Read Your Blood Sugar Level Report: Everything you need to know

Human beings need energy to function and to survive. We eat food to get this energy. The food is digested and assimilated in our blood stream in the form of glucose and is transported to various parts of the body. With the help of insulin, this glucose is absorbed into our cells where it is converted into energy.

The glucose that cannot be absorbed into the cells, remains in the bloodstream. People who have a significantly high level of glucose in the bloodstream are said to be diabetic. When the blood glucose is higher than normal but not high enough to be confirmed as diabetes, that stage is usually called Pre-diabetes. Although, it is significant for Pre-diabetics to measure the HbA1c levels which is a strong indicator of Pre-Diabetes in order to keep a watch.

If you belong to either of these categories, it is likely that you have got your blood sugar tested at least once. That test has probably been done on the advice of your doctor, and you understand little about diabetes and blood sugar testing beyond the numbers on your test report that reflect how high your sugar level is, against the accepted normal range.

Well, we believe knowledge is quintessential in diabetes treatment and reversal. Every patient should be aware of the changes that are taking place inside his body. Because only when you know what’s happening and why, can you be in control of the changes and your overall health in turn. So, our objective here is to tell you everything you need to know about blood sugar testing, blood sugar report, diabetes treatment and diabetes in general.

First things first – 

If you have diabetes, we often monitor blood glucose levels. Measuring your blood glucose levels is like waiting for your exam results, you will come to know that you are either diabetic or not. However, if you want to measure your levels as a predictor or indicator to diabetes and or insulin resistance, then we should also measure fasting insulin and TG/HDL ratios.

Understanding sugar levels:

When we get our blood test report in a standard format, we see the ‘normal range’ in one column and the result of our test entered alongside. It tells us where our blood sugar level stands in comparison to the normal fasting, PPBS test normal range, or random blood sugar range. But many people still have questions regarding blood sugar levels. So let’s try and answer some common ones.

What is the normal Blood Sugar range? (Fasting & After Food)

FBS normal value should be less than 100 mg/dL. PPBS normal range should ideally be around 140 to 160 mg/dL for a healthy person.

However, there is no need to check your blood sugar levels daily. Instead, you can check your fasting insulin which should be around 2 to 6.

After eating food, insulin level depends on a lot of factors and can go up to 80.

What Blood Sugar Level is Dangerous? (Fasting & After Food)

If your fasting blood sugar level before breakfast reaches 180 mg/dL, it means your mitochondria has been affected. You should start working on diabetes reversal or management. Your primary objective should be to eliminate the reasons that are causing damage to the mitochondria.

An A1C test is used to diagnose and monitor diabetes by measuring the body’s average blood sugar level over the past 3 months. A high Haemoglobin A1C shows that your body has difficulty in regulating glucose levels.

In non-diabetics, A1C levels stay below 5.7%. An A1C between 5.7% and 6.5% suggests pre-diabetes. If the A1C level is above 6.5%, it indicates Diabetes. Dangerous levels of A1C are 9% and higher. An A1C above 9% increases the risk of long-term diabetes complications like blindness, nerve damage, and kidney failure. If A1C levels are under 7%, it is considered good diabetes control.

What is the Normal Range of Blood Sugar by Age? (Fasting & After Food)

With age, mitochondria functioning gets limited. However, this should not be a problem in a healthy body. If the sugar level is going up, then it is not normal aging. A healthy body should not see such abnormalities.

The fasting blood sugar normal range and the PP or Postprandial sugar (after food) normal range – for a healthy and a diabetic person – are given in the normal blood sugar levels chart above. However, these figures serve as a guide.  However, fasting insulin should be less than 6 and TG/HDL ratios less than 1.5. These are true indicators of our metabolic health and can alert us in time from falling into the Diabetes trap.

Healthy normal range in Diabetic Adults (Men or Women)

Fasting blood sugar level among diabetics should be around 80-130 mg/dL. Normal blood sugar 2 hours after eating or PP sugar level should be less than 180 mg/dL. There is no difference between men sugar range and women sugar range.

However, it should be borne in mind that blood sugar level is not a reliable marker because it keeps fluctuating throughout the day. It is better to rely on Insulin levels and HbA1c as they are good markers. 

