What should A1C level be? Explore the factors that can lead to high A1C levels even if you don’t have diabetes, from anemia to kidney disease to medication side effects.

Factors That Can Cause High A1C Levels Without Diabetes

While high blood sugar may be a risk factor for diabetes mellitus, high A1C is not exclusively seen in those with the health condition. In fact, people can have a high A1C even if they don’t have a history of diabetes. Let’s explore what the A1C test measures, what lifestyle factors can lead to elevated levels, and what you can do if your A1C is high.

What is the A1C Test Measuring?

Any sugar that enters your bloodstream attaches itself to the hemoglobin on your red blood cells. Hemoglobin is the oxygen-rich protein found in red blood cells. Glucose attaches to the hemoglobin protein in the blood, and the amount of this glycated hemoglobin can be measured by a hemoglobin A1C test. This provides a good proxy of how much glucose on average was present in your bloodstream over a two to three-month period. Over time, high A1C levels may lead to impaired fasting glucose, high blood pressure, obesity, and an increased risk of type 2 diabetes and cardiovascular diseases.

Can You Have High A1C Without Diabetes?

The short answer is yes: it is possible to have high A1C levels without diabetes. Because there are a number of lifestyle factors that can affect your hemoglobin, you’ll want to work closely with your healthcare provider to determine what is causing your high A1C level. From there, you may be able to implement certain dietary and lifestyle changes that can help you improve your level. For some people, setting an A1C goal with your doctor may help you track and lower your levels over time.

7 Reasons Your A1C Might Be High

From vitamin deficiency to certain medical conditions, there are many factors that might lead to a high A1C result. Here are seven of the most common reasons:

1. You Have Anemia

Any interference with your red blood cells or changes in hemoglobin can falsely skew the results of an A1C test. Anemia, which is a condition usually caused by a lack of iron or deficiencies in vitamins B12 or folate, is a good example. According to one study, iron-deficient individuals without diabetes had higher A1C more frequently. When classified by gender, the study found that iron-deficient women were more likely to have higher levels of A1C.

2. You Have Kidney Disease or Liver Disease

Those who suffer from kidney disease may find it more challenging to rely on the efficiency of A1C tests. Kidney disease can cause complications like anemia, malnutrition, and even kidney failure. These factors may affect the results of an A1C test. In the case of liver disease, the A1C test may also not be an accurate predictor of glycemic control due to factors such as anemia, which can affect your red blood cells.

3. Some Medications Can Cause High A1C Levels

Several different medications may interfere with A1C test results. Some can even cause errors in readings or bring up inaccurate results. For example, some anti-retroviral drugs and even over-the-counter drugs like aspirin can cause your A1C levels to appear inflated or inaccurate. Research suggests that chronic or overuse of certain medications is what may skew the results of an A1C test to be high.

4. You Have Disorders Related to the Spleen

Spleen disorders, like splenectomy (removal of the spleen) or hypersplenism (enlarged spleen), can also lead to falsely elevated A1C levels. This is because the spleen plays a role in red blood cell turnover, and changes in red blood cell dynamics can affect the A1C test.

5. You Have a Hemoglobin Variant

Certain hemoglobin variants, like hemoglobin C and hemoglobin S, can interfere with the A1C test and cause inaccurately high results. These variants are more common in people of African, Mediterranean, or Middle Eastern descent.

6. You Have Severe Dehydration

Severe dehydration can cause your red blood cells to become concentrated, leading to a falsely elevated A1C reading. This is because the A1C test measures the percentage of glycated hemoglobin, and dehydration can skew that percentage higher.

7. You Have Severe Stress or Acute Illness

Acute stress or illness can cause a temporary spike in blood sugar levels, which can then translate to a higher A1C result. This is because the A1C test provides an average of your blood sugar over the past 2-3 months, so a recent spike will influence the overall reading.

What to Do If Your A1C is High

If your A1C is elevated but you don’t have diabetes, it’s important to work with your healthcare provider to identify the underlying cause. This may involve additional testing, medication adjustments, or lifestyle changes. With the right approach, you can often bring your A1C back down to a healthy range. Remember, high A1C levels can increase your risk of long-term health issues, so it’s important to take steps to manage them, even if you don’t have diabetes.

