Abnormal blood glucose risk, Re: Diabetes Treatment Risk Not Found in 2nd Study

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Hi All, http://www.ncbi.nlm.nih.gov/pubmed/17576864 The pdf is availed. Cheers <stephaniemurphy4@...> wrote: jwwright wrote:>> One thing I wonder about is the limits of BG.> My test ref is <100, but there is a criteria of 120 for type 2.> What's between 100 and 120?>[snip]Hi jwwright,I assume that these numbers

you listed are fasting glucose numbers. If this is the case, here are a few caveats:1) Home glucose meters are notoriously inaccurate - one study showed they can be off by +/- 30% depending on the temperature, amount of blood used, type of meter, and other factors. But if the result of 120 was consistent after several readings, I would be inclined to believe it.2) Circadian variations in several hormones (cortisol probably the most important) cause a rise in blood glucose during the early morning hours. This is exacerbated by getting up and moving around for several minutes before taking the measurement. It is possible that their BG runs around 90 all night and then with the morning cortisol spike rises to 120. Stress, lack of sleep, and depression can all raise blood glucose during morning hours as well as during the rest of the day.3) "Fasting" glucose is really only fasting if the person has eaten nothing for at

least 8 hours. Some physicians use 12 hours. I suspect that it depends on how large and/or carbohydrate-rich the last meal before bed was.4) Technically, the definition of frank diabetes is a fasting glucose more than 126 mg/dL on two or more occasions - or, a random glucose more than 200 mg/dL plus symptoms (polyuria, polydipsia, unexplained weight loss, visual changes, etc.) - or a glucose more than 200 mg/dL 2 hours after drinking a standardized glucose load (oral glucose tolerance test).There is a diagnosis thrown out there for people with fasting glucose between 100 and 126, and that is "impaired fasting glucose." A large percentage of the population (at least in the US) fits this criterion. The meaning is uncertain. It used to be that above 110 was impaired fasting glucose, but the cutoff was revised downward. Having impaired fasting glucose may indicate a predisposition to developing type 2 diabetes, or it

may be a normal variant, or an artifact of testing due to morning cortisol, not fasting long enough, inaccurate meter, etc.I'm a medical student - not that this makes me an expert by any means - but I have some experience caring for people with diabetes.Hope that helps.Best wishes,

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