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What Are Abnormal Glucose Levels And Why Do They Matter

Fasting and Blood Glucose | Jason Fung

Why is it unhealthy for glucose levels to be too high or too low ?

Hyperglycemia refers to elevated blood glucose levels. This usually occurs because the body does not appropriately remove glucose from the blood this can happen due to many complex reasons. Elevated glucose levels can damage blood vessels and nerves over time this can then lead to problems in the eyes, kidneys, and heart, as well as numbness in the hands and feet. Very high levels can lead to coma and even death in some cases. People with fasting glucose levels higher than 100 mg/dl have impaired glucose tolerance and should speak with their healthcare provider.

Some people may think that to avoid all these issues, they should just keep their blood glucose levels as low as possible. If too high is bad, then low must be good, right? Not exactly. When glucose gets too low, its called hypoglycemia. The threshold for hypoglycemia is typically thought to be when glucose falls below 70 mg/dl. When this happens, the body may release epinephrine , the fight or flight hormone, which can lead to a fast heart rate, sweating, anxiety, blurry vision, and confusion, but also helps the body mobilize glucose into the blood. If blood glucose levels stay too low for too long, it can cause seizures, coma, and in very rare instances, death.

After You Have Low Blood Sugar

If your low blood sugar was mild , you can return to your normal activities once your blood sugar is back in its target range.

After you have low blood sugar, your early symptoms for low blood sugar are less noticeable for 48 to 72 hours. Be sure to check your blood sugar more often to keep it from getting too low again, especially before eating, physical activity, or driving a car.

If you used glucagon because of a severe low , immediately call your doctor for emergency medical treatment. If you have had lows several times close together , you should also tell you doctor. They may want to change your diabetes plan.

How To Test Your Blood Sugar At Home

To perform a blood sugar test, you will need to prick your finger with a lancet . Youll put a small sample of blood from this onto a strip inserted into the blood glucose meter.

Before you test your blood sugar at home, its important to find out from your doctor what a healthy blood sugar range is for you. Your doctor will determine this range based on factors such as:

  • the type of diabetes you have
  • how long youve had diabetes
  • whether you have any other chronic health conditions

If you dont have a blood sugar testing machine on hand and are experiencing signs or symptoms of low blood sugar with diabetes, your symptoms may be enough to diagnose low blood sugar.

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What Is Considered A Normal Blood Sugar Level

The normal blood sugar level for a healthy, non-diabetic adult is determined by when and how blood sugar levels are tested.

The below information describes what normal blood sugar levels are prior to and after meals and what the recommended HbA1c and Haemoglobin A1c levels are for those with and without diabetes.

If you are diabetic, it is advisable to consult with your doctor in order for appropriate blood sugar level targets to be set based on your age, the severity of your condition, medications taken and overall health status.

Maintaining Healthy Blood Sugar Levels

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  • Eat a healthy breakfast containing fiber and protein within an hour of waking up to prevent hypoglycemia.
  • Always eat healthy fats, protein, and fiber with each meal, as this slows the digestive process and the number of carbohydrates released into the bloodstream, keeping blood sugar levels stable.
  • Exercise regularly to burn off extra blood sugar.
  • Drink plenty of water and avoid sugary drinks, such as soda, sports drinks, and juice, as these quickly raise blood sugar levels.
  • Keep a supply of hard candy, juice boxes, or glucose tablets on hand in case of low blood sugar crashes. If your loved one has hypoglycemia, he or she should consume a sugary snack or drink as soon as possible and then recheck his or her levels.

Read Also: Blood Sugar Level Type 2 Diabetes

Are A1c Tests Accurate

Certain factors can affect the accuracy of A1C tests, including:

  • Genetics, such as hemoglobin variants.
  • Medical conditions.
  • Medications and supplements.
  • Errors in the collection, transport or processing of the test.

These factors can make your result falsely low or falsely high. Most of the factors are due to differences in the lifespan and health of your red blood cells.

Hemoglobin variants and A1C results

Hemoglobin variants can affect the results of some A1C tests.

