular disease and hypertension in those with higher BG. Why is this research so important? It flies in the face of currently accepted medical guidelines that for years have used 100 as the magic number for diagnosing “pre-diabetes.” At LMI, I’ve been seeing red flags for years when patients come in with BG levels even in the 90’s, because these levels are often accompanied by being somewhat overweight or over fat, having a thick waist, or the spare tire of dangerous belly fat. These are signs that the body can no longer efficiently process the sugars that come from complex carbohydrates in whole grains, starchy vegetables, fruits, and simple sugars. In other words, they are signs of insulin resistance. Insulin is the “key” that unlocks the door to each cell in the body, letting glucose into the cell to be processed for energy. If the insulin key is faulty, the glucose remains in circulation, raising triglycerides, lowering HDL, and usually ending up at the waistline. Anytime you see your doctor for a routine physical, fasting blood glucose is tes Continue reading >>
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Why Your “normal” Blood Sugar Isn’t Normal (part 2)
Hi, I just found this site and would like to participate. I will give my numbers, etc. First, my last A1c was 6.1, the doc said it was Pre-diabetes in January of 2014, OK, I get it that part, but what confuses me is that at home, on my glucometer, all my fastings were “Normal” however, back then, I had not checked after meals, so maybe they were the culprits. Now, I am checking all the time and driving myself crazy. In the morning sometimes fasting is 95 and other times 85, it varies day to day. Usually, after a low carb meal, it drops to the 80’s the first hour and lower the second. On some days, when I am naughty and eat wrong, my b/s sugar is still low, and on other days, I can eat the same thing, and it goes sky high, again, not consistent. Normally, however, since February, my fbs is 90, 1 hour after, 120, 2nd hour, back to 90, but, that changes as well. In February, of 2014, on the 5th, it was horrible. I think I had eaten Lasagne, well, before, my sugars did not change much, but that night, WHAM-O I started at 80 before the meal, I forgot to take it at the one and two hour mark, but did at the 3 hour mark, it was 175, then at four hours, down to 160, then at 5 hours, back to 175. I went to bed, because by that time, it was 2 AM, but when I woke up at 8:00 and took it, it was back to 89!!!! This horrible ordeal has only happened once, but, I have gone up to 178 since, but come down to normal in 2 hours. I don’t know if I was extra stressed that day or what, I am under tons of it, my marriage is not good, my dear dad died 2 years ago and my very best friend died 7 months ago, I live in a strange country, I am from America, but moved to New Zealand last year, and I am soooo unhappy. Anyway, what does confuse me is why the daily differences, even though I may Continue reading >>
Is There A 'safe' Blood Sugar Level?
What is the "safe" blood sugar level? I have heard several opinions from other diabetics, and I am very confused. I was told that it was 154 about a year ago, and my doctor didn't recommend daily monitoring. At one time on a morning fasting, my level was 74. — Theresa, Alabama Yes, there is a safe blood sugar level. It is the optimum range that safely provides the body with adequate amounts of energy. For the average person, it is 70 to 105 mg/dl in a fasting state. (Diabetes is diagnosed when the fasting blood glucose level is at or above 126 mg/dl.) Glucose values vary depending on the time of day, your activity level, and your diet. Your sugar level of 154 mg/dl, which is high, may not have been determined while you were fasting. If it had been, a physician would have repeated the test. Your doctor did, and your level was determined to be normal at 74 mg/dl. In this case, daily monitoring is probably not necessary. If your levels are elevated in the future, you will be diagnosed with diabetes. Treatment can include lifestyle modification, diet, and exercise. If these strategies are not adequate to control your blood glucose level, your physician may prescribe oral medicines or insulin. Having a laboratory examination during your yearly physical and maintaining a healthy lifestyle are adequate for now. Why is it important to keep your glucose level within a normal range? An excess of glucose in the bloodstream causes various chemical changes that lead to damage to our blood vessels, nerves, and cells. Each cell in the body has a function that requires energy, and this energy comes primarily from glucose. The energy allows you to perform various tasks, including talking and walking. It allows your heart to beat and your brain to produce chemicals and signals that hel Continue reading >>
An Overview Of Estimated Average Glucose (eag)