7 Reasons Your A1C Might Be High When You’re Not Diabetic

As we explained in our guide to understanding A1C, HbA1C, or A1C, is a measurement used to determine your average blood sugar levels over the last three months. 

While high blood sugar may be a risk factor for diabetes mellitus, high A1C is not exclusively seen in those with the health condition. In fact, people can have a high A1C even if they don’t have a history of diabetes. 

Are you wondering what other factors can lead to high A1C? Let’s explore what the A1C test measures, what lifestyle factors can lead to elevated levels, and what you can do if your A1C is high.

What is the A1C Test Measuring?

Any sugar that enters your bloodstream attaches itself to the hemoglobin on your red blood cells. Hemoglobin is the oxygen-rich protein found in red blood cells. It’s oxygen-rich because it’s in charge of moving oxygen from your lungs to other tissues in the body. 

Glucose attaches to the hemoglobin protein in the blood, and the amount of this glycated hemoglobin can be measured by a hemoglobin A1C test. This provides a good proxy of how much glucose on average was present in your bloodstream over a two to three-month period. 

Over time, high A1C levels may lead to impaired fasting glucose, high blood pressure, obesity, and an increased risk of type 2 diabetes and cardiovascular diseases. A higher A1C percentage may indicate a higher risk of diabetes. 

According to the Centers for Disease Control and Prevention, under 5.7 percent is a regular A1C reading. A reading between 5.7 percent and 6.4 percent may indicate a risk of prediabetes, while values above 6.4 percent can be a sign of diabetes. 

As you review your A1C results with your doctor, it’s good to consider what other variables may be impacting these numbers. For example, the U.S. National Library of Medicine found that adults without a history of diabetes often have A1C levels at six percent or greater. 

However, there can be several reasons for a spike in blood sugar levels, and it’s a good idea to know what’s causing yours. The American Diabetes Association recommends repeating an elevated fasting glucose measurement to confirm the diagnosis of diabetes. 

Can You Have High A1C Without Diabetes?

The short answer is yes: it is possible to have high A1C levels without diabetes. Because there are a number of lifestyle factors that can affect your hemoglobin, you’ll want to work closely with your healthcare provider to determine what is causing your high A1C level.

From there, you may be able to implement certain dietary and lifestyle changes that can help you improve your level. For some people, setting an A1C goal with your doctor may help you track and lower your levels over time.

Now that you’re familiar with the A1C test and what it measures, let’s explore eight reasons why A1C may be high in people who do not have diabetes.

7 Reasons Your A1C Results Came Back High Even Though You’re Not Diabetic

From vitamin deficiency to certain medical conditions, there are many factors that might lead to a high A1C result. Here are seven of the most common reasons.

1) You Have Anemia

Any interference with your red blood cells or changes in hemoglobin can falsely skew the results of an A1C test. Anemia, which is a condition usually caused by a lack of iron or deficiencies in vitamins B12 or folate, is a good example. 

According to one study, iron-deficient individuals without diabetes had higher A1C more frequently. When classified by gender, the study found that iron-deficient women were more likely to have higher levels of A1C.

2) You Have Kidney Disease or Liver Disease

Those who suffer from kidney disease may find it more challenging to rely on the efficiency of A1C tests. Kidney disease can cause complications like anemia, malnutrition, and even kidney failure. 

These factors may affect the results of an A1C test. In the case of liver disease, the A1C test may also not be an accurate predictor of glycemic control due to factors such as anemia, which can affect your red blood cells.

3) Some Medications Can Cause High A1C Levels

Several different medications may interfere with A1C test results. Some can even cause errors in readings or bring up inaccurate results. For example, some anti-retroviral drugs and even over-the-counter drugs like aspirin can cause your A1C levels to appear inflated or inaccurate.

The types of medicines that can lead to false A1C levels include drugs that cause hemolysis, such as dapsone, may interfere with glycation. This study also found evidence that extremely high doses of antioxidants may also affect glycation.

Research suggests that chronic or overuse of certain medications is what may skew the results of an A1C test to be high. However, low doses of medications like aspirin have also been found to cause A1C levels to skew low.

4) You Have Disorders Related to the Spleen

Spleen disorders, like sickle cell or asplenia, may also affect your A1C tests. Some research has shown that A1C levels can appear elevated following a splenectomy, or spleen removal procedure.