If the HbA1c is more than 5.6, the person is diabetic. When a normal person touches an HbA1c of 5.2, he/she should start changing his lifestyle in order to avoid further damage to the body which will happen if diabetes sets in. In order to do so, we must first understand what HbA1c is and why it increases.

When should we measure blood sugar?

If you are diabetic and have diabetic sugar levels (your blood sugar level is not within the acceptable RBS normal range), you may be required to monitor it frequently (on a weekly basis) until it is in control. If your sugar level is in control, you should still be monitoring it once or twice in a month.

Normal individuals should also get their blood sugar levels checked at least once a year, as a precautionary measure. . Because your blood sugar levels may not be high and you may not be experiencing any symptoms but there may be certain underlying conditions that serve as a precursor to pre-diabetes. 

You should also get tested if you are experiencing any of the following symptoms:

• Fatigue and tiredness
• Frequent infections (Urinary tract infections & Balanoposthitis)
• Increased hunger, thirst and urination 
• Frequent nocturia
• Dental issues 
• Blurred Vision 
• Numbness of hands or feet
• Non-healing or slow healing wounds

In the last 10-20 years, there has been a significant increase in the number of Type-2 diabetes cases among children and young adults. So it would be wise to measure the fasting insulin and TG/HDL ratios along with blood glucose parameters annually for this age-group as well.

Now that we have the ‘when’ out of the way, the next big question is –

How should we prepare for a blood sugar test?

There will be many questions regarding this that you would want to know. The most important ones are regarding medications ahead of taking a test. Let’s answer them for you. 

Should I take my diabetic medication before a blood test?

Overnight fasting of 8-12 hours is required. Normally, drugs or insulin are not skipped on the previous night, but should not be consumed in the morning prior to having a glucose test. However, for fasting blood sugar the previous dose can also be skipped in order to efficiently assess the ability of the liver to handle blood sugars.

In case of Type-1 Diabetes, the morning basal insulin can be taken before the test.

For measurement of postprandial blood sugar (PPBS), regular anti-diabetic medication can be taken at the usual time of the day for correct readings.

How to adjust your other medications for a blood sugar test?

The following medications can be skipped since they could raise your glucose:

• Steroids like hydrocortisone and prednisolone, but steroid creams (for a rash) or inhalers (for asthma) are not a problem.
• Drugs that treat anxiety, depression and mental health issues (such as Clozapine, Olanzapine, Quetiapine) 
• Anti-hypertensive like beta-blockers & diuretics 
• Statins to lower cholesterol 
• High doses of asthma medicines
• Isotretinoin for acne
• Cough syrups & decongestants

Apart from the medications, there are certain dos and don’ts you should adhere to ahead of taking a blood sugar test. It could be helpful in getting accurate results.

Do’s & Don’ts before the blood tests

• Drink adequate water. It will not only make you feel better if you are fasting, it will also make for a smoother blood draw
• Sleep well the night before the blood test
• Calm down and relax for 10-15 min prior to blood withdrawal
• Avoid Caffeine & chewing gum
• Avoid specific foods and drinks such as herbal tea, alcohol etc.
• Make sure not to over-eat the day before a test
• Avoid smoking
• Avoid strenuous physical activity like exercise
• If on medication, ask the doctor if you can take those medications

How do you conduct your blood sugar test at home?

The most widely known method of checking blood sugar is using the finger-prick method with a glucometer. Once pricked, you can place the drop of blood on the strip. The strip is then inserted into a meter that measures the amount of glucose attached to your blood cells.

You can also check your blood sugar level without the need for finger sticks or needles by using a Continuous Glucose Monitor (CGM) or flash monitor. While glucometer gives you the capillary blood glucose, CGM reflects the interstitial glucose levels. However, measuring the venous blood glucose (which is also done in lab tests) is considered the standard test, as CGM (Interstitial) glucose lags behind blood glucose by 30 minutes.

Since the body runs on fats during fasting, there is not much of a difference between the standard venous sampling and glucometer levels when measuring fasting glucose. However, in the postprandial period, the glucometer reading can be higher than the standard venous sampling by around 20-25% as the body runs on glucose after eating.

