Blood Sugar Numbers

This is information assembled from the ADA website, and a number of other sources, written as I understand it. Cross reference and double check the accuracy of what I am presenting.

Before we get into the actual numbers, it is important that you understand that there are control targets for controlling diagnosed diabetes, and then there are numbers which "normal" people should have. Just because you do not have a diagnosis of diabetes does not mean you do not have blood sugar problems!

These numbers will vary by as much as 10-20 points in accuracy from monitor to monitor, but even a cheap monitor can give you enough of an idea of whether your body is handling insulin well to be worth using. There are two types of numbers which doctors are concerned with:

Fasting - Fasting blood sugar levels are sometimes the only criteria a doctor will use to diagnose diabetes, but they are NOT an accurate means of showing whether problems exist. Fasting blood sugar levels will only be elevated in people with advanced disease, and will not show early warning signs that could help many people learn to avoid worse problems later.

Post-prandial - These levels are taken after eating. The standard for diabetes control is two hours after eating. A one hour post-prandial reading can be valuable in telling whether or not you are in an early phase of reduced insulin response.

Recommended targets for Diabetics:

Fasting: below 110

1 hour post-prandial: below 180

2 hours post-prandial: below 140 (this is a controversial number, many sources are still using the older goal of 180)

Normal Blood Sugar Readings:

Fasting: below 100

1 hour post-prandial: below 140

2 hours post-prandial: below 120

It is known that cellular damage is verifiable at 140, therefore it is safe to assume that the human body will not, in ideal conditions, allow blood sugar to rise to a point of bodily harm. Doctors will not usually diagnose diabetes though, until readings are in excess of 200. The standard is supposed to have changed in the last few years, but in reality, most doctors don't change their ways easily, and are still using the old standards.

Diabetes develops in about three phases:

1. Blood sugar spikes. Early on, your body will handle things fine most of the time, but if you eat too much at one time, your body will not be able to compensate, or may compensate too slowly. This kind of response may be due to either insulin resistance (poor use of insulin by your body), or by insulin insufficiency. Spikes may occur only at the one hour reading, but as the condition worsens, the two hour reading will also get worse. At this point, dietary control is generally very simple, and often the progress of Type II diabetes can be completely arrested if proper control is maintained.

2. High blood sugar during the daytime. At first, your body will only handle meals badly, but after a while, it may not bring your blood sugar levels back to normal between meals very well. Fasting levels at this time may or may not be elevated, or may simply be erratic.

3. High fasting levels. Finally, your body cannot even handle the small amounts of glucose that your liver produces to keep your blood sugar levels from bottoming out during the night, and you'll have high levels all the time. By the time you get to this point, permanent damage is usually fairly well progressed, and drastic measures will be needed to control your blood sugar.

There are also several types of diabetes, or diabetes related conditions:

1. Insulin resistance. USUALLY, but not always associated with obesity. The connection is so strong that you can say with fairly high accuracy that if you have extra weight around your middle, then you have some degree of insulin resistance. Whether or not it is significant or will develop into something serious though will vary from person to person, and the only way to know is to test. Insulin resistance occurs when the body does produce enough insulin, but the cells do not use it well, so blood sugar levels are higher than normal at times even though there is enough insulin. Insulin resistance is usually accompanied by abnormally high insulin levels in early phases.

2. Type II Diabetes. This is usually a progression from Insulin Resistance. Eventually the pancreas fails to produce enough insulin to compensate for the resistance, and blood sugar levels become high enough to result in a diagnosis of diabetes. Since high blood sugar levels ironically damage the pancreas, the actual amount of insulin produced will eventually decline in Type II diabetes. It may be treated with medication first, and then insulin later. Type II progresses very slowly, taking 10-20 years to worsen significantly.

3. Type I.5 or LADA Diabetes. This type usually looks like Type II at first, and is often mis-diagnosed. This type is caused by a slow deterioration in the pancreas, thought to be from a viral, autoimmune, or other secondary cause. The common dogma is that fat people get Type II, skinny people get type I.5, but this attitude results in mis-diagnoses, and is a dangerous assumption. Many sources also say that people with Type I.5 never have insulin resistance also, but this is also false, as newer research is showing. Because people with insulin resistance may develop pancreatic damage from unexpected causes, anyone, no matter whether they have a previous tendency to insulin resistance or not, may develop Type I.5 diabetes. (We have a relative who is obese, with insulin resistance, who has a diagnosis of Type 1.5, because it is progressing too fast for Type II diabetes). Type 1.5 will develop over a period of months, compared to the almost immediate development of Type 1, and the progression over years of Type II.

4. Type 1 Diabetes. This is generally more common in children, but can occur in adults also. It is generally though to occur from a viral or other secondary cause which creates sudden catastrophic damage to the pancreas, and causes rapid decrease in the amount of insulin produced. Type 1 is due to insulin insufficiency, but it can also occur in people who have previous obesity. Type 1 generally has rapid onset symptoms, and becomes very serious, very fast. Insulin is required for it, and while dietary control is essential, and supplements may improve control, they are no substitute for insulin injections.

5. Gestational Diabetes. It is suspected that a large percentage of people with gestational diabetes have prior existing (but undiagnosed) insulin resistance or Type II diabetes. Gestational Diabetes results from two factors - increased resistance to insulin caused by pregnancy hormones, and a higher than average need for insulin due to increased dietary needs during pregnancy. The problem must be addressed wisely, because you cannot simply reduce your diet until you can control the numbers, since weight loss is not advisable when pregnant. Insulin is often used, and medications are increasingly being used for gestational diabetes, though there is not enough of a track record yet to truly predict safety statistics.

Tracking your blood sugar numbers is the key to good control. It is also the key to knowing whether a problem is developing, and to knowing whether or not the measures you are taking to slow down deterioration are actually working.

So get a monitor - and compare the price of the test strips, NOT the price of the monitor if you are needing to save money, because that is where the real cost is. Expect to use more strips at first as you experiment to know what your body is doing, then fewer as you become able to predict results more accurately.

Written by Laura Wheeler, Owner of Firelight Business Enterprises, Inc.