These disorders, which are known as hemoglobinopathies, have been shown to affect the accuracy of A1C tests when a patient inherits a hemoglobin variant. If you suffer from any of these conditions, you may start to see false highs in your test results.

5) You Have Low Thyroid Hormone Levels

Thyroid hormones regulate your metabolic rate and the rate at which your body burns calories. The amount of thyroid hormones in the bloodstream can affect your A1C level.

This can potentially cause the reading to fluctuate or give you false results. For example, hypothyroidism, or low thyroid hormone levels, has been shown to lead to an elevated level of A1C.

6) You Have an Abnormal Hemoglobin Variant

Did you know there are a number of variants of hemoglobin? The most common type is hemoglobin A. It’s not common to know your type, but if you’re wondering what’s leading to elevated A1C levels, you may want to check yours with your doctor. 

Type HbAS, which is most commonly observed in people of African descent, is an inherited blood disorder that can lead to false A1C readings that may not accurately reflect your glycemic control.  

To find out what types you have, you might talk to your doctor about considering a blood test called the hemoglobin electrophoresis test. 

7) Your Age

Early studies looking at the impact of age on A1C failed to demonstrate an association due to failures in methodology. However, newer studies like this one studying the effects of age on A1C have found a link between age and higher A1C in individuals with normal glucose and without diabetes.

Researchers believe that changes in the rate of glycation associated with aging may be responsible for this altered A1C reading.

Supporting Healthy A1C Levels

As we’ve discussed, there are many reasons why your A1C may be elevated even when your glucose levels are still within a healthy range. 

Since many of those reasons are related to health conditions like anemia, altered thyroid function, and organ (liver, kidney, spleen) function, it’s important to work with your qualified healthcare provider in exploring any potential deeper issues.

Implementing healthy lifestyle habits like eating a balanced diet, getting regular exercise, getting adequate sleep, and managing your stress are other ways to improve your glucose response and overall well being. For more on A1C levels, visit our Instagram.

Engage with Your Blood Glucose Levels with Nutrisense

Your blood sugar levels can significantly impact how your body feels and functions. That’s why stable blood glucose levels can be an important factor in supporting overall wellbeing.

With Nutrisense, you’ll be able to track your blood glucose levels over time using a CGM, so you can make lifestyle choices that support healthy living.

When you join the Nutrisense CGM program, our team of credentialed dietitians and nutritionists are available for additional support and guidance to help you reach your goals.

Ready to take the first step? Start with our quiz to see how Nutrisense can support your health.

Where Should Blood Sugar Control Really Be for Type 2 Diabetes

Hemoglobin A1C (A1C) is a way of looking at the average blood sugar levels over the preceding two to three months in people living with diabetes. And the American College of Physicians has published a new recommendation suggesting that some people with type 2 diabetes can safely raise their A1C level.

The update suggests the 29.1 million Americans with diabetes should aim for an A1C between 7 and 8 percent, an increase from the 6.5 to 7 percent that national guidelines from the American Diabetes Association (ADA) and the American Association of Clinical Endocrinologists (AACE) recommend.

This change has come with critics, though, including myself. The ADA, AACE and the Endocrine Society have published statements challenging a broad relaxation the A1C target. I strongly agree with these national organizations, which are the voice of doctors who are specialists in treating diabetes. If a person’s blood sugar levels, as reflected in their A1C, are too high, they could be at increased risk over many years for:

• Heart attack
• High blood pressure
• High cholesterol
• Kidney failure
• Leg amputation from infection
• Stroke
• Vision loss

Evidence shows that controlling your A1C to no greater than 7 percent lowers your risk for these diabetes-related complications. So, if the new guidelines are too loose, what targets for diabetes control are best for people with type 2 diabetes? And how can we make it easier for people to achieve their goal?

What’s a safe A1C for me?

Every person living with type 2 diabetes should have their own targets for blood sugar levels and A1C. You should speak with a doctor about what targets are best for you. During your visit, many things are taken into consideration including:

• How many diabetes medications you are taking
• Your age
• Your physical activity levels
• Whether you already have any diabetes complications

Generally, if you haven’t had diabetes for many years and you either have no, or very few, diabetes complications, you should aim for an A1C under 7 percent. However, people who are 65 years or older, have had trouble with severe low blood sugar reactions, or have had advanced diabetes complications might benefit from a more relaxed target A1C closer to 8.

