# Is there a risk to slightly elevated glucose with normal A1c? **URL:** \ **Category:** In My Humble Opinion\ **Created:** [April 21, 2025, 4:58am UTC](https://boards.straightdope.com/t/is-there-a-risk-to-slightly-elevated-glucose-with-normal-a1c/1017292 "2025-04-21T04:58:02Z")\ **Posts on this page:** 20\ **Page:** 5
**Author:** ![Dr.Strangelove](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dr.strangelove/32/6613_2.png) [@Dr.Strangelove](https://boards.straightdope.com/u/Dr.Strangelove)\ **Post date:** [April 28, 2025, 3:13am UTC](https://boards.straightdope.com/t/is-there-a-risk-to-slightly-elevated-glucose-with-normal-a1c/1017292/81 "2025-04-28T03:13:02Z")
I’m at 45% waist ratio, so no problem there. My scale says 12.7% body fat, but I don’t take that too seriously. The past 48 hours I’ve been on a more normal (for me) OMAD schedule and the readings have been very stable, staying within 70-140 the whole time, with the 5th percentile at 86 and the 95th percentile at 120. Average is 99, in line with my A1c within margin of error. Like I said, I’m not too interested in optimizing my glucose curves–there’s a wide range of normal. But it is interesting that I do seem to have pretty stable levels with my natural routine. I had a banana with my coffee earlier and it caused a “spike” on par with dinner the night before. Nothing remotely concerning, and less carbs than the dinner, but maybe the lack of fat/protein made it more apparent. ---
**Author:** ![Beckdawrek](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/beckdawrek/32/3647_2.png) [@Beckdawrek](https://boards.straightdope.com/u/Beckdawrek)\ **Post date:** [April 28, 2025, 3:18am UTC](https://boards.straightdope.com/t/is-there-a-risk-to-slightly-elevated-glucose-with-normal-a1c/1017292/82 "2025-04-28T03:18:05Z")
I’ve found some bananas are “super sugars”. Fruit is iffy. I can kinda tell with the first taste if it might be a problem. And make my choices about it. Sounds like you had a doozie. ---
**Author:** ![puzzlegal](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/puzzlegal/32/3827_2.png) [@puzzlegal](https://boards.straightdope.com/u/puzzlegal)\ **Post date:** [April 28, 2025, 3:19am UTC](https://boards.straightdope.com/t/is-there-a-risk-to-slightly-elevated-glucose-with-normal-a1c/1017292/83 "2025-04-28T03:19:41Z")
I was surprised at how little apples increased my glucose levels. The apples were pretty sweet, too. ---
**Author:** ![Beckdawrek](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/beckdawrek/32/3647_2.png) [@Beckdawrek](https://boards.straightdope.com/u/Beckdawrek)\ **Post date:** [April 28, 2025, 3:23am UTC](https://boards.straightdope.com/t/is-there-a-risk-to-slightly-elevated-glucose-with-normal-a1c/1017292/84 "2025-04-28T03:23:21Z")
Apples have high fiber. Slows the absorption. I like to have them if my meal might be late. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [April 28, 2025, 12:38pm UTC](https://boards.straightdope.com/t/is-there-a-risk-to-slightly-elevated-glucose-with-normal-a1c/1017292/85 "2025-04-28T12:38:53Z")
> [@puzzlegal](#): > > _right now_ And CGM focuses attention on that “right now”. Yes if you’ve just eaten aerobic exercise will right now blunt your glucose rise. Even a good brisk walk after a meal. Its improvement on your glucose regulation 24 7 _is_ more mediated by fat loss. Strength training does more to impact insulin resistance but that is less seen in the right now of the activity. I am on these boards a broken record that any exercise is good and that a balanced approach is best yet. And that is easiest to keep up with if you find exercise one enjoys. This is true looking at overall glucose control (beyond the right now) as the sole lens, and there are few of us for whom glucose control is the only lens that matters. If a CGM result leads one to conclude that strength training is not of benefit because they see no positive impact or even a spike up in the right now then it is giving misleading information. ---
