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In my quest to learn everything I can about reversing type 2 diabetes, I’ve come to realize you can’t ignore diabetes tests for your blood sugar. For several years after my first reversal of 2008-2009, I didn’t bother testing because of my attitude of denial. I used to say, “what is the point, I know it’s high anyways.”
Well, we know that’s a poor way of thinking and it’s really being in denial. I’m sure we’d all agree, just because we deny or ignore a situation, it doesn’t mean it isn’t happening. High blood sugars immediately come to my mind.
Now that I’m several years older and wiser, I realize testing my blood sugar puts me in a position of power. Testing allows me to see where my blood sugar levels have been, where they are today and what I need to do tomorrow to get them under control.
There are blood glucose tests for each of those snapshots in time, as I refer to them. But as I’ve researched over time, I’m finding that not any single test tells the complete story. One test will not tell you what the other one can. The fasting blood sugar and two-hour postprandial (post meal) tests are the topics of this blog post.
Let’s start with probably the most common test used, the fasting blood sugar (FBS). This test is typically administered after an 8 hour fast. It is also routinely used to diagnose prediabetes or diabetes. For the patient, it is usually our first test of the day before breakfast.
In a normal (non-diabetic) person, after this length of time, their blood sugar will be at or less than 100 mg /dl or 5.6 mmol/l. Any reading over this level obviously is indicative of a problem, as we know.
For a long time, doing a FBS test on myself first thing in the morning was the one time, I always ensured to administer. My reasoning was and still is that, it tells me how I did overall the previous day.
For example, yesterday my FBS in the morning was 133, which is not too bad all things considered. I made excellent dietary choices all day except for the evening. I went to a birthday party and had a slice of cake. Today, my FBS was 157. With only these morning tests in mind, I now have a baseline and a frame of reference that allows me to determine that the slice of cake is the most likely culprit of the higher reading.
I’ll take this scenario a step further. Hypothetically, what if my FBS on the 2nd morning was 220? And I still had that one slice of cake, which was pretty small. From experience, I know the size would not have done much damage. I now think further back on the previous day. I all of sudden recall snacking on my kid’s popcorn. Not only that, the darn popcorn had caramel. Ugh! I make a mental note to avoid the popcorn altogether the next time.
Although I feel just a little guilty, I now realize I have to be extra good today. I started off the day with a high reading but now I’m motivated and determined to bring it back down. I do just that. Tomorrow morning, my FBS is 129 and I am happy! Not only that, as long as I’m good on this new day, I can presume my glucose reading will be at least slightly better the next day after.
That type of scenario is where I believe the highest value lies with the fasting blood sugar test. It serves as a snapshot for the previous day and a motivator for today. What it doesn’t tell us is how we’re doing over time or how my pancreatic insulin release is reacting to my meals.
These two tests are essentially the same. One, the OGTT or oral glucose tolerance test is usually conducted in a doctor’s office for screening type 2 diabetes. Its administration consists of giving the patient a 75-gram dose of glucose. Glucose levels are then taken at certain intervals or at the end of the two-hour period.
You do the two-hour postprandial test, two hours after starting to eat a meal. This one is simply using your glucose meter to take a reading. As you see, both of these tests consist of waiting two hours. Why are these important?
Well, after two hours of having started a meal, a non-diabetic’s blood sugar level will return to normal, which is 100 mg/dl or 5.6 mmol/l, or under. Their glucose would have peaked somewhere around 125 mg/dl or 6.9 mmol/l. However, there is recent research that I will get into my upcoming post about the A1c test that suggests lowering the two-hour target to 120 mg/dl or 6.7 mmol/l. This makes sense. We all should know by now, that for diabetics, in terms of blood sugar lower is better.I have to admit I’ve not paid too much attention to this test day to day. My main reason for that is as I stated above, I always felt the fasting blood sugar test was the most indicative of how good or bad overall my blood sugar control is on a day to day basis. Well, I believe that still to be true but after further research, I now know type 2 diabetics have bigger fish to fry as they say.
The American Diabetes Association and World Health Organization have defined impaired glucose tolerance as having blood glucose levels between 140-199 mg/dl or 7.8-11 mmol/l. Not that long ago, I would’ve thought, ‘so what, big deal!’
It turns out; having those IGT levels is organ damage territory, starting with the peripheral nervous system where neuropathy develops.
This in ADA Diabetes Care found that people with IGT already can and do suffer from some level of neuropathy. I now realize I am one of those people. I can’t begin to count the number of incidences where my feet would ache and give off prickly sensations as I lay in bed at night. I can correlate this directly with high glucose levels, no doubt at all.
A surprising fact is that some people can have normal fasting blood sugar and A1c levels but have IGT. This actually qualifies them as type 2 diabetics. Jeff O’Connell wrote about this very subject in his book . Doctors couldn’t find anything wrong with him but he surely felt it. I read this book a few years ago so I don’t recall the details but in the end he figured it out and changed his lifestyle and diet accordingly. But what if he hadn’t? <br />
The moral of this whole story is that we must do everything in our power to keep our blood glucose levels as close to normal as possible at all times. Not doing so usually leads to disaster unfortunately.
As diabetics, our #1 enemy is the carbohydrate. There’s absolutely no doubt. If you’ve not made this a belief, then I invite you test you blood sugar before and after meals, with and without carbohydrates. I’d ask you to let me know what the outcome is but I already know the answer.
Whenever I feel that neuropathic pain in my feet, I know what I have to do. That means, I get up and avoid carbohydrates for most of the day. I also get moving physically, either around the house or I hit the gym. What I am doing is not introducing (or at least a minimal amount of) new glucose into my bloodstream and burning off the existing amount by engaging in physical activity. I then keep on repeating the following days.
By the way, you do know that of the three macronutrients, carbs, protein and fats; carbohydrates (except fiber) ALL break down into glucose in the blood? Right?
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