Saturday, July 4, 2009

No, not EVERYBODY. Sheesh!

The diabetes post yesterday was aimed at people who are obese or well on their way to being obese. I apologize if I didn't make that clear. It was not my intention to tell healthy people of healthy weight to buy a glucose meter and check their blood. Sorry if there was a misunderstanding. The intent of the post was to talk about insulin resistance and how it comes about.

If you DO decide to keep tabs on your blood glucose levels, you may be assured that the process is painless and that only the tiniest droplet of blood is required to test. I hope you won't let the false fear that testing is painful keep you from finding out if you are diabetic. And no, not every day (yet) - just a couple of tests to see if you need to start a program or not. And DO see a doctor if it is high. Get started early.
What's normal? 75-90 if you are young and healthy and haven't eaten. Probably. "Normal" is a term which is a bit flexible. But healthy normal people very seldom will go over 145 even after a meal. Even after a piece of pie. And down it goes really fast after it peaks. These numbers are mg/dl. Milligrams per decaliter. Glucose to blood. But you can switch to the mole scale if you prefer. Meters are flexible too.

What does this mean? If you get a reading of 200, then wake up and smell the roses. If you get a reading of 300, make an appointment with your doctor for a counseling session. Get some tests run: liver function, kidney function, thyroid, and, of course, A1c. He or she will explain that last one to you.

But another important thing is how fast a high number comes down.

There are two types of insulin responses your body makes when you eat. Phase I response and Phase II. Phase I is a store of insulin that can be shot out into your bloodstream rapidly when the body senses coconut cream pie coming down. Or any carbohydrate food, actually. This fast response nips a blood glucose peak in the bud right away and doesn't let it get much higher. But if you eat a bowl of ice cream and your test a half hour later (or even sooner) is, say, 230, it means your Phase one response isn't there. The slower, longer acting Phase II response must not only bring your glucose down below 100 (only over a considerable length of time) but it also is the only thing that is there to knock down the initial deluge of glucose. And it can't. Only time is the answer with Phase II response of insulin.

We'll talk in more detail about Phase I and Phase II responses next time. But for now, if you are obese or well on your way, just test first thing in the morning after fasting all night, and test a half hour or so after you've eaten a meal with carbs in it. Those 2 will give you some initial information on where you stand.

Finally, even if you are healthy and not obese, please go take an A1c (HgA1c) test once a year. That is the most accurate guage of longer-term average blood glucose levels.


  1. I have to disagree that it's painless (and I know, too). There more nerve endings in your fingers and feet than anywhere else.

    But I don't disagree with the sentiment. And unexplained weight gain is another flag that makes testing or speaking with your doctor a good idea. It's good to know the warning signs.

  2. I have a very good friend that has always been heavy. He suddenly started dropping weight. When asked why he said because he was drinking lots and lots of water. He waited a year before getting the weight loss checked out. It was determined he had lost the equivalent of two of himself in weight and had severe diabetes. Because of the long weight he now has some kidney damage and his body did what you were talking about, it started digesting the muscle. I know a lot of people with diabetes, not all of whom are obese.

  3. @Stephanie B - I guess "pain" is relative. Try setting your lancet more shallowly. :) And are you SURE the finger has the most nerve endings of ANYPLACE??? Hmmmmm. :) :)

    @Ettarose - Losing weight with diabetes is called the honeymoon factor. So (oddly) if you LOSE weight without trying, that is a symptom to check out just as much as gaining is.

    Diabetes is a crazy disease. Probably the first symptom to sit up and take notice of is the constant thirst and the frequent urination. It is amazing how many people know that, but still wander around searching for a bathroom instead of searching for a doctor.



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