**Author:** ![LSLGuy](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lslguy/32/5813_2.png) [@LSLGuy](https://boards.straightdope.com/u/LSLGuy)\ **Post date:** [April 28, 2025, 1:38pm UTC](https://boards.straightdope.com/t/is-there-a-risk-to-slightly-elevated-glucose-with-normal-a1c/1017292/86 "2025-04-28T13:38:34Z")
> [@Beckdawrek](#): > > I’ve found some bananas are “super sugars”. IME the glycemic-ness of bananas changes massively based on how ripe they are. A banana with some green still on the skin that’s distinctly stiff to bite through is mostly a starchy low-glycemic food. When they’re at peak ripeness, soft & succulent, they’re much sugary-er. And if they’ve got a bunch of brown spots on the peel and are almost more mush than substance to eat, well, you’d do as well to just mainline a cup of table sugar. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [April 28, 2025, 3:52pm UTC](https://boards.straightdope.com/t/is-there-a-risk-to-slightly-elevated-glucose-with-normal-a1c/1017292/87 "2025-04-28T15:52:10Z")
> [@Dr.Strangelove](#): > > Last night (after I ate) it reported a “glucose spike” I want to return to this in context of this: > [@Dr.Strangelove](#): > > researchers potentially have a wealth of new data. Dexcom says they don’t sell your data but they do use it for internal research Of course they would to correlate by sub population, who has completely normal sugars, who elevated FBG, who elevated hgbA1c, but this does seem like a missed opportunity. Instead of labeling something normal as “a spike” they could report back how an individual’s curves compared to the population of others with those motivations to purchase a CGM from them. That would be more … interesting. ---
**Author:** ![puzzlegal](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/puzzlegal/32/3827_2.png) [@puzzlegal](https://boards.straightdope.com/u/puzzlegal)\ **Post date:** [April 28, 2025, 3:55pm UTC](https://boards.straightdope.com/t/is-there-a-risk-to-slightly-elevated-glucose-with-normal-a1c/1017292/88 "2025-04-28T15:55:38Z")
Maybe they’ll do that after they actually more data. That would be interesting. Gamify your health info! Are you in the top 20% of users? ---
**Author:** ![Dr.Strangelove](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dr.strangelove/32/6613_2.png) [@Dr.Strangelove](https://boards.straightdope.com/u/Dr.Strangelove)\ **Post date:** [April 28, 2025, 7:29pm UTC](https://boards.straightdope.com/t/is-there-a-risk-to-slightly-elevated-glucose-with-normal-a1c/1017292/89 "2025-04-28T19:29:39Z")
> [@LSLGuy](#): > > A banana with some green still on the skin that’s distinctly stiff to bite through is mostly a starchy low-glycemic food. The banana in question was actually still a tad green, and yet still seemed to cause a (mild) spike. Well, I bought a bunch and as the week progresses they’ll ripen and I’ll be able to see if it gets more extreme. The biggest factor seems to be what the sugars are paired with. I had butter chicken last night, and the sauce claimed to have ~160 cal of sugars, but paired with 1 lb of chicken the meal barely registered on the meter. > [@DSeid](#): > > Of course they would to correlate by sub population, who has completely normal sugars, who elevated FBG, who elevated hgbA1c, but this does seem like a missed opportunity. Like **puzzlegal** said, maybe with more data they’ll be able to do these sorts of things. They do ask for some basic personal information like sex and age, as well as if you have (pre)diabetes. They didn’t ask me for an A1c figure but maybe they do for diabetics. And in any case, it can be inferred from the long-term data. ---
**Author:** ![Dr.Strangelove](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dr.strangelove/32/6613_2.png) [@Dr.Strangelove](https://boards.straightdope.com/u/Dr.Strangelove)\ **Post date:** [April 28, 2025, 8:35pm UTC](https://boards.straightdope.com/t/is-there-a-risk-to-slightly-elevated-glucose-with-normal-a1c/1017292/90 "2025-04-28T20:35:41Z")
Today’s banana, still a tad green but a little more ripe than yesterday: another glucose spike. Again, nothing abnormal looking, but it peaked at 154 from a baseline of 85. Surprising that one banana can have a much larger effect than a whole meal. Maybe I’ll eat one with dinner as well and see if the behavior is any different. ---
