Different Levels And What They Mean
The ranges of safe levels of blood glucose depend on factors such as what time of day it is and when you last ate. Safe levels of blood sugar are high enough to supply your organs with the sugar they need, but low enough to prevent symptoms of hyperglycemia or complications of diabetes which follow the National Institute of Diabetes and Digestive and Kidney Diseases guides. Dangerous levels of blood glucose are outside of this range.
The target levels can also vary if you have diabetes. For example, if you are diabetic and are monitoring your blood sugar, you might get a reading of 65 mg/dl. That is considered to be mild hypoglycemia, and you would be wise to eat 15 grams of fast-acting carbohydrates and retest your blood sugar in 15 minutes.
If you were not diabetic, you probably would not know that your sugar was low because you would not test and because you would not symptoms, and you would not act.
That is fine because your body is capable, under normal circumstances, of raising your blood glucose to healthy levels when needed, even if you have not eaten. It is important to keep them in control to help prevent issues like heart disease or nerve damage.
Looking for the best prediabetes diet? Learn what foods are best to help you manage your prediabetes.
Prediabetes Flies Under The Radar
You can have prediabetes for years without symptoms. This means you likely wont know you have prediabetes until serious health problems show up. Talk to your doctor about getting your blood sugar tested if you have any of the risk factors for prediabetes, including:
- Being overweight
- Being 45 years or older
- Having a parent, brother, or sister with type 2 diabetes
- Being physically active less than 3 times a week
- Ever having gestational diabetes or giving birth to a baby who weighed more than 9 pounds
Race and ethnicity are also a factor. African Americans, Hispanic/Latino Americans, American Indians, Pacific Islanders, and some Asian Americans are at higher risk.
Ready to find out your risk? Take the 1-minute prediabetes risk test and be sure to share the results with your doctor.
Why Doctors Order It
A fasting blood glucose test is done to screen for prediabetes and diabetes. It also helps doctors monitor diabetes and determine if medications and dietary changes are having an effect .
Your fasting blood glucose level is the lowest your blood sugar can be because the influence of recent meals is minimized .
Fasting blood sugar is often checked alongside HbA1c , which is a measure of your blood sugar levels over the past three months. The more sugar there is in the blood, the more it will attach to hemoglobin, raising HbA1c .
Taken together, the two offer more information than each test alone. For example, even if your blood sugar levels are very high at one random point, they may have been mostly low over the past couple of months . On the other hand, HBA1c could be higher but your glucose levels at the moment lower.
Apart from diabetes, abnormal levels can point out issues such as insulin resistance, hormonal imbalances, and pancreatic, liver, or kidney disease.
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Lack Of Physical Exercise
Exercise is a powerful tool for controlling glucose levels. There are multiple mechanisms by which exercise positively impacts glucose levels, including:
But perhaps the most important aspect of exercise is consistency. Research has found that even a 10-day break in exercise in fit individuals decreased insulin sensitivity.
Normal Vs Optimal Blood Sugar Ranges
Ive written extensively about the difference between normal and optimal blood markers here, and the same applies to your blood sugar ranges.
From the perspective of conventional medicine, a fasting blood sugar level of 100-125 mg/dL indicates prediabetes.
Two consecutive fasting glucose levels of 126 mg/dL indicates diabetes, as well as a random glucose reading of 200 mg/dL , and a 2-hour post-meal reading of 200 mg/dL .
But much of the data in conventional medicine comes from populations who are not enjoying optimal health.
So what does a healthy daily glucose response look like from the perspective of preventative medicine?
On waking: Research indicates that your optimal glucose after waking in the morning should be between 82-88 mg/dL . This level is associated with optimal aging, the lowest risk of chronic disease, and the lowest mortality risk.
After meals: Blood sugar peaks between 1 and 2 hours after the meal and should be back down to fasting levels by 3 hours post-meal. From the perspective of optimal health, you should avoid regularly eating foods that raise your blood sugar over 100 mg/dl .
One strategy to test the impact of your diet on your long-term health is to measure your blood sugar before and after meals.
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Why Does Blood Sugar Go Up In The Morning What Is The Dawn Phenomenon
There are a few main reasons why your glucose levels may be higher in the morning. One of these is known as the dawn phenomenon.
The dawn phenomenon occurs early in the morning between 3 am and 8 am while you are still asleep. As morning approaches, the body naturally signals your liver to produce glucose, giving your body the energy it needs for the start of the day. Caused by changes in hormonal levels, the dawn phenomenon happens to all people, with or without diabetes. However, for those without diabetes, insulin levels increase and they do not experience hyperglycemia.
