Hey, Medina! Know Your Numbers
Here’s the first of a few posts for our members to catch up on health knowledge concerning the “numbers” which are good to know about ourselves. As an endocrinologist (a medical specialist dealing with diabetes and other health disorders common today), I counsel patients about these numbers all the time. Today I’ll say a few words about what I deal with most often: the glucose numbers. In time, I’ll discuss blood pressure, cholesterol, vitamin D, and other topics which may be suggested by fellow living well colleagues!
What’s a Blood Sugar?
Glucose is the basic energy unit the human body uses for fuel. It is also a very simple form of sugar (sucrose and fructose are other forms). It’s important that body fluids such as the bloodstream run on a fairly constant concentration of glucose. Too low (hypoglycemia), and organs like the brain don’t function well and we don’t feel well and can get confused (or worse). Too high (hyperglycemia) and the high glucose levels can cause damage to the body over long periods of time, which is what can happen in uncontrolled diabetes. Diabetes is the condition which is associated with high glucose levels.
So, what should we know about these numbers? Well, they go up and down all the time so it can be confusing! One way to get a handle on them is to know what’s appropriate when we haven’t eaten for a long time, such as overnight. This is referred to as the fasting blood glucose level. The normal fasting blood glucose level is less than 100 mg/dL (mg/dL is milligrams of glucose per deciliter of serum from the blood). If the fasting glucose is 126 mg/dL or above on more than one occasion, that’s consistent with diabetes. Results in the 100-125 mg/dL range are consistent with pre-diabetes, an important condition to recognize because it’s an important risk factor for both diabetes and heart disease.
Another way to look at glucose is to examine how high the glucose is going after a meal or after drinking a certain amount of glucose such as for a diabetes test. The normal two-hour after-meal glucose level in non-pregnant adults is less than 140 mg/dL. Two-hour values greater than 200 mg/dL are consistent with diabetes, and results in the 140-200 mg/dL range are consistent with pre-diabetes.
What’s an A1C Test?
A different way of looking at glucose control is to measure the A1C level in the blood. The A1C looks at how much (the percentage, actually) glucose is “stuck” to a particular part of the hemoglobin molecule in the red blood cells. This test actually gives an idea of the average of all the glucose levels for the past 2-3 months. A normal A1C is less than 5.7%. An A1C of 6.5% or greater suggests diabetes. A1C values in the 5.7%-6.4% range are consistent with prediabetes. The A1C test does not require fasting, and is commonly used by persons who have diabetes to monitor how well their diabetes is being treated over time. The A1C test is also approved as a diagnostic test for diabetes.
Please feel free to leave comments and questions!
Richard Shewbridge, MD
Anyone with risk factors for diabetes (such as overweight, family history of diabetes, etc.) should be tested every 3 years. Those without risk factors should be tested every 3-5 years starting at age 45.
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