**Author:** ![Beckdawrek](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/beckdawrek/32/3647_2.png) [@Beckdawrek](https://boards.straightdope.com/u/Beckdawrek)\ **Post date:** [April 28, 2025, 8:45pm UTC](https://boards.straightdope.com/t/is-there-a-risk-to-slightly-elevated-glucose-with-normal-a1c/1017292/91 "2025-04-28T20:45:56Z")
Well, you’ve successfully found your glucose Achilles heel. From experience, Mangoes won’t work for you either. Grapes break my balance. I’ve tried them all. 4 grapes or 10 grapes doesn’t matter. I fly into a spike almost immediately. They have no mechanism to digest slowly. I suppose. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [April 29, 2025, 1:04am UTC](https://boards.straightdope.com/t/is-there-a-risk-to-slightly-elevated-glucose-with-normal-a1c/1017292/92 "2025-04-29T01:04:31Z")
> [@Dr.Strangelove](#): > > maybe with more data Maybe. But personally after the 23 and me debacle I’m not so eager to share my personal medical information with a private company not restrained by HIPPA, no matter what they say their current policy is. Someday Apple will perfect their optical glucose sensor and incorporate it into their iWatch. Not sure I am comfortable with them having that sort of data. It is bad enough that Garmin knows my VO2max! 😁 Re banana - maybe they an endurance event favorite for a reason? ---
**Author:** ![Dr.Strangelove](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dr.strangelove/32/6613_2.png) [@Dr.Strangelove](https://boards.straightdope.com/u/Dr.Strangelove)\ **Post date:** [April 29, 2025, 1:16am UTC](https://boards.straightdope.com/t/is-there-a-risk-to-slightly-elevated-glucose-with-normal-a1c/1017292/93 "2025-04-29T01:16:31Z")
> [@DSeid](#): > > a private company not restrained by HIPPA A certain degree of paranoia is probably justified, but Dexcom is subject to HIPAA, according to their privacy policy: > **[Stelo privacy policy | Stelo by Dexcom](https://www.stelo.com/legal/privacy-policy)** > > Stelo privacy policy > \*\*\*\*This includes the removal of identifiers from protected health information required under the Health Insurance Portability and Accountability Act (“ **HIPAA** ”), 45 CFR § 164.514(b)(2). We will not attempt to reidentify you or anyone else from this de-identified data, and if we disclose it to third parties, we will require that they not attempt to reidentify you or anyone else from the de-identified data. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [April 29, 2025, 1:33am UTC](https://boards.straightdope.com/t/is-there-a-risk-to-slightly-elevated-glucose-with-normal-a1c/1017292/94 "2025-04-29T01:33:09Z")
Yeah maybe paranoid but I don’t read that as them counting as an entity required to follow HIPPA just that the current policy does. It also says this: > In limited circumstances, recipients may include, (1) in the event of a sale, assignment, merger, consolidation, corporate reorganization, or transfer, to the buyer, assignee, or transferee. … Which is the 23 and Me concern. ETA Looking more they do [state](https://www.dexcom.com/notice-of-privacy-practices) they are considered healthcare providers and therefore subject. ---
**Author:** ![LSLGuy](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lslguy/32/5813_2.png) [@LSLGuy](https://boards.straightdope.com/u/LSLGuy)\ **Post date:** [April 29, 2025, 1:55pm UTC](https://boards.straightdope.com/t/is-there-a-risk-to-slightly-elevated-glucose-with-normal-a1c/1017292/95 "2025-04-29T13:55:37Z")
> [@Dr.Strangelove](#): > > The banana in question was actually still a tad green, and yet still seemed to cause a (mild) spike. Well, I bought a bunch and as the week progresses they’ll ripen and I’ll be able to see if it gets more extreme. Starch is still a simple carb. Just not quite as glycemic as sugar is. Some spike is to be expected. IME about 1/2 a typical tad-greenish banana is about all I can stand with an otherwise simple-carb-free meal. And ref **Beck** , IME grapes are teeny glycemic nuclear bombs. The maximum safe dose is zero. For me. > [@Dr.Strangelove](#): > > The biggest factor seems to be what the sugars are paired with. I had butter chicken last night, and the sauce claimed to have ~160 cal of sugars, but paired with 1 lb of chicken the meal barely registered on the meter. That has been my experience as well. Eating something carb-less along with whatever serving of carbs produces a smaller slower rise. It also helps blunt the urge to binge on whatever the carbs are. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [April 29, 2025, 5:49pm UTC](https://boards.straightdope.com/t/is-there-a-risk-to-slightly-elevated-glucose-with-normal-a1c/1017292/96 "2025-04-29T17:49:07Z")