What time of the day should you test?

Blood sugar is conventionally measured in the morning. However, it is equally important to check the post-lunch blood glucose levels as it is the largest meal of the day and the ability to handle carb-rich meals can be tested.

Sometimes, the fasting blood glucose can be elevated up 120 mg% due to the Dawn phenomenon which entails a rise in counter-regulatory hormones. This is perfectly normal. You just need to ensure that the pre-meal (lunch and dinner) levels are fine and well within basal range. There is no need to treat the mildly elevated fasting glucose levels. Calming down the nervous system and grounding in parasympathetic dominant mode, often helps.

How does the Oral Glucose Tolerance Test differ?

Normal meals of carbs (starch) are in solid state. It takes a long time to be digested and assimilated. It is not ideally suited to test the insulin production capacity of the pancreas. In order to challenge the insulin production, an Oral Glucose Tolerance Test (OGTT) is conducted. It involves the oral administration of a standard load of glucose (50-75 g) dissolved in water. The glucose is absorbed rapidly into the bloodstream and increases the blood sugar levels quickly, thereby challenging the production of insulin.

OGTT can be used to screen impaired glucose tolerance (Pre-diabetes) and Diabetes Mellitus. However, for the diagnosis of Diabetes and Pre-diabetes the other two tests (fasting glucose and HbA1c) are comparatively easier to administer. Hence, OGTT is typically reserved for specific clinical scenarios such as screening for gestational Diabetes between 24-28th week of pregnancy.

Why Does Blood Glucose Level Rise in Diabetes?

Our body derives energy for day-to-day functioning from the food we eat. After this food is digested, it takes the form of sugar in the bloodstream and is called ‘blood sugar’ or ‘blood glucose.’ Our pancreas produce insulin – a hormone that helps in the absorption of blood glucose into our cells. The process of absorption of sugars into our cells is called metabolism. The better our metabolism, the more sugar is absorbed into our cells. How good or bad our metabolism is, depends upon the quality and quantity of mitochondria in our cells.

Mitochondria is the engine that drives our cells. Each cell has about 500-1500 mitochondria. Sometimes, due to the impact of our internal or external environment, the quality and quantity of the mitochondria in our cells deteriorates. This directly impacts the ability of our cells to absorb blood sugars and it is reduced. This phenomenon is called ‘insulin resistance.’ As a result of this, there is more unabsorbed sugar in our blood, or a rise in our blood sugar levels.

Thus, in Type-2 Diabetes, the pancreases produce enough insulin but the mitochondria is dysfunctional or vice versa, leading to insulin resistance which does not allow the cells to absorb blood sugar. It is a metabolic problem that can be corrected by restoring the mitochondria function.

So the next obvious question is – 

How to restore mitochondria function?

There are a few basic changes that we need to make in order to restore mitochondria function. These are as follows:

• Correct circadian mismatch or misalignment:  When sunlight falls on the human body, it gives a signal to start the metabolic function. When there is no sunlight and the human body is in the dark, it is time for repair and regeneration. But nowadays, we are constantly under artificial lights. So our body is constantly in the metabolic state and rarely goes into the repair mode. Thus, lack of sunlight and exposure to artificial light causes a circadian mismatch. Rebalancing this circadian mismatch should be the first step towards halting the damage to mitochondria.
• Hydration: The second step is hydration. Normal RO water robs our body of nutrients. Our cells need sufficient structured water for biochemical reactions. 
• Food: The third important thing is food. However, it isn’t about eating ‘good food’ or having a ‘rich diet’. It is more about having a ‘balanced diet’ and giving the body what is needed in the right proportions. For instance, carbohydrates comprise a major portion of our diet in general. But it isn’t essential for structural formation. Instead, we need to eat more healthy fat and protein to repair and regenerate the body.
• Microbiome: The health of the body is directly related to its digestion function which largely depends on the quality of the microbiome in our gut. Food is converted to post-biotic which are required for repairing the mitochondria. If there are more pathogenic microbes in the gut than good microbes, it causes endotoxemia. These toxins in turn affect metabolic function.
• Reduce consumption of heavy metals: Metabolism can become dysfunctional due to the consumption of heavy metals such as lead, aluminium and mercury. Therefore, removal of these heavy metals from the system is significant.
• Mineral and Vitamins: Repair and replacement of mitochondria is a continuous process for which minerals and vitamins are essential.

