a question about healthy blood glucose levels for diabetes

Factual Questions
1

I’ve just recently had bloodwork done, including a series of tests to check on my lungs, liver, etc after having difficulty breathing a few weeks ago. Without getting into too much detail about those tests (I’m okay, at least for now), I just looked at my blood glucose levels and see my fasting blood sugar is at 89 mg/dL, which is within the healthy range. Nevertheless, this number for some reason worries me because it is too close to the “prediabetes” range (at least by my estimation).

I didn’t have a chance to ask my doctor in detail about this reading because of the more urgent medical issues at the time. But now that I’ve finally been able to consider it more fully, I’ve looked up some info online and it seems that the American Diabetes Association considers 90 to 100 mg/dL as “high normal.” This really scares the hell out of me now. I don’t really understand the basis of the range and if one healthy number is better than another or if they are all created equal. In other words, is it more ideal to be at 82 mg/dL than at 89? If so, is there a way to decrease my reading to a more comfortable level?

Sorry if I put this in the wrong forum. I considered Mundane Pointless Stuff . . . but came here since it’s actually a question.

2

I’m a doctor who takes care of diabetics. I’m delighted to see my patients with a number like 89. Sometimes that can even be too low, depending on what med they’re on and when it’s taken, as it could indicate a risk for hypoglycemia coming on, under certain conditions.

What blood sugar levels are acceptable? Depends who you ask. The ADA recommends 2 hour post-prandial (after eating) blood sugars be under 180. The American College of Endocrinology recommends they be under 140. Frankly, I go with the ADA’s recommendation mainly because shooting for that 140 causes hypoglycemia more often. Blood sugars that are too low can be devastating and cause serious damage too.

I’d recommend re-visiting the American Diabetes Association’s website and looking at some more of their patient education materials.

ETA, I would not worry about a fasting level of 89 in a non-diabetic. I only get interested when it goes over 100, in most cases

3

Previous thread asking the same question:

4

How long did you fast before the blood was drawn? Did you follow the standard advice given before having these types of blood tests? (which I believe is fasting 12hrs, although I may be wrong). If you fasted less than that, it may have impacted those one-time readings. And you’re still normal anyway, just on the higher end.

5

How long should one fast before an accurate “fasting glucose level” can be determined? Is it 12hrs?

6

12 hours is ideal, most diabetes professionals will accept 8.

7

In our pregnant diabetic patients, we like the 8 to 12 hour fasting blood glucose level to be under 100. We would be very pleased with an 89 and tell what a good job you are doing!

8

My fasting blood glucose ranges between 97 and 102…or so. I’m prediabetic, but I control it through diet and exercise, when I don’t need knee surgery. I need to do a tad better, but am doing ok. (My A1C is in the normal range, at least…)

89 is nothing to worry about. I’d be feasting on spaghetti and chocolate cake if I had an 89. :slight_smile:
-D/a

9

89 is a great level for someone who is diabetic.

For a non-diabetic, it is indeed high normal. If you are overweight, sedentary, etc., now would be the time to do something about it.

My doctor told me my level should be below 80. He has admittedly high standards for what he considers healthy.

10

Have your Dr. check your A1C level, which is your average blood sugar level for the last 2 to 3 months. It will give you a better idea on where your glucose levels are at.

11

Levels below 70 can cause symptoms of hypoglycemia, and there’s not much room between that and 80. If you consider 70-100 to be the normal range for non-diabetics, then in the 80’s is perfectly normal and below 80 is lower than average although still normal. I also doubt there’s evidence that you do any good by aiming for extremely low numbers. There’s still debate, but recent research in the critical care field is pointing towards tight glucose control in some situations worsening outcomes, not universally improving them as was assumed less than a decade ago. Many policies and positions were formed on the basis of a handful of studies with extremely limited scope (several of cardiac surgery patients with extended ICU stays) which now appear to not be generalizable to the larger ICU and hospital populations. I’m not saying that’s the case in other situations, but assuming that more of something (like glycemic control) is better doesn’t always work out. Certainly, a healthy diet and exercise routine are beneficial, but chasing the numbers in a healthy person may not be if it leads to prescription of medications, excess anxiety, etc. Just sayin’.

Just to muddy the waters, the evidence is not great for fasting blood glucose being the best test out there, blood sugar-wise.
Also, I don’t knowif this has been more recently refuted, but

And there are other studies showing that fasting blood glucose is not the best measure of diabetic control or predictor for bad outcomes such as heart attacks - measurements that show how your body reacts to glucose input, such as 2-hr glucose challenge test or postprandial tests by diabetics, are more predictive.

A general spiel about lab testing:

If you WERE to get a blood test result that was out of whack and didn’t fit the situation, the first thing to do is to RECHECK IT. Lab techs can be wrong, machines can be wrong, samples can be damaged or improperly collected, etc. One blood sample is only one point in time and may represent an aberrant datum or moment at which the body was just making corrections to bring itself back into homeostasis. I almost put my cat through a series of expensive, invasive, tests because one of her liver values was elevated. Fortunately, the vet had the common sense to say that, before we did the additional blood work, ultrasound, biopsy, etc., we were going to recheck her basic chemistry. It came back perfectly normal the second time and she has never shown any sign of liver disease before or since (including repeat bloodwork). This is not the only time I have seen this happen. Finally, reference ranges are just averages (plus or minus a couple standard deviations), and a few normal people will be outliers. With any screening test when a disease or condition is rare (a couple percent in the population or less), you are going to get more false positives than true positives.

12

Insurance might not cover the test, given the fact that the OP’s got a normal fasting blood sugar level. I wouldn’t order it on a patient without more indicators than are given by the OP.

13

You can buy A1c testing kits at WalMart and Target for about $10-$20. For a bit more $$, you can get one that does it instantly; the cheaper ones require you to send in your blood sample to a lab. By all reports, they’re both pretty accurate, but the mail-in one is a bit more so. I’ve done the mail-in ones on the same day that I get the doc to do an A1c at the lab, and they have come back within .1 or .2 of a point of each other. That’s good enough for me.

Alternatively, if the OP would rather see blood glucose level, he could go buy a cheapo blood glucose monitor. Again, WalMart and Target both have their store brand monitors and strips for relatively cheap, and people like them.

14

I believe I fasted for eight to ten hours, up until the blood was drawn.

Thanks for all the great answers and the links. I’m going to save this information for future discussion with my doctor.

15

I have all the symptoms of hypoglycemia, but I test dead on normal every time with a morning fasting glucose. I have a co-operative family doctor now, and he has given me a requisition for a random glucose test, to be taken when I’m shaking and feeling unreal and nauseated from hunger. A fasting glucose test is useful, but it’s not the whole story of blood glucose.