Many mainstream physicians look at fasting blood glucose as the primary indicator of a person's diabetes related risk. However recently published scientific literature points to postprandial (after-meal) glucose and A1C as equally important. Postprandial glucose can be high and dangerous even in people with normal fasting glucose levels. Fasting blood sugar is often the last to go out of range. That is why everyone, not just diabetics, need to be alert to postprandial glucose and take necessary steps to address the underlying metabolic dysfunction. Elevated blood sugar can damage vital organs and take years off your life without you even being aware there is an issue.
A Glucose Tolerance Test measures blood glucose both when fasting and again two hours after a standardized glucose drink. To pass the postprandial glucose test, blood glucose should not rise above 140mg/dL at the two-hour mark. This indicates both potent pancreatic insulin secretion and healthy uptake of glucose from the blood. While the glucose tolerance test is ordered by your physician if they suspect an issue, you can also test your 2-hour post-meal glucose levels using a meter and test strips yourself.
Postprandial levels between 140 and 200mg/dL indicate pre-diabetes, a condition in which most of the risk factors for diabetes and its complications, including cardiovascular disease, are heightened. Unfortunately, 70% of pre-diabetic people go on to develop diabetes and suffer its widespread damage. In fact, damage to the vascular system begins once people become pre-diabetic.
Postprandial glucose levels above 200mg/dL are classified as diabetes.
Another way of evaluating how the body is handling blood glucose is to measure the proportion of glucose that has become "stuck' to hemoglobin protein, which is called hemoglobin A1C or HBA1c. The normal value for A1c is 5.6% or lower. A1c levels between 5.6% and 6.5% indicate pre-diabetes. A level of 6.5% or greater is an indicator of diabetes if found on two separate occasions.
According to 2012 public health data, 51% of Americans over 65 years of age are pre-diabetic, based on fasting blood glucose or A1C levels. These numbers have likely increased since the 2012 data was released.
Because uncontrolled high blood sugar leads to cardiovascular disease, nerve damage, kidney damage, retinal damage and cancers, we strongly recommend all adults see their doctor and know their fasting, postprandial glucose and A1C levels. It is far easier to bring metabolic imbalances and blood sugar back into the normal range when identified early.
For more information on preventing, treating, or reversing diabetes along with other health topics, check out the many health articles on our website at www.vitopiahealth.com.
Mike Woodley, R.Ph., FAARM, ABAAHP
Chief Health Officer