Another reason you may experience higher morning glucose levels is because your injected insulin wears off. If your body has insufficient insulin during the night, your glucose levels may start to rise. To combat this, you may consider trying a new basal insulin, adjusting the timing and amount of your basal dose , or changing your nighttime basal rates .
The last reason you may experience higher morning glucose levels is known as the Somogyi effect. This occurs if your glucose levels fall too low during the night, caused by too much insulin or medication. To respond, your liver produces more glucose to try to maintain your glucose levels, which may result in hyperglycemia. The Somogyi effect is not as common as the other reasons described.
How A Continuous Glucose Monitor Can Help Control Morning Levels
Troubleshooting morning glucose levels can be tricky. As we have discussed, there are a lot of factors that influence overall glucose status in the body. Exercise, stress, circadian rhythm, macronutrient composition, nutrient timing, and more are continually affecting glucose management in your body.
If your morning glucose levels are higher than you would like, always start with the four fundamentals:
Of course, it can be difficult to tease out which specific factor is causing your issue, which is why it is crucial to track the data.
The gold standard for tracking glucose levels is with a continuous glucose monitor . When you use a CGM, you can see your glucose values in real time, 24/7. You donât have to wait for an annual blood test to determine whether the changes you made are working. Instead, you can troubleshoot solutions by trying different things out and seeing how they improve the numbers every single day.
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Your Blood Sugar Isnt Just Because Of What You Eat
Mainstream media would have you believe that your blood sugar levels are impacted only by what you eat and how much you exercise, but people with type 1 and type 2 diabetes who test their blood sugars frequently could tell you otherwise.
Its especially important to keep this in mind when looking at your own blood sugars and your goals because there are certain variables and challenges that impact blood sugar levels that you cant always control.
- Menstrual cycles: raises blood sugar and insulin needs
- Adrenaline rushes from competitive sports, heated arguments, or rollercoaster rides: raises blood sugar and insulin needs
- The common cold and other illnesses: usually raise blood sugar and insulin needs
- Hormonal changes due to puberty and healthy growth in young adults: raises blood sugar and insulin needs
- An injury that raises overall inflammation levels: raises blood sugar and insulin needs
- Glucogenesis during anaerobic exercise: raises blood sugar
While you cant necessarily prevent these factors that affect your blood sugar from occurring, you can work with your diabetes healthcare team to adjust your insulin, other diabetes medications, nutrition and activity levels to help compensate for them when they do occur.
For example, when engaging in anaerobic exercise like weightlifting many people with type 1 diabetes find it necessary to take a small bolus of insulin prior to or during their workout because anaerobic exercise can actually raise blood sugar.
Blood Sugar Levels 2 Hours After Youve Eaten
Many foods have types of carbohydrates called starches and sugars. When you eat foods with these types of carbohydrates, your body breaks them down into glucose, which is a type of simple sugar, and releases the glucose into your bloodstream. Aside from glucose produced by your liver, food is the main source of plasma glucose.
Two hours after eating, your blood sugar levels rise. They rise more when you eat more carbohydrates, when you do not eat fiber, fat, or protein with your carbs, and when you eat certain types of carbohydrates, such as refined sugars and starches.
These are target values from The Joslin Diabetes Center, which include levels for people with diabetes:
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Fasting Glucose Goal: 72
Why? Previously we discussed that the ADA considers normal fasting glucose as anything < 100 mg/dl. However, multiple research studies show that as fasting glucose increases, there is an increased risk of health problems like diabetes and heart disease even if it stays within the normal range. The highlights of some of the study results include:
- Men whose fasting blood glucose was greater than 85 mg/dl had a significantly higher mortality rate from cardiovascular diseases than men with blood sugars less than 85 mg/dl.
- People with fasting glucose levels in the high normal range had significantly increased cardiovascular disease risk than people whose levels remained below 80 mg/dl.
- Children with fasting glucose levels 86-99 mg/dl had more than double the risk of developing prediabetes and Type 2 diabetes as adults when compared with children whose levels were less than 86 mg/dl.
- People with fasting glucose levels between 91-99 mg/dl had a 3-fold increase in Type 2 diabetes risk compared to those with levels less than 83 mg/dl.
- Among young, healthy men, higher fasting plasma glucose levels within the normal range constitute an independent risk factor for Type 2 diabetes. This means that as fasting glucose increases, even if the level is still considered normal, it could indicate a significantly higher risk of developing diabetes, and this is particularly pronounced if BMI is greater than 30. .
Testing For Pre Diabetes
Doctors generally use one of two different blood tests to diagnose diabetes and prediabetes. One is called the fasting plasma glucose test in which a person’s blood glucose level is measured first thing in the morning before breakfast. The normal fasting blood glucose level is below 100 mg/dl. A person with prediabetes has a fasting blood glucose level between 100 and 125 mg/dl. If the fasting blood glucose level is to 126 mg/dl or above, a person is considered to have diabetes.