Estimated average glucose (eAG) or "average glucose" is a newer term you may see reported by your doctor. The American Diabetes Association (ADA) introduced this term to help us translate our A1c tests into numbers that would more closely represent our daily glucose meter readings. Making Sense of eAG: Estimated Average Glucose To understand eAG, we have to begin with the A1c test (also known as glycated hemoglobin or HbA1c). The A1c test measures the amount of hemoglobin in your blood that has glucose attached to it in the red blood cells (glycated hemoglobin). It tells you what your average blood glucose control has been for the past two to three months. The problem is that the A1c test reports a percentage of total hemoglobin that is glycated hemoglobin. In other words, an A1c of 7 percent means that 7 percent of the total hemoglobin has glucose attached to it. But your glucose meter measure glucose directly in the blood in milligrams per deciliter (for example, 150 mg/dl). The two types of numbers are confusing and few of us would be able to easily translate one into the other. Researchers discovered an accurate way to calculate estimated glucose levels from the A1c results. This way we can use the same numbers we are accustomed to seeing on our daily glucose meters. Quick Reference Chart for Hemoglobin A1c to eAG Below is a quick reference guide that will help you calculate your estimated average blood glucose level from your A1c result. A1c (%) to eAG (mg/dl) 6.0% = 126 mg/dl 6.5% = 140 mg/dl 7.0% = 154 mg/dl 7.5% = 169 mg/dl 8.0% = 183 mg/dl 8.5% = 197 mg/dl 9.0% = 212 mg/dl 9.5% = 226 mg/dl 10.0% = 240 mg/dl A1c Versus Daily Monitoring While the A1c test is important for measuring your long-term blood glucose management, it can’t replace daily blood glucose te Continue reading >>
Normal Fasting Glucose With High Hba1c
Jonathan's fasting glucose: 85 mg/dl Jonathan's high HbA1c reflects blood glucose fluctuations over the preceding 60-90 days and can be used to calculate an estimated average glucose (eAG) with the following equation: (For glucose in mmol/L, the equation is eAG = 1.59 × A1C - 2.59) Jonathan's HbA1c therefore equates to an eAG of 145.59 mg/dl--yet his fasting glucose value is 85 mg/dl. This is a common situation: Normal fasting glucose, high HbA1c. It comes from high postprandial glucose values, high values after meals. It suggests that, despite having normal glucose while fasting, Jonathan experiences high postprandial glucose values after many or most of his meals. After a breakfast of oatmeal, for instance, he likely has a blood glucose of 150 mg/dl or greater. After breakfast cereal, blood glucose likely exceeds 180 mg/dl. With two slices of whole wheat bread, glucose likewise likely runs 150-180 mg/dl. The best measure of all is a postprandial glucose one hour after the completion of a meal, a measure you can easily obtain yourself with a home glucose meter. Second best: fasting glucose with HbA1c. Gain control over this phenomenon and you 1) reduce fasting blood sugar, 2) reduce expression of small LDL particles, and 3) lose weight. Continue reading >>
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Blood Sugar Too High? Blood Sugar Too Low?
If you have diabetes, your blood sugar doesn't call your cell phone and say, "My readings are too high right now." Instead, blood sugar rises slowly and gradually, causing complications that may damage your organs -- heart, eyes, kidneys, nerves, feet, and even skin are at risk. Sometimes you wonder, "Is my blood sugar too high? Too low?" because "normal" levels are so important. "Diabetes is not a 'one-size-fits-all' condition, and neither are blood sugar readings. Different targets are established for different populations," says Amber Taylor, M.D., director of the Diabetes Center at Mercy Medical Center in Baltimore, Maryland. Targets may vary depending on a person's age, whether they have type 1 or type 2 diabetes and for how long, what medications they're taking, whether they have complications, and, if the patient is a female, whether she is pregnant. "Patients on insulin may need to test more frequently than someone on oral agents," says Taylor. "Those with type 1 diabetes always require insulin, but many with type 2 diabetes also need it." Target Blood Sugar Levels If you have diabetes, these are target "control" blood glucose levels, using a rating of milligrams to deciliter, or mg/dl: Blood sugar levels before meals (preprandial): 70 to 130 mg/dL Blood sugar levels one to two hours after the start of a meal (postprandial): less than 180 mg/dL Blood sugar levels indicating hypoglycemia or low blood glucose: 70 or below mg/dL Types of Blood Sugar Tests Blood glucose testing can screen, diagnose, and monitor. Glucose is measured either after fasting for eight to ten hours, at a random time, following a meal (postprandial), or as part of an oral glucose challenge or tolerance test. You can compare your levels to these results for specific tests, based on clinical Continue reading >>
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Prediabetes