Tips for managing your blood sugar and A1C levels

1. Ask your doctor or diabetes educator about new ways to monitor and treat diabetes

Checking your own blood sugar levels with a fingerstick is becoming easier, as researchers continue to develop new ways to do so. Some of the latest innovations include:

• The FreeStyle Libre: This is the first blood glucose meter that can read your blood sugar levels by waving the meter over an adhesive patch that sticks to your arm, rather than pricking your finger to get a drop of blood. This device records your blood sugar level every five minutes and shows you a graph of the results on its screen.
• New medications: Several new classes of medications have come out relatively recently and can help people with type 2 diabetes maintain their target blood sugar levels. Some of these newer medications also provide protection against cardiovascular and kidney complications that can arise because of diabetes.

2. Make sure you receive diabetes self-care education from a certified diabetes educator

Many health care organizations offer diabetes education, which your doctor can refer you to and is covered by most insurance plans.  Diabetes education is recommended when you are first diagnosed with diabetes, before and during pregnancy with diabetes, and any time your blood sugars are poorly controlled. People who receive diabetes education learn important information, such as lifestyle and medication tips, which helps them successfully take control of their diabetes.

Anyone in the MedStar Health system can access the MedStar Diabetes Institute’s Diabetes Self-Management Education program through their own primary care provider. Furthermore, people with type 2 diabetes and an A1C of 9 percent or higher, can participate in our three-month Diabetes “Boot Camp” upon a referral from your provider, which helps patients lower their A1C by an average of 3 percent. Protocol for the program can be found here.

For those with type 2 diabetes, have you spoken with your doctor about your specific average blood sugar level goal?

Tell us about your experience on Facebook using the #LiveWellHealthy hashtag.

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Application of high-performance liquid chromatography method to determine the level of glycated hemoglobin in patients with diabetes mellitus

Safronova ON, Sergeeva SM, Romanovskaya IO.

Diabetes mellitus (DM) is a systemic metabolic disease that has become pandemic in nature. Over the past 30 years, in terms of the rate of increase in the incidence of diabetes, it has outstripped many infectious diseases, and the number of patients with diabetes in the world has more than doubled and reached 366 million people in 2011. In the Russian Federation, as in all countries of the world, there is a high rate of increase in the incidence of diabetes, according to the State Register, there are 3.357 million patients with diabetes. The most dangerous consequences of the global epidemic of diabetes are its systemic vascular complications: retinopathy, nephropathy, damage to the main vessels of the heart, brain, peripheral vessels of the lower extremities. It is these complications that are the main cause of disability and mortality in patients with diabetes. Treatment of diabetes is aimed at preventing, delaying, slowing down or stopping the development of late complications.

Diagnosis of DM, monitoring the effectiveness of ongoing therapy is not possible without the use of laboratory research methods, among which the study of glycated hemoglobin is currently recognized as the most important.

Glycated (glycosylated) hemoglobin (HbAlc) is a compound of hemoglobin with glucose, which is formed as a result of a non-enzymatic chemical reaction of hemoglobin A contained in red blood cells with blood glucose. The rate and volume of this reaction depend on the average blood glucose level throughout the life of the erythrocyte. Thus, the level of glycated hemoglobin reflects the glycemia that occurred during the lifetime of an erythrocyte (up to 120 days), i.e. according to the content of glycated hemoglobin, one can judge what the concentration of glucose was for the previous 4-8 weeks of the study. In this regard, patients with diabetes mellitus are recommended to conduct a study of the level of glycated hemoglobin once a quarter to monitor diabetes therapy, and 4-6 weeks after changing treatment tactics [1]. There are several forms of glycated hemoglobin: HbAla, HbAlb, HbAlc. The latter form quantitatively predominates and gives a closer correlation with the severity of hyperglycemia, therefore, in the course of prospective studies of DCCT (Diabetes Control and Complications Trial, 1983-1993) it was determined that of all the variants of glycated hemoglobin, only the determination of the HbAlc fraction is clinically significant [2].

Methods for the determination of glycated hemoglobin include electrophoresis, immune tests and chromatography [3]. Considering the narrow range of glycated hemoglobin values ​​used to evaluate the degree of DM compensation and, consequently, the effectiveness of the therapy, the method for determining glycated hemoglobin must meet the following requirements: the method must be certified (NGSP or IFCC certificate); determination of the fraction of glycated hemoglobin HbAlc, intra- and inter-laboratory coefficient of variation should not exceed 4%, the study should be short.

