Blood sugar balance.
I know you’ve heard of it and maybe you’ve had yours tested and told your blood sugar was borderline high – but you don’t know exactly how high or what that even means.
Today I’m going to help you make sense of your blood sugar test values so we can get focused on preventing conditions like diabetes and pre-diabetes.
What you’ll learn in this video:
0:35 What is fasting glucose?
1:44 What do the different ranges of fasting glucose mean?
2:44 The importance of knowing your fasting glucose values
3:20 How often should you get your blood sugar tested & who should get it tested?
4:11 How to know if your blood sugar levels are optimal for you
4:44 How to proactively address impaired fasting glucose levels
5:21 What is hemoglobin A1C (HbA1C)?
6:25 What do the different ranges for HbA1C values mean?
6:55 A naturopathic approach to improving blood sugar levels
7:46 Other testing for blood sugar balance
8:37 A naturopathic approach to blood sugar testing & management
https://youtu.be/9d2kT3sI4DQ
Fasting glucose – also known as Fasting Plasma Glucose (FPG) or Fasting Blood Sugar (FBS)
Fasting glucose gives us an idea of how your body handles blood sugar. This tells us how well your body responds to insulin one of the main hormones involved in blood sugar balance. If you want to know more about insulin please make sure you watch this video about insulin from my Know Your Hormone Series. For fasting glucose testing, you need to fast (no food or drink) for at least 8 hours before the test. (1)
So let’s talk about fasting glucose values:
Normal Range Fasting Glucose: 3.6 – 6.0 mmol/L (2)
Pre-diabetes or Impaired Fasting Glucose: 6.1 – 6.9 mmol/L (2, 3)
Diabetes Fasting Glucose: ≥ 7.0 mmol/L (2, 3)
So what is borderline high blood sugar?
When your doctor tells you that you have borderline high blood sugar – they could mean that you’re in the impaired fasting glucose range or they could mean you’re right at 6.0 mmol/L. You see, you really don’t know which it is unless you get a copy of your blood work or ask your doctor for the actual number and write it down or take a picture of the results with your phone.
Compare your blood sugar test results over the years
If last year, your fasting glucose was 4.0 mmol/L and this year it’s 5.8 mmol/L which is still in the normal range, I would definitely ask some questions around food intake, exercise and stress since all of these can affect your body’s ability to handle blood sugar.
In my experience, there’s no need to wait until your fasting glucose rises to 6.3 mmol/L (impaired fasting glucose) to get motivated to do something about it. If you wait and do nothing because you’re told everything’s normal, the chances of that number coming back down into an optimal normal range while eating and exercising (or not exercising) the same as you always have, is not very good.
Remember, these blood tests are a sign of what’s going on inside your body, which is a good indication of how well you are taking care of your body.
Hemoglobin A1C (HbA1C)
Now the next test for blood sugar levels that we want to discuss is HbA1C. I know a lot of you have had this test done and have no idea what it is, or how it’s related to blood sugar levels. So I’m going to explain it to you.
Hemoglobin A1C gives us an idea of your blood sugar levels over the last 2-3 months (1). You don’t have to be fasting to have this test done, but it’s fine if you have fasted, as this is often ordered with fasting glucose. Now if you watched my video from week 2, then the word hemoglobin should sound familiar. It’s a crucial protein in our red blood cells. From a chemistry point of view, glucose is a pretty large molecule and if the levels get too high in your bloodstream it can stick to things like protein. Hemoglobin is a protein, and if glucose levels are high enough in the blood, it will stick to the hemoglobin. If we want to get fancy we call it glycated hemoglobin – and that is what HbA1c is (1). It’s a percentage of hemoglobin that has glucose stuck to it – which we do not want, because when glucose sticks to something then that molecule can’t work efficiently.
So let’s talk about normal HbA1C ranges:
Normal range HbA1C < 5.5% (2, 3)
At risk HbA1C: 5.5 – 5.9% the body is having trouble utilizing blood sugar levels (2, 3)
Pre-diabetes: 6.0 – 6.4% the body is having even more trouble utilizing blood sugar levels (2, 3)
Diabetes: ≥ 6.5% (2, 3)
So knowing those ranges, if you are told your HbA1C is 6.0% which is pre-diabetic, that’s going to be a pretty good motivator to change some nutrition & lifestyle habits.
But what about if it’s 5.5%?
Would you watch and wait until next year or do something about it?
The choice is really up to you. But for my patients – I encourage them to do something about it, and we create a plan that helps them do just that.
What other testing should I consider?
The oral glucose tolerance test (OGTT) measures how well you manage blood sugar after consuming a specific amount of sugar. It reflects post-prandial blood sugar levels, or blood sugar levels after a meal providing a good idea for how well your body secretes and responds to insulin.
Fasting insulin is another test to consider as it can provide more information as to how insulin is functioning when you are not quite at the diabetes stage. I find it most helpful when there is high normal fasting glucose or impaired fasting glucose, at risk or pre-diabetes HbA1C or other conditions with suspected insulin resistance like polycystic ovarian syndrome (PCOS).
My proactive naturopathic approach to blood sugar testing
My goal with patients is always to work proactively:
- Identify increasing levels of fasting glucose and HbA1C
- Improve nutrition and exercise habits. A LOT can be done with nutrition and exercise – but you need someone to help you individualize what your body needs and help you determine what’s going to work best for you.
- Introduce nutritional supplements and/or herbs to help improve your body’s ability to balance blood sugars if necessary.
- Retest fasting glucose and HbA1C in 3-6 months depending on your individual test results and see adjust your treatment as necessary.
Who needs to be screened for pre-diabetes and diabetes?
- Anyone with the classic signs of high blood sugar (hyperglycemia):
- Increased appetite
- Increased thirst
- Increased urination
- Fatigue (1)
- Blurred vision (1)
- Slow-healing infections (1)
- Family history of diabetes: parents, sibling
- History of gestational diabetes (diabetes when pregnant)
- Cardiovascular disease (high blood pressure, stroke, heart attack)
- Women with/or with suspected polycystic ovarian syndrome (PCOS)
- People who are overweight with other signs of insulin resistance (1, 2)
Thank you
I hope you’ve enjoyed this month’s Lab Tests Explained video series and found the motivation to take control of your health! Thank you to all who have taken the time to watch, share and comment on these videos. You can always connect with me on Facebook, Instagram or YouTube to let me know what you think. And if there are any ideas you would like to see for future video series, I’d love to hear it!
Join me next week for a new video series that you’re not going to want to miss!
Take care until then!
References
- https://labtestsonline.org/tests/hemoglobin-a1c
- LifeLabs normal blood value ranges
- http://guidelines.diabetes.ca/docs/CPG-quick-reference-guide-web-EN.pdf#page=2