The gist of these articles is that when measuring blood gucose, and as part of my blood glucose experiment design, three different measurements are necessary:
Fasting Blood Glucose; “normal*” is less than 99 mg/dL, with optimal according to Chris being at less than 86**.
* Normal according to the American Diabetes Association (ADA)
** Chris says, “If you’re following a low-carb diet, fasting blood sugars in the 90s and even low 100s may not be a problem, provided your A1c and post-meal blood sugars are within the normal range.”
Oral Glucose Tolerance Test (OGTT), or post meal (aka post prandial) blood sugar “spikes;” normal is less than 140 mg/dL with optimal being less than 120. The OGTT involves drinking a concoction containing 75 grams of glucose and watching how your body responds. No thanks, I don’t ingest that amount of carbs in a full day much less at a sitting. This must be some form of cruel and unusual punishment, and I’m not doing it; call me a rebel. I will though do the post-meal measurements in place of the OGTT.
Hemoglobin A1c (or A1c for short); and according to Chris, “A1c measures how much glucose becomes permanently bonded (glycated) to hemoglobin in red blood cells. In layperson’s terms, this test is a rough measure of average blood sugar over the previous three months.” The A1c result is expressed as a percentage, with normal being less than 6%, and optimal less than 5.3%.
Basically, we are looking for the best 2 out of 3. Each of the measurements is problematic if used individully, hence the necessity of measuring all three to arrive at a better understanding.
Blood Glucose Experiment Background
90 day average blood sugar by glucometer
Why bother? In my case it is because my fasting blood glucose remains stubbornly at or above 100 mg/dL. Geri and I have been using glucometers since the middle of 2014, when I was diagnosed with Hashimoto’s Disease and we began a strict adherance to the Paleo Autoimmune Protocol (AIP). These are the same blood glucose monitoring devices used by diabetics. Relatively cheap and effective. My fasting blood glucose has also been measured at my annual physicals; since 2014 those measurements have averaged 100 mg/dL, with a high of 107 and a low of 93. More recently according to my home-use glucometer, the last 90 day average (76 data points) was 110 mg/dL, this on 2018 October 29th. Considering only my Fasting Blood Glucose measurements indicates that I might have a problem. Hence the need for a more comprehensive analysis of blood sugar metabolism, and this blood glucose experiment.
Blood Glucose Experiment Conduct
Let’s just say that I’m not always compliant. But I think I took a fair swing at the experiment, and I don’t think my failure to comply in every particular impacted the results.
I started the experiment on October 29th and ended it on November 5th, the better part of 8 full days. I was good about measuring my morning FBG, and I usually measured my blood glucose immediately pre-meal, and between 45 minutes and 1 hour after each meal (post meal, or post prandial). I also measured here and there throughout the days as it came to mind. Finally, on day 8 I measured my A1c using a home test kit.
Blood Glucose Experiment Results
Average Fasting Blood Glucose (FBG): 114 mg/dL (8 readings)
Average 1 hr post-meal Blood Glucose: 115 mg/dL (10 readings)
High Blood Glucose measured: 133 mg/dL
Low Blood Glucose measured: 77 mg/dL
Average Blood Glucose***: 108 mg/dL (43 readings)
A1c 2018 November 5th: 4.9%, or 94 mg/dL
My Key Blood Glucose Experiment Takeaways
No excursions post-meal above 140 mg/dL; 4 of the 10 were over 120 mg/dL
Average measured blood glucose, which means during waking hours, was 108 mg/dL
A1c, which accounts for average blood glucose regardless of whether I am awake or asleep, 4.9%, which is rock-solid
I was surprised at the impact on blood glucose of two particulr foods, apples and cashews; both one apple and 5 oz of cashews caused what I thought to be a large blood glucose spike
Blood Glucose Analysis and Further Thoughts
Fasting Blood Glucose is indeed stubbornly above 100 mg/dL
My blood glucose is pretty damn stable during the woke hours; generally between 100 and 120 mg/dL, with some excursions below 100 and about the same number above 120
No indications that my blood glucose ever exceeds 140 mg/dL
According to Chris, “Far more important than a single fasting blood glucose reading is the number of hours a day our blood sugar spends elevated over the level known to cause complications, which is roughly 140 mg/dl (7.7 mmol/L)…If post-meal blood sugars do rise above 140 mg/dL and stay there for a significant period of time, the consequences are severe. Prolonged exposure to blood sugars above 140 mg/dL causes irreversible beta cell loss (the beta cells produce insulin) and nerve damage. 1 in 2 “pre-diabetics” get retinopathy, a serious diabetic complication. Cancer rates increase as post-meal blood sugars rise above 160 mg/dL.”