High performance liquid chromatography (HPLC), which is used by the world’s leading laboratories, meets the most modern requirements. The HPLC method has been successfully implemented by Bio-Rad Laboratories in the D-10 analyzer. The company is a world leader in the production of equipment and reagent kits for the determination of glycated hemoglobin. The use of the analyzer D10 “Bio-Rad” allows you to provide the necessary reproducibility of the results of the determination of HbA1c: the coefficient of variation is 1. 5-2.0%. The analyzer is NGSP certified, this program offers standards based on the DCCT (Diabetes Control and Complication Trial) guidelines. The D-10 analyzer is equipped with a built-in quality control system. The use of control allows for a high level of automation. Both venous and capillary blood can be used for analysis. The time of one analysis is 3 minutes.

Our laboratory has accumulated considerable experience in the study of the level of glycated hemoglobin using the Bio-Rad D-10 analyzer. The analyzer allows you to determine the percentage of HbA1c in human whole blood using ion-exchange high-performance liquid chromatography. In this case, the sample is automatically diluted, the sample is injected into the analytical cartridge, where a programmed buffer gradient of increasing ion concentration is created, due to which hemoglobins are separated based on their ionic interactions with the cartridge material. The separated hemoglobins then pass through the flow cell of the photometer, where changes in absorbance are measured at a wavelength of 415 nm. The result of the study is issued in the form of a chromatogram, which clearly shows the various variants of hemoglobin, each of which has its own peak (Fig. 1). The area and percentage of hemoglobin A1c are calculated. The results do not require further recalculations, while HbA1c results obtained on analyzers oriented to IFCC standards must be recalculated using a special formula. We use Bio-Rad calibrators and control materials. Intralaboratory quality control is carried out in each analytical series on two levels of certified control samples. Participation in the system of external quality control of the RF FSMOK allows you to get an assessment of the following parameters: repeatability (intra-serial variation), reproducibility.

Fig. 1. (interday) and correctness.

Conducting a study of the level of HbA1c in the samples submitted to the FSMOK (2 in each cycle of two annual ones) showed that the data obtained by us in all cases were within the range acceptable for the HPLC method. The practical use of the technique in the clinical diagnostic laboratory of the Central Center of Russian Railways began in 2009. Determination of the level of glycated hemoglobin was carried out in patients referred for analysis by endocrinologists of the polyclinic. The volume of research has steadily increased. (Table 1).

Table 1

More than half of the patients (59% of cases) had HbA1c levels above 6%.

Interpretation of the results of determining the level of HbA1c in patients was carried out taking into account modern ideas about the clinical significance of the method. In 2011, WHO approved the use of glycosylated hemoglobin for diagnosing diabetes. The HbA1c level > 6.5% was chosen as a diagnostic criterion; the HbA1c level up to 6.0% is considered normal. At the same time, based on international and domestic experience in the treatment of DM, including the IDF 2005 recommendations; AACE 2009; ISPAD 2009; RAE2011, changes were made to the management of patients with type 1 and type 2 diabetes mellitus. According to these changes, the choice of individual therapeutic targets is based on the values ​​of the HbA1c level, which is regarded depending on the patient’s age, life expectancy, risk of severe hypoglycemia and the presence of late micro- and macrovascular complications. (Table 1).

Table 1

Thus, the results of the test help the doctor to develop a patient management strategy, because determination of HbA1c allows to judge the level of glucose in the blood for the last 6-8 weeks.

Maintaining the level of glycated hemoglobin in the blood at close to normal values ​​helps to reduce the frequency of vascular complications of diabetes or slow down their progression, i.e. to keep the working capacity of patients for a longer time.

References:

1. Diabetes, Hemoglobin A1c as an Indikator of the Degree of Glucose Intolerance in Diabetes, 25(3):230-2, 1976.
2. Algorithms for specialized care for patients with diabetes mellitus (second edition). M., 2006.
3. Ilyin A.V. The level of glycated hemoglobin is a key control parameter in the treatment of diabetes mellitus and the prevention of its complications. Laboratory. 1.2008.