What causes high or low HbA1c levels?

HbA1c is your average blood glucose (sugar) levels for the last two to three months. In a normal person, the HbA1c is below 5.7%. But if a person has diabetes, his HbA1c is above 6.5%. If a person’s HbA1c is between 5.7% and 6.5%, it means he has Pre-diabetes.

Thus, high blood sugar causes high and low HbA1c.

What are Low Blood Sugar Levels Symptoms?

When a person is healthy and has normal metabolism, low blood sugar or hypoglycaemia is highly unlikely. However, it is still possible in case of malnutrition or fasting.

In diabetic cases, hypoglycaemia happens either if the diabetic person has taken an extra dose of insulin, or if he/she has taken any such drug that pressurizes the pancreas to produce extra insulin in the body.

The symptoms of low blood sugar are:

• Fast heartbeat
• Shaking
• Sweating
• Nervousness or anxiety
• Irritability or confusion
• Dizziness
• Hunger

How to treat low blood sugar?

Consuming really sugary foods and drinks like regular soda and orange juice can help raise your sugar levels very fast. You can also take glucose tablets or gel if available. The sugar will kick in within 10 minutes. Foods that contain protein or fat such as chocolates, candy bars and ice-cream take a longer time to raise the sugar level.

What are high Blood Sugar level symptoms?

Uncontrolled Diabetes generally leads to high Blood Sugar levels. Some of the symptom of high Blood Sugar are:

• ncreased thirst and a dry mouth.
• Frequent urination
• Headache
• Tiredness and fatigue
• Blurred vision
• Weight loss
• Recurrent infections
• Slow healing cuts and wounds

How to treat high Blood Sugar?

In order to suppress high Blood Sugar levels, doctors usually prescribe anti-diabetic or insulin medication. However, this medication only treats the symptom. That is, it suppresses the high Blood Sugar, but it never really rectifies the root cause – damaged mitochondria.

As discussed elsewhere in this article, the following steps can be taken to repair damaged mitochondria:

• Correcting circadian mismatch and misalignment
• Drinking enough water and staying hydrated
• Eating a balanced diet
• Maintaining good microbes in the gut
• Reducing the consumption of heavy metals
• Taking the right amount minerals and vitamins to cover for any deficiency

In summation, Type-2 Diabetes is a metabolic disorder that can be reversed and managed by making lifestyle changes. Type-1 Diabetes (which is the result of low insulin production) can also be managed by making similar changes.

 However, we should also keep track of our fasting insulin and TG/HDL ratios for the early detection of underlying symptoms so that we can restore the balance of the body before pre-diabetes sets in and things become more difficult. 

FAQs:

1. My sugar level is 300 what should I do?

This depends on the type of Diabetes you have. In case you have Type-2 Diabetes, you do not require Insulin. Type-1.5 patients may or may not require Insulin, depending upon investigation. On the other hand, Type-1 patients require Insulin. This is because the two main problems in Type-1 Diabetes are – insufficient or no insulin production, and metabolic disorder.

However, the metabolic function can be improved with functional medicine treatment, thereby reducing the need to take Insulin. In some cases, there may also be some degree of recovery of the pancreas.

2. What happens if sugar level is high?

Early symptoms of high blood sugar levels or Hyperglycemia include increased thirst and/or hunger, blurred vision, frequent urination and headache.

There may be additional symptoms such as fatigue, weight loss, vaginal and skin infections and slow healing cuts and sores.

Dangerous blood sugar levels can cause life-threatening complications. These are:

Diabetic ketoacidosis (DKA) – a condition caused by the body’s need to break down fat as a source of energy, which can leads to a diabetic coma. This usually tends to affect people with Type-1 diabetes. The symptoms of Ketoacidosis are; vomiting, dehydration, heavy breathing or hyperventilation, rapid heartbeat and disorientation.