Hemoglobin A1C – 90 day average blood glucose
For me the A1c measurement sealed the deal, indicating a blood glucose average of 94 mg/dL over the past 90 days; with that result I am very happy and my mind is at ease on the subject
On Hormones and Blood Glucose: Cortisol
I’m pretty convinced that cortisol has a lot to do with my “stubborn” morning FBG. According the to the wiki entry for cortisol:
“In the early fasting state, cortisol stimulates gluconeogenesis (the formation of glucose), and activates antistress and anti-inflammatory pathways. Cortisol also plays an important, but indirect, role in liver and muscle glycogenolysis, the breaking down of glycogen to glucose-1-phosphate and glucose…Diurnal cycles of cortisol levels are found in humans. In humans, the amount of cortisol present in the blood undergoes diurnal variation; the level peaks in the early morning (around 8 am) and reaches its lowest level at about midnight-4 am, or three to five hours after the onset of sleep. Information about the light/dark cycle is transmitted from the retina to the paired suprachiasmatic nuclei in the hypothalamus.”
I may take on measurement of cortisol levels to get a better understanding of how this might be impacting my FBG.
On Hormones and Blood Glucose: Adrenalin
I’m 100% convinced that adrenaline, the “fight or flight” hormone, has a lot to do with levels of glucose in the blood stream. I personally experienced this twice during the conduct of the experiment.
On the first occasion I was hunting from a high tree stand on October 31st. While in the tree stand I measured my blood glucose at 86 mg/dL. Not too much later an 8-point buck walked into view; my heart rate went through the roof, and it was difficult to keep my respiration rate under some sort of control. “Buck fever” to be sure. Two and a half hours later when I was back at home, by blood glucose was still 131 mg/dL, with no food or drink of any sort having been consumed in the meantime.
On the second occasion I was just awake, on November 5th at about 0600. I’m in the bathroom, standing in front of the pot of course, when Geri starts screaming “John, John…I NEED YOU!” The house MUST be on fire, or so my nervous system assumes. Scared the hell out of me. “There’s a mouse in the bathroom!” Yup, you guessed it, I just about came unhinged at that point. Measured the morning FBG minutes later; 129! The highest fasting blood glucose measurement of the experiment.
I’ll just say that your body knows how to get glucose into the bloodstream, and it puts glucose in the bloodstream instantly if it perceives a fight or flight situation is upon you. This is the same stuff paramedics use to restart your heart, should it come to that. According to the wiki entry for Adrenalin:
“Adrenaline, also known as adrenalin or epinephrine, is a hormone, neurotransmitter, and medication. Epinephrine is normally produced by both the adrenal glands and certain neurons. It plays an important role in the fight-or-flight response by increasing blood flow to muscles, output of the heart, pupil dilation response, and blood sugar level.”
No kidding. Wow. The body is an amazing piece of equipment. It’s mechanisims for maintaining homeostasis, and for ensuring that we survive, are both complex and totally comprehensive. I won’t be running any more “experiments” on the effects of Adrenalin on blood glucose.
Blood Glucose Experiment Equipment :
ReliOn Prime glucometer ($9) and test strips ($9/50 strips) – Walmart
Update 2018 November 07: Impact of “Bulletproof Coffee” on Blood Glucose
Originally I had decided to exclude a discussion of “post meal,” or post prandial (PP) blood sugar measurements after my usual morning coffee; I didn’t consider the coffee a “meal,” per se. Perhaps I should have. On four mornings in my notes however, I did record blood sugar upon completion of the coffee. For the record, typically I consume an entire 40 oz. pot of coffee (1/3 cup beans) myself, to which I add:
Great Lakes Collagen, about 3 rounded tablespoons (15g protein more or less)
I guess you could call that a meal. And the impact on blood sugar ranges from none to a slight lowering, if I exclude the morning with the spike due to Geri’s mouse. The average of the other three is a lowering of about 5 mg/dL.
All for now then, this post ended up being a bit longer than I expected. Any questions, please comment.