The form of hemoglobin in your blood depends on the genes you inherit from your biological parents. There are many different forms. The most common form is hemoglobin A. Other, less common forms of hemoglobin are called hemoglobin variants.

A hemoglobin variant doesnt increase your risk of developing diabetes, but it can affect A1C results. Labs have different ways to do A1C tests on blood with a hemoglobin variant.

The most common variants include:

  • Hemoglobin C trait: Black people, people of West African descent and people from South and Central America, the Caribbean Islands and Europe are most likely to have this trait.
  • Hemoglobin D trait: People who live in China, India, Turkey, Brazil and some parts of Europe are most likely to have this trait.
  • Hemoglobin E trait: Asian Americans, especially those of Southeast Asian descent, are most likely to have this trait.
  • Hemoglobin S trait: Black people and Hispanic Americans are most likely to have this trait.

Causes of falsely low A1C results

Diagnosing Prediabetes Type 2 And Type 1 Diabetes

Depending on which country or medical organization you ask, the qualifying numbers for normal versus prediabetes versus diagnosed type 1 or type 2 diabetes can vary slightly.

The following blood sugar and A1c results are used to diagnose prediabetes and diabetes according to sources including the American Diabetes Association and Diabetes UK:

Prediabetes

  • HbA1c: 5.7 to 6.4 percent
  • Fasting: 100 to 125 mg/dL
  • 2 hours after a meal: 140 mg/dL to 199 mg/dL

Type 1 or 2 diabetes

  • HbA1c: 6.5 percent or higher
  • Fasting: 126 mg/dL or higher
  • 2 hours after a meal: 200 mg/dL or higher

Please note:Type 1 diabetes tends to develop very quickly which means that by the time symptoms are felt, blood sugar levels are generally well above 200 mg/dL all the time. For many, symptoms come on so quickly that they are dismissed as the lingering flu or another seemingly ordinary virus.

By the time blood sugar levels are tested, many newly diagnosed type 1 patients will see levels above 400 mg/dL or higher. If you do suspect that you or a loved one has type 1 diabetes, visit your primary care or urgent care immediately and ask for a urine test to measure ketones in addition to testing blood sugar levels and A1c.

Read more about ketones at diagnosis in ourDiabetic Ketoacidosis Guide.

Recommended Reading: Precision Xtra Blood Glucose & Ketone Monitoring System

Dont Drive When You Have Low Blood Sugar

It’s dangerous. If you’re driving and you have hypoglycemia symptoms, pull off the road, check your blood sugar, and eat a sugary food. Wait at least 15 minutes, check your blood sugar, and repeat these steps if needed. Eat a protein and carbohydrate source before you drive on. Be prepared. Keep a sugar source, such as glucose tablets, in your car at all times for emergencies.

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Determining The Right A1c Goal For You

How to Avoid Blood Sugar Spikes after Meal | 7 Easy Tips

Just because a normal blood sugar range of 70 to 130 mg/dL is considered the healthiest doesnt necessarily mean thats the appropriate goal range for you especially if you have type 1 diabetes, or take insulin as a person with type 2 diabetes.

The reason this may not be the right goal for you is that extremely tight blood sugar management in people taking insulin can potentially lead to frequent low blood sugars which can be dangerous.

Achieving extremely tight blood sugar management, like a range of 70 to 130 mg/dL, also often requires a strict nutrition plan, more frequent than usual blood sugar monitoring, precise medication management, and most importantly, years of experience studying your blood sugar levels.

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Cgm Studies In Nondiabetic Individuals

One study from 2009 entitled Reference Values for Continuous Glucose Monitoring in Chinese Subjects looked at the glucose levels of 434 healthy adults using CGM and found the following:

  • On average, their daily glucose levels stayed between 70140 mg/dl for 93% of the day, with very small portions of the day spent above 140 mg/dl or below 70 mg/dl.
  • Also, their mean 24-hour glucose levels were around 104 mg/dl
  • 1-hour post-meal glucose values average 121-123 mg/dl for breakfast, lunch, and dinner
  • 3-hour post-meal glucose values were around 97-114 mg/dl.
  • Peak post-meal values appeared to be around 60 minutes after eating.
  • Mean fasting glucose was 86 ± 7 mg/dl.
  • Mean daytime glucose was 106 ± 11 mg/dl.
  • Mean nighttime glucose was 99 ± 11 mg/dl.