The second test used in the diagnosis of diabetes is the oral glucose tolerance test , although this test is no longer commonly used as in the past. This test may be used to diagnosegestational diabetes inpregnant women. In this test, a person’s blood glucose is measured in the morning after fasting overnight and again two hours after drinking a glucose-rich beverage. The normal value for blood glucose is below 140 mg/dl two hours after the drink. In prediabetes, the two-hour blood glucose is 140 to 199 mg/dl. If the two-hour blood glucose rises to 200 mg/dl or above, a person has diabetes.
Make Sure Youre Getting Adequate Nutrition Throughout The Day
If you are restricting calories to lose weight, your body may not be getting enough of the basic building blocks it needs to properly manage glucose levels. The same thing can happen in those who are very physically active and consuming energy-dense, but nutrient-poor, diets.
While it is beyond the scope of this article, there is a dynamic interplay between the various metabolic pathways of the body: fat metabolism, ketone metabolism, glucose metabolism, protein metabolism, and more. Your glucose needs can significantly vary depending on which of these metabolic pathways are dominant.
The liver holds approximately 100g of glucose in the form of glycogen. It takes about 24 hours for it to be depleted while fasting or ~90 minutes of moderate-high intensity. Glucose can be synthesized from several substrates , but generally speaking, it is easiest to simply consume the glucose you need.
Therefore, a relatively sedentary person may do well with 50-100g of carbohydrates per day, whereas an athlete or a person with a physically demanding job may do best with 2-4 times that value. The best way to determine your needs, of course, is through accurate monitoring of your glucose levels.
Still Frustrated With Your Blood Sugar And A1c Results
Your blood sugars and your insulin or medication needs never stay in one place. If you gain weight or lose weight, your insulin and medication needs will change. If you become more active or less active, your needs will change. If you make drastic or even small changes to your nutrition, your needs will change!
Working with your diabetes healthcare team, and diabetes coaches who can teach you how to make changes in your overall diabetes management plan are essential. Diabetes is a lifelong learning process.
Take a deep breath and be patient. If you dont like what youre seeing on your glucose meter, dont get madget studying! Take good notes and work with your team to make changes to reach your goals.
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How To Test Your Blood Sugar
To test your blood sugar at home, all you need is a very inexpensive piece of equipment you can find at any drug store or pharmacy called a glucose meter or glucometer.
Glucose testing from home using a glucometer is typically done by a finger stick test. This involves pricking the tip of your finger and collecting a small drop of blood onto the testing strip.
The test itself is very mildly painful but if you are feeling squeamish, I recommend having someone else help you with the finger stick because it may be harder to do on yourself.
Here are the data points that you will want to track when assessing your bodys response to meals: :
- fasting blood sugar levels
- blood sugar 1 hour after eating
- blood sugar 2 hours after eating
- blood sugar 3 hours after eating
- how long it takes for blood sugar to return to fasting levels after eating
- a diary of foods eaten before the tests
Lets work through the best way to test your blood sugar and get all these data points.
First: Test your blood sugar first thing in the morning before you have eaten anything.
This is called your fasting blood sugar level. Optimally this level should be between 82-88 mg/dL . Conventional medicine considers anything < 100 mg/dL as normal.
Second: Test your 1-hour post-meal blood sugar.
Third: Test your 2-hour post-meal blood sugar.
This reading tells you how efficient your body is at balancing your blood sugar. Optimally this level should be less than 120 mg/dL . The closer to 100, the better.
Summary Of Normal Glucose Ranges
In summary, based on ADA criteria, the IDF guidelines, a persons glucose values are normal if they have fasting glucose < 100 mg/dl and a post-meal glucose level < 140 mg/dl. Taking into account additional research performed specifically using continuous glucose monitors, we can gain some more clarity on normal trends and can suggest that a nondiabetic, healthy individual can expect:
- Fasting glucose levels between 80-86 mg/dl
- Glucose levels between 70-120 mg/dl for approximately 90% of the day
- 24-hour mean glucose levels of around 89-104 mg/dl
- Mean daytime glucose of 83-106 mg/dl
- Mean nighttime glucose of 81-102 mg/dl
- Mean post-meal glucose peaks ranging from 99.2 ± 10.5 to 137.2 ± 21.1 mg/dl
- Time to post-meal glucose peak is around 46 minutes 1 hour
These are not standardized criteria or ranges but can serve as a simple guide for what has been observed as normal in nondiabetic individuals.
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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.