What Should Your Glucose Levels Be? – KETO-MOJO

Blood glucose (also called blood sugar) is the main marker for diabetic risk. The higher the blood sugar level, the higher the risk factors. But blood sugar isn’t just an indicator of diabetes. As blood glucose levels rise, the risk of many other life-threatening conditions increases, most notably heart disease.

The best way to reduce your risk is to maintain normal blood sugar levels. Are you wondering what is the target blood sugar level? The answer is debatable. The American Diabetes Association (ADA) defines certain levels as “normal blood sugar,” but “normal” ADA may not mean “optimal.”

Moreover, measuring blood glucose is not the only (or even the best) way to assess metabolic health (ideal levels of blood sugar, triglycerides, high-density lipoprotein (HDL) cholesterol, blood pressure, and waist circumference; more on this later.) This article helps clarify things. You will learn all about blood glucose: the basics, measurement, management, and what levels are considered healthy.

What is blood glucose?

Glucose, as you probably know, is a form of sugar. Also, you can call glucose by another, more polysyllabic name: carbohydrate. Yes, when you eat starchy carbohydrates or sugar, you are eating glucose. This glucose then passes through the intestines and into the blood.

Blood glucose simply refers to sugar molecules (C6 H12 O6) floating around in your veins and arteries.

Blood glucose is essential for survival. For example, your red blood cells cannot use any other fuel. Your brain also sucks up glucose like a vacuum cleaner – about 120 grams per day. (Only 30 grams per day if it’s in ketosis, though).

Carbohydrates, however, are not necessary for survival. When glucose levels are insufficient (for example, when fasting), blood sugar levels do not drop to zero. Instead, to maintain glucose levels, your body activates two glucose storage mechanisms:

1. Glycogenolysis: Release of stored glucose from muscle and liver cells. (You store about 500 grams of glucose as glycogen.)
2. Gluconeogenesis: When glycogen is depleted, your liver produces glucose from protein and lactate. Cool survival gear. ( Learn more about gluconeogenesis here.)

But in obese and diabetic populations, glucose levels are not restricted. Most likely, this is too much.

Blood sugar, insulin resistance and disease

Since the 1950s, the rate of diabetes in the US has increased more than sevenfold. The driving force behind this epidemic is a sharp increase in sugar consumption.

This is a little more nuanced, however, than more dietary sugar = high blood sugar = diabetes . We need to talk about insulin.

You see, when you eat, your blood sugar rises and a hormone, insulin, is released to move that sugar out of the blood and into safe cells. As a good blood sugar controller, insulin protects your blood vessels from the dangers of hyperglycemia and too high blood sugar levels.

But when sugar is constantly ingested (think daily big sips), the boss is overworked. And when the boss is overworked, he can no longer do his job.

This is called insulin resistance – the inability of insulin to effectively store blood sugar in the muscles and liver cells. In a state of insulin resistance, blood sugar stays too high for too long. This is how type 2 diabetes begins.

In addition to diabetes, insulin resistance underlies many other chronic diseases: heart disease, cancer, Alzheimer’s, you name it. In fact, some researchers now view Alzheimer’s as a case of insulin resistance in the brain.

Later you will learn strategies to prevent insulin resistance. But first, a word about measurement.

How to measure blood glucose

To quantify your metabolic health, you need to measure your blood glucose levels. Common tests include:

• • Hemoglobin A1c (HbA1c) : Provides a rough estimate of “average blood glucose” over the past 2-3 months by measuring the amount of sugar stored in red blood cells.
  • OGTT : An oral glucose tolerance test (OGTT) performed in a laboratory involves taking sugar and measuring its effect on blood sugar levels.
  • Fasting blood glucose level : Blood glucose level after an overnight fast is about 12 hours.
  • Postprandial blood glucose : This is your postprandial blood glucose. This peaks 1 to 1.5 hours after a meal.

Both fasting blood sugar and postprandial blood glucose are simple home blood tests if you have a blood glucose meter. Just prick your finger, insert a test strip and record your result. If you have a Keto-Mojo glucose and ketone meter, you can track your results over time with the free app .

Blood sugar testing is the perfect way to find out how different foods affect your body. Simply measure baseline (at least 3 hours after last meal), eat specific food, then check 1 or 2 hours after eating. You may be wondering which foods raise (or don’t raise) your blood sugar. see it test guide for your bio-personality and learn which foods raise your glucose levels so you can avoid them.

What should your blood glucose be?