A 2010 study, Variation of Interstitial Glucose Measurements Assessed by Continuous Glucose Monitors in Healthy, Nondiabetic Individuals, looked at a healthy population of 74 individuals that included children, adolescents, and adults during daily living using CGM. This research showed that:

  • Glucose levels stayed between 71-120 mg/dl for 91% of the day.
  • Levels were lower than 70 mg/dl for 1.7% of the time and greater than 140 mg/dl, only 0.4% of the time.
  • Mean 24-hour glucose was 98 ± 10 mg/dl.
  • Mean fasting glucose of 86 ± 8 mg/dl.

Compared to the first study mentioned, these healthy, nondiabetic individuals appeared to have a tighter range of glucose, spending the vast majority of the 24-hour period between 71-120 mg/dl.

What Is Blood Glucose

Glucose mainly comes from carbohydrates in the food and drinks you consume. Its your bodys main source of energy. Your blood carries glucose to all of your bodys cells to use for energy.

Several bodily processes help keep your blood glucose in a healthy range. Insulin, a hormone your pancreas makes, is the most significant contributor to maintaining healthy blood sugar.

If you have elevated blood glucose levels , it usually indicates diabetes. Diabetes develops when your pancreas doesnt make any insulin or enough insulin or your body isnt responding to the effects of insulin properly.

Also Check: How Does Diabetes Affect The Brain

Beyond Normal Goals: Whats An Optimal Glucose Level And Why Does It Matter

Exact numbers for what is considered optimal glucose levels to strive for while using CGM to achieve your best health are not definitively established this is a question that is individual-specific and should be discussed with your healthcare provider. With that said, research shows that there is an increased risk of health problems as fasting glucose increases, even if it stays within the normal range, making finding your optimal glucose levels all the more important.

While the International Diabetes Federation and other research studies have shown that a post-meal glucose spike should be less than 140 mg/dL in a nondiabetic individual, this does not determine what value for a post-meal glucose elevation is truly optimal for your health. All that number tells us is that in nondiabetics doing an oral glucose tolerance test, researchers found that these individuals rarely get above a glucose value of 140 mg/dL after meals.

So, while this number may represent a proposed upper limit of whats normal, it may not indicate what will serve you best from a health perspective. Many people may likely do better at lower post-meal glucose levels. Similarly, while the ADA states that a fasting glucose less than 100 mg/dL is normal, it does not indicate what value is optimal for health.

Repeated high glucose spikes after meals contribute to inflammation, blood vessel damage, increased risk of diabetes, and weight gain.

How Is Prediabetes Treated

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The best way to treat diabetes is through healthy lifestyle changes. Eating a nutritious diet and getting regular exercise can help prevent or delay Type 2 diabetes.

Even small changes can significantly lower your risk for developing Type 2 diabetes. The Centers for Disease Control and Prevention recommends:

  • Weight loss: Losing 5% to 7% of your body weight can have an impact. For example, a 200-pound person who loses 10 to 14 pounds could see a significant health improvement.
  • Regular activity: Aim for 30 minutes a day, five days a week, for a total of 150 minutes a week. Try walking or another activity you enjoy.

Lowering your risk factors for prediabetes can often get your blood sugar levels back to healthy levels. You might:

  • Work with a nutritionist or dietitian to plan a healthful diet you can stick with long-term.
  • Find ways to reduce or manage stress.
  • Diagnose and treat sleep disorders.
  • Manage related disorders, such as high cholesterol and high blood pressure.
  • Find support groups where you can meet other people going through the same challenges.