For anyone really wanting to get into the weeds with a deep dive analysis of the appropriateness of widespread use of CGM in “people not living with diabetes” (PNLD in the article) the following is a fascinating comprehensive review. @Dr.Strangelove I suspect you’ll enjoy it. Wow lots there! [https://onlinelibrary.wiley.com/doi/10.1111/dme.15369](https://onlinelibrary.wiley.com/doi/10.1111/dme.15369) The short version is in the discussion. GV is glucose variability. > [@](#): > > This current review underscores a lack of compelling evidence for the utility of CGM in PNLD. Despite their popularity CGMs currently appear not to be suitable for repurposing from a device for diabetes management to a comprehensive tool for metabolic health improvement and disease prevention at present. … > > … As it stands, notions suggesting minimising GV can be protective of T2DM or other non-communicable diseases feed off anecdotal evidence. … > > … Despite CGMs not being officially endorsed for abnormal glucose detection or shaping behavioural changes in PNLD, marketing narratives suggesting the opposite abound increasing off-label demand for these devices.[9](https://onlinelibrary.wiley.com/doi/10.1111/dme.15369#dme15369-bib-0009)S15 Such claims risk being labelled ‘misleading’ in the face of significant evidential gaps as outlined in this review. Addressing regulatory and research gaps remains imperative to prevent the continued misinformation risk to PNLD. > > Particularly concerning is the lack of studies inquiring into the unanticipated psychological impact of commercial CGM use.[3](https://onlinelibrary.wiley.com/doi/10.1111/dme.15369#dme15369-bib-0003) Excessive glucose monitoring has the risk of unintentionally creating maladaptive dietary changes in PNLD (e.g., exclusion of health food to avoid glucose excursion; whole grain bread), especially if inexperienced users struggle to understand what the glucose excursions actually mean. … > > … CGMs, in their present form, appear not appropriate to optimise metabolic health or prevent metabolic conditions in PNLD. The available studies lack comprehensive assessments of long-term benefits and fail to prove the clinical significance of the interventions on health outcomes at present. … A dense review but really comprehensive! ---
**Author:** ![Beckdawrek](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/beckdawrek/32/3647_2.png) [@Beckdawrek](https://boards.straightdope.com/u/Beckdawrek)\ **Post date:** [April 29, 2025, 6:01pm UTC](https://boards.straightdope.com/t/is-there-a-risk-to-slightly-elevated-glucose-with-normal-a1c/1017292/97 "2025-04-29T18:01:22Z")
Not to be really negative but CGMs, the pods and other diabetic supplies will soon be hard to get for PLD. I’m sure they’re all made overseas. So off label use may be detrimental to those who _need_ the devices. Anyway, if you don’t live with diabetes you will not respond to foods in the way a diabetic person does. I can’t see where in can set a baseline you can trust. As soon as disease sets in all things change, metabolically. For Science, I suppose its fine to experiment. Now. Don’t make my expenses go up. Or make availability difficult. Please. ---