That’s the question, isn’t it? For starters, here’s how the ADA categorizes diabetes risk by “fasting blood glucose (FBG) and HbA1c”

• • Regular: FBG up to 100 mg/dL (5.6 mmol/L), HbA1c up to 5.7%
    
  • Prediabetes: FBG 100 to 125 mg/dL (5.6 to 6.9 mmol/L), HbA1c 5.7 to 6.5%
  • Diabetes: FBG greater than 125 mg/dl (6.9 mmol/l), HbA1c 6.5% or greater

But “normal” does not necessarily mean “optimal”. Case in point: A large observational study following 46,578 non-diabetics over a period of seven years found that patients with FBG between 95 and 99 mg/dL (5.3 to 5.5 mmol/L)—considered normal—are likely to develop diabetes 2.33 times higher than those with FBG below 85 mg/dl (4.7 mmol/l)

Therefore, fasting blood glucose is best below 85 mg/dL (4.7 mmol/L). But what to do after eating?

As a general rule: the smaller and shorter the spike in blood sugar, the better. Practically, try to keep your blood sugar below 30mg/dL from baseline for one hour after eating. (If your baseline is 85 mg/dl (4.7 mmol/L), you don’t want to go over 115 mg/dl (6.4 mmol/L)). And three hours after eating, you should be back to baseline. This indicates that insulin – your blood sugar boss – is doing its job.

A word of caution about fasting blood sugar and postprandial blood glucose: they are not the most reliable indicators of metabolic health. For example, stress can cause your liver to release a significant amount of glucose into your bloodstream, so if you’re nervous before a test, it can ruin your results. Poor sleep can have a similar effect. And then there’s “ dawn effect “The natural release of cortisol in the early morning hours, which raises glucose levels, helps the body prepare for growth. Therefore, it is better to wait an hour or more after waking up to take fasting blood glucose, and longer for people with insulin resistance.

That’s why, in addition to measuring blood glucose, you should measure HbA1c (average blood glucose over 2-3 months) and insulin levels. Remember, insulin is your blood boss. Thus, monitoring your insulin response after an oral glucose tolerance test (OGTT) can give a real indication of your metabolic flexibility. Often, a hyperinsulinemic (high insulin level) response to glucose is a precursor to type 2 diabetes.

Controlling your blood glucose

Here are some proven strategies for keeping blood sugar in a healthy range:

• • Exercise: Physical activity increases insulin sensitivity, as opposed to insulin resistance. Both endurance and strength training have been shown to have positive effects.
  • Fasting: Nothing lowers blood glucose and insulin levels like not eating. Start at 16 o’clock intermittent fasts and work your way up as comfort and schedule allow.
  • Keto Diet: The ketogenic diet severely restricts carbohydrates to help minimize the blood sugar response. (Carbohydrates are sugar, after all).
  • Test your blood glucose: Knowing how blood sugar levels fluctuate with different foods will help you make the right choice.
  • Spices and additives: Spice up your food with turmeric and cinnamon – or consider adding berberine – to limit your blood sugar response.
  • Goodnight: Sleep is critical to insulin function. This is the priority.

Relationship between glucose and ketones

Glucose and ketones generally have an inverse relationship. As glucose rises, ketones fall. But blood sugar responds faster to foods than ketones, which is why measuring glucose levels on a ketogenic diet is so important when preparing foods that negatively impact ketosis.

Last word

If you’re not tracking your blood glucose, now is a good time to start graphing your blood sugar, noting your test results. Along with other tests, it provides an important picture of your metabolic health.

The optimal fasting blood sugar level is 70 to 85 mg/dL (3.9 to 4.7 mmol/L). The higher, the higher the risk of diabetes. If you lower your blood sugar, you risk hypoglycemia.

Measuring blood glucose is very easy. All you need is a glucometer (glucometer) and test strips. This is a great tool for identifying foods that are causing your body to have high blood sugar so you can adjust your diet accordingly.

To keep your blood sugar levels under control and closer to your target level, be sure to exercise, sleep, and avoid overeating carbohydrates. To really take it up a notch, consider the keto diet or intermittent fasting. All of these strategies improve insulin function, which in turn improves the blood sugar response. As always, before making major dietary and lifestyle changes due to weight loss or other reasons, it’s important to discuss the idea with your doctor, especially if you’re at increased risk for cardiovascular disease and heart attack.