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Talk To Your Doctor Or Nurse

If you use insulin and your blood sugar is frequently or consistently low, ask your doctor or nurse if you:

  • Are injecting your insulin the right way
  • Need a different type of needle
  • Should change how much insulin you take
  • Should change the kind of insulin you take

Do not make any changes without talking to your doctor or nurse first.

Sometimes hypoglycemia can be due to accidently taking the wrong medicines. Check your medicines with your pharmacist.

What Causes Low Blood Glucose

  • Symptoms occur when blood glucose levels fall below 70 mg/dl a condition known as hypoglycemia.
  • In most cases, low blood glucose results from overtreatment: Either taking too much diabetes medication or not eating enough food. Higher doses of medicine than the person actually requires can also lead to hypoglycemia.
  • People who aim for too-low values on their A1C test tend to experience more frequent drops in blood glucose.
  • Vigorous exercise doesn’t just burn calories, it also burns blood glucose! Hypoglycemia can occur unless blood glucose levels are carefully monitored during and after exercise.
  • Not eating on a regular basis can deprive the body of glucose and make it difficult to prevent hypoglycemia. Eat balanced meals throughout the day and always keep a snack on hand.

Read Also: Does Medicare Cover Diabetic Testing Supplies

What Can I Expect During A Blood Glucose Test

You can expect the following during a venous glucose test, or blood draw:

  • Youll sit in a chair, and a phlebotomist will check your arms for an easily accessible vein. This is usually in the inner part of your arm on the other side of your elbow.
  • Once theyve located a vein, theyll clean and disinfect the area.
  • Theyll then insert a small needle into your vein to take a blood sample. This may feel like a small pinch.
  • After they insert the needle, a small amount of blood will collect in a test tube.
  • Once they have enough blood to test, theyll remove the needle and hold a cotton ball or gauze on the site to stop the bleeding.
  • Finally, theyll place a bandage over the site, and youll be finished.

You can expect the following during a capillary blood glucose test :

  • A healthcare provider will ask you which finger youd like them to use.
  • Theyll disinfect your fingertip with an alcohol swab and prick it with a small needle called a lancet, which is usually contained within a small plastic device.
  • Theyll squeeze your fingertip to form a drop of blood.
  • Theyll place your finger/the drop of blood against a test strip thats inserted into a glucometer.
  • After they have enough blood for the test, theyll give you a cotton ball or gauze to hold against your fingertip to stop the bleeding.
  • The glucometer will show your blood glucose level within seconds.

Symptoms Of Low Blood Sugar

What’s A Normal Fasting Blood Glucose Level?

How you react to low blood sugar may not be the same as how someone else with low blood sugar reacts. Its important to know your signs. Common symptoms may include:

If youve had low blood sugar without feeling or noticing symptoms , you may need to check your blood sugar more often to see if its low and treat it. Driving with low blood sugar can be dangerous, so be sure to check your blood sugar before you get behind the wheel.

You may not have any symptoms when your blood sugar is low . If you dont have symptoms, it will be harder to treat your low blood sugar early. This increases your risk of having severe lows and can be dangerous. This is more likely to happen if you:

  • Have had diabetes for more than 5-10 years.
  • Frequently have low blood sugar.
  • Take certain medicines, such as beta blockers for high blood pressure.

If you meet one or more of the above and you have hypoglycemia unawareness, you may need to check your blood sugar more often to see if its low. This is very important to do before driving or being physically active.

Read Also: Diabetes Medications And Kidney Disease

Normal Blood Sugar Ranges In Healthy Non

For a person without any type of diabetes, blood sugar levels are generally between 70 to 130 mg/dL depending on the time of day and the last time they ate a meal.

Newer theories about non-diabetic blood sugar levels have included post-meal blood sugar levels as high as 140 mg/dL.

Here are the normal blood sugar ranges for a person without diabetes according to the American Diabetes Association:

  • Fasting blood sugar : Less than 100 mg/dL
  • 1-2 hours after a meal: Less than 140 mg/dL
  • 2-3 hours after eating: Less than 100 mg/dL

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