How Blood Glucose Affects Your Body

For once WebMD is using numbers other than what the American Diabetes Association (ADA) recommends for blood glucose levels (they still list what the

ADA recommends, but at the end of the article).

When you have diabetes, your blood glucose levels may be consistently high. Over time, this can damage your body and lead to many other problems.

How much sugar in the blood is too much? And why is high glucose so bad for you? Here’s a look at how your levels affect your health.

What is the WebMD blood glucose recommended levels? They're less than 100 mg/dl after fasting for at least 8 hours. And they're less than 140 mg/dl 2 hours after eating.

During the day, levels tend to be at their lowest just before meals. For most people without diabetes, blood sugar levels before meals hover around 70 to 80 mg/dl. For some people, 60 is normal; for others, 90.

What's a low sugar level? It varies widely, too. Many people's glucose won't ever fall below 60, even with prolonged fasting. When you diet or fast, the liver keeps your levels normal by turning fat and muscle into sugar. A few people's levels may fall somewhat lower.

Doctors use these tests to find out if you have diabetes:

• Fasting plasma glucose test. The doctor tests your blood sugar levels after fasting for 8 hours and it’s higher than 126 mg/dl.

• Oral glucose tolerance test. After fasting for 8 hours, you get a special sugary drink. Two hours later your sugar level is higher than 200.

• Random check. The doctor tests your blood sugar and it’s higher than 200, plus you’re peeing more, always thirsty, and you’ve gained or lost a significant amount of weight. He’ll then do a fasting glucose level test or an oral glucose tolerance test to confirm the diagnosis.

Any glucose levels higher than normal are unhealthy. Levels that are higher than normal, but not reaching the point of full-blown diabetes, are called prediabetes.

According to the American Diabetes Association, 86 million people in the U.S. have this condition, which can lead to diabetes if you don't make healthy lifestyle changes that your doctor recommends. It also raises the risk for heart disease, although not as much as diabetes does. It's possible to keep prediabetes from becoming diabetes with diet and exercise.

Why are high blood glucose levels bad for you? Glucose is precious fuel for all the cells in your body when it's present at normal levels. But it can behave like a slow-acting poison.

• High sugar levels slowly erode the ability of cells in your pancreas to make insulin. The organ overcompensates and insulin levels stay too high. Over time, the pancreas is permanently damaged.
• High levels of blood sugar can cause changes that lead to a hardening of the blood vessels, what doctors call atherosclerosis.

Almost any part of your body can be harmed by too much glucose. Damaged blood vessels cause problems such as:

• Kidney disease or kidney failure, requiring dialysis
• Strokes
• Heart attacks
• Vision loss or blindness
• Weakened immune system, with a greater risk of infections
• Erectile dysfunction
• Nerve damage, also called neuropathy, that causes tingling, pain, or less sensation in your feet, legs, and hands
• Poor circulation to the legs and feet
• Slow wound-healing and the potential for amputation in rare cases

Keep your blood glucose levels close to normal to avoid many of these complications. The American Diabetes Association's goals for blood glucose control in people with diabetes are 70 to 130 mg/dl before meals, and less than 180 mg/dl after meals.

The Value of SMBG Testing – Part 1

Gretchen Becker's blog of August 1 got me thinking and now I want to review prior blogs of mine on self-monitoring of blood glucose (SMBG) to attempt to make the message of the value of SMBG testing stronger.

In the past several years, many reports have been published saying that self-testing of blood glucose (BG) by people with type 2 diabetes is useless, a waste of money, and simply increases rates of depression. I can understand this because there is no education of value given to help people use the testing data and change their way of eating that will help manage diabetes to lower blood glucose levels to near normal.

What the studies omit is that the medical professions in all countries are lax in giving patients the education necessary to understand how to use the blood glucose readings. They provide very little in guidance to their patients for proper decision-making when looking at blood glucose readings.

Some of us have been fortunate to receive some education in what to do with our blood glucose test results. Others have been able to research online and self-educate themselves. It is knowing how to adjust diet and exercise to keep blood glucose levels as close to normal as possible that gives meaning to testing. The readings are truly of no value unless you know what to do to bring high readings down and how different foods affect your blood glucose levels. This also applies to preventing lows and all extreme highs and lows.

In essence, you need to become your own science experiment with yourself as your own lab rat or mouse. This is where the challenge is and where learning how diet and exercise affect your blood glucose proves, knowledge can be very powerful. There are many factors like general health, other diseases, mental or medical conditions can make this even more of a challenge.

Alan Shanley at loraldiabetes has been writing about the lack of respect and understanding SMBG has been receiving since at least 2006 and he has not missed much in the lack of understanding by researchers and the medical community.

When I was diagnosed with type 2 diabetes, I wondered what was ahead. Experiences in my life have been varied, but in my research on self-monitoring of blood glucose (SMBG), I experienced something unlike anything else. I did not realize that whole industries and governments rely on and participate in funding studies fabricating false and misleading information to demean and direct fraudulent intent at a group of people with type 2 diabetes on no medications or oral medications.

These fabricated studies have been reported in trusted reviews, belying the truth in the way the studies were assembled and carried out. The editor of leading diabetes community website Diabetes.co.uk, Benedict Jephcote states: “There are a number of problems with the way results are presented within the Cochrane review. For instance, in the UK, there are many people with type 2 diabetes that are actively interested in self-testing and significant numbers of these people have to buy test strips from their own income. Studies which exclude these people cannot therefore give a fair representation of people with type 2 diabetes in the UK."