**Author:** ![Dr.Strangelove](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dr.strangelove/32/6613_2.png) [@Dr.Strangelove](https://boards.straightdope.com/u/Dr.Strangelove)\ **Post date:** [April 29, 2025, 9:20pm UTC](https://boards.straightdope.com/t/is-there-a-risk-to-slightly-elevated-glucose-with-normal-a1c/1017292/98 "2025-04-29T21:20:56Z")
> [@DSeid](#): > > @Dr.Strangelove I suspect you’ll enjoy it. Wow lots there! Thanks, that was very interesting. I do still think CGMs have useful potential in non-diabetics but not the way they’re frequently used. I think I’m taking the right approach here, which is to basically reverse the direction of inference. If a banana causes a glucose spike, the conclusion is not to stop eating the banana. It’s that since a banana is obviously a perfectly normal thing to eat for a non-diabetic, the effect should also be considered normal (in me, at least). I can see that eating a banana in isolation produces a modest spike, which there’s no need to do anything about, but possibly if it gets more extreme it’s worth investigating. > [@Beckdawrek](#): > > As soon as disease sets in all things change, metabolically. Well, that’s the point. I’m healthy now and can consider this the baseline. If things change dramatically, then it is worth investigating. Just like I’d consider a 10 lb weight increase (or loss) a problem since I’ve spent a few decades now at 125-130 lbs. The absolute numbers aren’t such a big deal as keeping track of changes. But I promise not to buy more CGMs for a while 🙂 . ---
**Author:** ![puzzlegal](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/puzzlegal/32/3827_2.png) [@puzzlegal](https://boards.straightdope.com/u/puzzlegal)\ **Post date:** [April 29, 2025, 10:00pm UTC](https://boards.straightdope.com/t/is-there-a-risk-to-slightly-elevated-glucose-with-normal-a1c/1017292/99 "2025-04-29T22:00:11Z")
Perhaps i am naive and overly trusting of my fellow human beings, but i think the solution to “people might rely too much on this one metric” is to make more metrics available, not to artificially restrict what people are able to learn about themselves. 🤷‍♀️ ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [April 29, 2025, 11:57pm UTC](https://boards.straightdope.com/t/is-there-a-risk-to-slightly-elevated-glucose-with-normal-a1c/1017292/100 "2025-04-29T23:57:38Z")
I would not call it either “naive” or “trusting” … but possibly not applying what you likely actually know about human behavior in other realms. We humans can only focus a few outcomes at a time and when you are in charge of any quality improvement initiative, be it corporate, health system, or individual health, you are wise to frame two or three goals as the metrics to follow. So the chosen few should ideally be ones that actually _matter_. Not merely ones that are convenient to see. (And again there is only speculation that minimizing glucose variability has any health impact in people not living with diabetes.) It is general in getting by in the world, especially today, our problem is not lack of information, it is an over abundance of information, it is filtering information so that we _focus our attention_ on that which is high quality and _matters_. A fever can be a sign of some disease; checking your temperature every hour and being concerned that you are not 98.6 all day, trying to take actions to keep your temperature curve flatter, is still not a good idea. (Nor does measuring your pulse ox several times a day as one of making “more metrics available” improve the health of a typical person.) Heck even blood pressure falls in this category. Elevated BP is unequivocally a risk factor. If modestly elevated lowering it to a normal range is a great goal. But continuous blood pressure monitoring and avoiding things that in the moment make it go up a smidge, like anaerobic exercise might do, is not likely very helpful. Even if it is interesting. But hey, more metrics more better! Don’t restrict! > [@Dr.Strangelove](#): > > If things change dramatically, then it is worth investigating. To be very clear: I respect the curiosity you had and your reasoned cautious thought process. But I strongly suspect that if there ever is a point that you notice your personal CGM curves changing meaningfully you’d have also seen changes on your FBG and/or HgbA1c. [Previous page](https://boards.straightdope.com/t/is-there-a-risk-to-slightly-elevated-glucose-with-normal-a1c/1017292.md?page=4) [Next page](https://boards.straightdope.com/t/is-there-a-risk-to-slightly-elevated-glucose-with-normal-a1c/1017292.md?page=6)