Hyperosmolar hyperglycemic state (HHS) – severe dehydration caused by the body trying to get rid of excess sugar. This tends to affect people with type 2 diabetes.

Regularly having high blood sugar levels for long periods of time (over months or years) can result in permanent damage to parts of the body such as the eyes, nerves, kidneys and blood vessels.

3. What is a dangerous level of HbA1c?

An A1C test is used to diagnose and monitor diabetes by measuring the body’s average blood sugar level over the past 3 months. A high Haemoglobin A1C shows that your body has difficulty in regulating glucose levels.

In non-diabetics, A1C levels stay below 5.7%. An A1C between 5.7% and 6.5% suggests pre-diabetes. If the A1C level is above 6.5%, it indicates Diabetes. Dangerous levels of A1C are 9% and higher. An A1C above 9% increases the risk of long-term diabetes complications like blindness, nerve damage, and kidney failure. If A1C levels are under 7%, it is considered good diabetes control.

4. What blood sugar level requires insulin?

Insulin requirement has got to do more with the type of diabetes than the level of sugar. 

Type-2: In this case, the pancreas produces sufficient insulin but the mitochondria – which helps in the absorption of sugar in the cells – is dysfunctional. This phenomenon is known as ‘insulin resistance’ and causes blood sugar levels to rise. This is only a metabolic disorder and does not require insulin.

Type 1.5: When sugar is not absorbed by the cells, the pancreas tries to produce more insulin, and over-works itself. This causes premature aging of the pancreas over a period of time. Due to aging, the capacity of the pancreas to produce insulin is reduced. Insulin is required to make up for the deficit in insulin production by the pancreas.

Type 1: Insulin is required.

5. At what sugar level is insulin required?

Insulin is required only when the pancreas does not produce enough insulin to meet the requirement of the body. This is usually in the case of Type-1 and some Type-1.5 cases.

Type-2 Diabetes is a metabolic problem. There is no shortage in the production of insulin. Type-2 Diabetes occurs when the cells become insulin resistant due to dysfunctional mitochondria. Hence, insulin is not required in this case. Rather, mitochondria function needs to be restored. This is possible through a set of lifestyle changes.

6. What happens when sugar level goes down?

When the level of glucose in your blood is abnormally low, that condition is called ‘Hypoglycaemia.’ It is usually associated with Diabetes and occurs when a Diabetes patient takes too much insulin, misses a meal or exercises too hard. It is very rare for non-diabetics to have Hypoglycemia, but it is possible in cases of malnutrition, binge drinking, and certain underlying conditions such as Addison’s disease.

Hypoglycaemia comes with some warning signs. These are – feeling hungry, trembling and shakiness, sweating, blurred vision and tiredness or fatigue. In more severe cases, you can be disoriented or in a state of confusion and unable to focus. In extreme cases, patients experience loss of consciousness and can even slip into a coma.

When Hypoglycemia occurs during sleep, it causes excess sweating, disturbed sleep and feeling tired and confused upon waking.

7. What is the normal sugar level before food? or What is the normal fasting BSL Level (blood sugar level)?

Fasting blood sugar normal range should be less than 100 mg/dL. If it is 100 to 125 mg/dL, it indicates you have pre-diabetes. Fasting blood sugar level of over 126 mg/dL indicates you have diabetes.

8. What is normal blood sugar level immediately after eating?

The random blood glucose sugar test (GRBS) or a casual blood glucose test (CBG test) after food of a non-diabetic person, is less than 140 mg/dL.

9. What is a normal blood sugar level for a child?

For a child, a good Hb1c should be 4.8 and normal blood sugar in fasting should be less than 100 mg/dL. The blood sugar levels (BSL) of kids aged 6-12 years range between 80 to 180 mg/dL over the course of the day. The PP sugar level range goes to the higher side usually post meal.

10. What is the normal blood sugar level for adults? What is normal blood sugar level in India?

The normal sugar level in the human body (fasting) is less than100 mg/dL. Random blood sugar normal range should be less than 140 mg/dL. Click to jump to the normal blood sugar level chart for adults. Note: The normal sugar level for women is the same as men.