Cracks along the above line are already showing evidence to prove just that. In addition, in the future, researchers that are more honest will begin to refute these false studies. What is astounding is that the US Government has participated in this cover-up of studies that are done to show patients with type 2 diabetes do not need to self-monitor their blood glucose levels. The National Institute of Health leads the way and the Center for Medicare and Medicaid Services follows by cutting testing supplies for people needing them. By not educating Medicare and Medicaid patients about the value of self-monitoring of blood glucose and showing them how and when to test, they can support many studies proving that people with type 2 diabetes do not need the testing supplies.

Other writers proclaim that the studies are right and say that the results beyond a year do not hold up. I can understand this because these study participants are no longer given the supplies with which to self-monitor blood glucose. Many of the study participants probably are unable to afford the testing supplies and therefore without them the results would be expected to not hold up. That is one reason to have long-term studies of three to five years.

We have many factors working against us in the way people are selected for most of the studies and this discrimination and falsification in studies continues to harm people with type 2 diabetes. Tomorrow I will include more information about SMBG.

Important Tests Needed By People With Diabetes - P2

Back in August 2010, I wrote about five or six important lab tests for people with type 2 diabetes. I need to update this and add more tests and be a little more detailed than I was then. It is not my intention to discuss the tests for gestational diabetes, but a few are common across all diabetes types. The discussion for this blog is about monitoring diabetes, by your doctor and by you.

Once you are diagnosed with diabetes, the glucose (or blood glucose) test will become very important to you. This test has other names starting with fasting blood glucose (FBG), or fasting plasma glucose (FPG). This is done either in a lab or in the doctor's office lab. Normal fasting is required of a minimum of 8 to up to12 hours. This is done by drawing blood from you and gives two results. The first is the fasting plasma glucose reading and the second is the A1c results. Normally other tests are done at the same time, but this discussion is on glucose. An A1c test can be accomplished without fasting and is often done this way.

These tests can be performed at various intervals depending on the patient and the doctor. If the doctor is overworked and the patient is active in his/her care, some doctors only see a patient once a year. Others see their patients twice a year, but most doctors still try to see their patients with diabetes four times per year.

The blood glucose (or glucose) test will become one of your daily tests. This is not the same as the blood glucose test taken in the doctor’s office or lab. This requires a blood glucose meter and test strips and is done several times per day depending on the type of diabetes you are diagnosed with and the limits of test strips mandated by your medical insurance or Medicare. This will also depend on whether you are on oral medications, insulin, or a combination of the two.

If you can afford to purchase test strips on your own over and above what your insurance or Medicare covers, please consider doing this. If extra test strips are over your budget, pick times for study like your fasting after arising in the morning. Know what you wish to attain and look to this test for guidance. Then pick another time during the day, which will assist you in maintaining your goals. Then after a period of time switch your testing times and use them for about a month. Be prepared to return to the original testing times if the secondary times are well managed.

One of the reasons for encouraging people to purchase extra test strips over what insurance reimburses is to test what different foods do to your blood glucose levels. This requires you to test after every meal at approximately 1 to 2 hours. This will tell you if you need to reduce the portion or eliminate the food from the menu. Because everyone's body chemistry is different, it is important to become you own chemistry experiment and learn by testing how the different foods affect you.

Until you learn to count carbohydrates from a dietitian or certified diabetes educator or another professional, the testing will only give you general ideas. Get a referral by your doctor and lacking that, call your insurance company and ask them for permission or a list of registered dietitians knowledgeable in diabetes.

Yes, we can say to eliminate certain foods and often encourage people to do so because of our own history and the history of others with type 2. However, everyone being different, it is still best to test for yourself. It is almost like a symmetrical bell curve with carbohydrates. Some people can only tolerate a small number of carbohydrates and people at the other end of the curve can tolerate more than the average person. The American Diabetes Association treats everyone the same in the number of carbohydrates they can consume. This is far from the truth and is a reason for testing more shortly after diagnosis. Once you have found your level of carbohydrates, then reduce testing to what insurance or Medicare will reimburse.

I would also suggest that more testing be done again when foods are changed or blood glucose levels from your tests show an increasing trend. Maybe you can reduce the number of carbohydrates consumed without increasing testing, but for those of us that are very conscious of blood glucose levels, we like to be sure. Read my blog here for testing.

What we are looking for is trends and hopefully the levels are steady and not increasing. When blood glucose levels are trending upward, this will most likely be reflected in your next A1c test and you should be ready to discuss this with your doctor. Most endocrinologists will want to take readings from your own meter and see what readings you are getting. Not all doctors want or can deal with this information so always be prepared.

Several bloggers have also discussed this topic and I offer their discussions for your reading as they can possibly shed a different perspective on this subject of testing that will make more sense to you. Tom Ross has two blogs that may assist you in knowing how to test if on a limited supply of test strips. The first is here and the second with additional thoughts is here.

Joslin Diabetes Center has a blog here and Alan Shanley has a blog here about the importance of testing. Alan's second blog is here. The blogs by Tom and Alan are important as they also have type 2 and presently Tom is managing his with diet and exercise. 

Part 2 of 4.