A condition in which blood glucose levels are elevated, but not yet within the diabetic range. Prediabetes is also known as impaired fasting glucose (IFG) or impaired glucose tolerance (IGT). The new term was inaugurated by the U.S. Department of Health and Human Services (HHS) and the American Diabetes Association (ADA) in March 2002 to promote public understanding of this increasingly widespread problem. According to HHS, nearly 57 million Americans have prediabetes. Studies have shown that most people with blood glucose levels in the prediabetes range go on to develop Type 2 diabetes within 10 years; the condition also raises the risk of having a heart attack or stroke by 50%. Prediabetes can be controlled, and in many cases even reversed, through lifestyle changes. Prediabetes can be detected by either of the two standard tests currently used to diagnose diabetes. In the fasting plasma glucose test (FPG), a person fasts overnight and then has blood drawn for testing first thing in the morning, before he eats. Until recently, a normal fasting blood glucose level under 110 mg/dl was considered to be normal and fasting blood glucose in the range of 110 to 125 mg/dl indicated impaired fasting glucose (IFG), or prediabetes. In late 2003, an international expert panel recommended that the cutoff be lowered to 100 mg/dl, so now people with a fasting blood glucose level of 100 to 125 mg/dl are considered to have prediabetes. A fasting blood glucose level over 125 mg/dl indicates diabetes. (A second test must be done on a subsequent day to confirm a diagnosis of diabetes.) In the oral glucose tolerance test (OGTT), a person’s blood glucose is tested once after an overnight fast and again two hours after he has consumed a special, glucose-rich drink. A normal blood glucose Continue reading >>
Understanding Your A1c Reading With Your Eag: Estimated Average Glucose
Every three to six months we have our A1C measured"but what does that number really mean? You know it’s a measure of your average blood sugar reading, but when was the last time your blood glucose monitor gave you a percentage? Your A1C is essentially a measurement of the Advanced Glycogenated End-products that have accumulated in your blood from blood sugar levels"the higher our blood sugars are, the more AGEs are present in our blood. These AGEs are also what lead to various complications we’re warned about: nerve damage, retinopathy, etc. So, as usual, our goal is to reduce our A1C which will reduce our AGEs, and we do this by controlling our blood sugars better. The Joslin Diabetes Center recently published an article about a new way to report your A1C so you can translate that number to the numbers you see on your monitor. This is your eAG= Estimated Average Glucose. So what does it mean to you when your doctor says your A1C is 8%? According to the Joslin article an A1C of 8% means your eAG is 183, which means your blood sugars run usually between 147 to 217. My last A1C was 7.6%. This means my blood sugars run between 140 to 200 on average through the day. The lowest A1C I’ve ever had was 6.2% and the highest I’ve had was a few years ago when I started college, at 8.4%. **Here’s a chart for your A1C readings translated to your eAG: 12% = 298 (240 - 347) 11% = 269 (217 - 314) 10% = 240 (193 - 282) 9% = 212 (170 -249) 8% = 183 (147 - 217) 7% = 154 (123 - 185) 6% = 126 ( 100 - 152)** So, if your A1C is 11%, your average glucose reading is 269, which means ninty-five percent of the day your blood sugar is somewhere between 217 to 314. Numbers like those makes it much more difficult to ignore that 11% We all know we can’t be feeling very well or be treating Continue reading >>
What Is A1c?
A1c stands for glycated hemoglobin, a molecule that forms when the oxygen transporting-protein hemoglobin naturally bonds with glucose in the blood. This ‘glycated’ molecule is also commonly expressed as hemoglobin A1c, and measuring it gives clinicians a marker of your average blood sugar over the preceding 8 to 12 weeks. How is A1c measured? An A1c test is a clinical test that involves taking a sample of blood, often from the arm but sometimes from the finger, and using a specialist machine to measure the level of glycated hemoglobin. Hemoglobin is a protein found within your red blood cells that helps to carry oxygen around the body. In the presence of glucose, hemoglobin bonds to glucose so people with higher levels of glucose in the blood for extended periods of time will have higher levels of glycated hemoglobin until those red blood cells reach the end of their life, which typically takes 90 days. The A1c test therefore gives a good indication of how high your blood glucose levels have been over the past 3 months. When are A1c tests run? A1c tests are run so you and your health team can monitor how well your diabetes is being controlled. Your doctor may give you your results as an A1c percentage or may give your results as estimated average glucose (eAG) which is given in mg/dL (milligrams per deciliter). A1c tests may also be used in assessing risk of type 2 diabetes for people not diagnosed with diabetes. Target A1c levels Targets for A1c are as follows: For people without diabetes, the range is 4 to 5.9% (eAG 68 to 123 mg/dL) For non-pregnant adults with diabetes, an A1c level of 7% (eAG 154 mg/dL) is considered good control, although some people that are not at risk of hypoglycemia may prefer their numbers to be closer to that of non-diabetics For childre Continue reading >>
