Author's Perspective: As engineers, we just love numbers -- we love everything about numbers -- counting, recording, adding, subtracting, multiplying, dividing, collecting and analyzing the numbers. We really love doing all of this to help solve a complex problem.
As it turned out, blood glucose testing was a Godsend for me. It helped me to separate fact from fiction, and also how to better use the data to help me to improve and optimize my blood glucose control.
During my recovery, my mother told me: "Son, God gave you the perfect disease for an engineer who loves mathematics." She was right -- being able to collect and analyze the data put me in a comfort zone that allowed me to safely wean off the insulin.
During my research, I discovered that most books written on diabetes and most doctors and diabetes experts only used blood glucose testing to determine the drug dosage, the number of carbs that a diabetic could eat, and whether there was a problem with a specific food.
I couldn't find a diabetes book or expert that explained how to leverage the data to actually reverse the diabetes! Death to Diabetes is the only book and the only program that I'm aware of that leverages the data (and the other blood testing data) to reverse the disease!
In addition, so that you don't have to wait to get the test results from the medical lab, the data can also be used to extrapolate hemoglobin A1C readings. Also, the data can be used to evaluate glucose stabilization and slope factors. But, then, that's what you would expect -- because that's what we (engineers) do ... :-)
The Power of Blood Glucose Testing to Reverse Type 2 Diabetes
Blood glucose testing is essential for anyone with diabetes -- especially if you want to properly manage your diabetes and have the opportunity to prevent future complications and possibly reverse your diabetes.
Even if you're not diabetic, but, you're struggling with your weight, you may want to consider getting a blood glucose monitor also. Why? Because, you may be insulin resistant; and, if you are, your blood glucose may rise, but, it may not rise high enough for you to be diagnosed as a diabetic.
For most people attempting to achieve good glucose control, four or more tests a day are usually required. Readings should always be recorded, as well as the food eaten and medications or insulin doses taken. This information can then be used to adjust medications, meal planning, and exercise to greatly improve blood glucose levels.
Although testing can clarify unclear symptoms, the major reason to test is to improve your blood glucose results, and to maintain excellent results once control targets are achieved.
Because of the major advances of medical science and technology, blood glucose testing is a very important tool for diabetics to track the progress of their blood glucose levels. Blood glucose (BG) testing is a very powerful diagnostic tool.
Next to nutrition and exercise, blood glucose testing is the most important key to effectively control the disease. And, for Type 2 diabetics, it has the power to help reverse the disease – once effective nutritional, exercise and support programs have been implemented.
Unfortunately, most diabetics are not taught how to use the blood glucose test data to get tighter control over their blood glucose levels and possibly reverse their diabetes! Instead most diabetics are taught how to use the data to figure out their drug dosage and/or determine the amount of carbs they can eat.
Most diabetics don't like to test for fear of a high reading, and being reminded that they have little control over their diabetes.
One of the advantages of having an engineer explain how to use the data is that engineers like Mr. McCulley understand the intricacies of the data.
Unfortunately, most diabetics either do not test their blood glucose on a frequent-enough basis or do not understand the appropriate corrective actions to take based on their test results. Consequently, most diabetics can never get to a point where they can proactively control their blood glucose level and their diabetes.
By increasing your blood glucose testing, you can more readily determine the potential cause and effect relationships between your high glucose readings and the events that may be driving those high readings, e.g. meals, drugs, exercise, stress, illness, emotional state, menstrual cycle start (for women).
Of course, keep in mind that there will be times when your glucose levels will be high for no apparent reason, but, the more you test, the more infrequent will be those types of occurrences.
Blood glucose testing is probably the most misunderstood and least-performed activity of the eight “living” elements for managing and controlling diabetes, so do not overlook this critical activity.
Blood Glucose Tests & Normal Ranges
The fasting blood glucose test is performed by pricking your finger and placing a drop of blood on a test strip. This drop of blood is analyzed by your blood glucose meter and translated into a number that is displayed in the window of your glucose meter. This number indicates your blood glucose level at that particular moment and is based on what you ate and did during the past few hours since your last meal.
The following is the set of normal ranges for blood glucose levels.
Fasting glucose level before meals:80-100 mg/dl
Optimum Range: 80-95 mg/dl
Optimum Running Average: 92 mg/dl or less
Postprandial glucose level (2 hours after meals): 90-110 mg/dl
Optimum Range: 80-100 mg/dl
Optimum Running Average: 95 mg/dl or less
FYI: The following table shows a correlation of the hemoglobin A1C percentages and blood glucose meter readings [Ref: Death to Diabetes book (Chapter 11, Page 185)]:
Note 1: For international (non-U.S.) countries, to convert mg/dl to mmol/l, use the table above; or, divide the mg/dl number by 18; or, use an online blood glucose calculator.
Note 2: Although online calculators may differ and while some of the numbers above have changed slightly over the years, you still want your readings to fall below 6, no matter what calculator you use.
What's the "Normal" Range?
In general, the normal fasting blood glucose (BG) range is 80 to 99 -- that correlates to an A1c of 4.4 to 5.0%. But, the "normal range" can be a little higher for some people -- until their body adjusts to the lower readings.
The "normal" range may vary slightly when you first change your eating habits to a healthier diet such as the Death to Diabetes Diet.
Because your body is not used to the lower blood glucose (BG) levels, you may experience some shakes or headaches when your BG drops into the 70s or 80s. This is a hypoglycemic attack, so you should eat something immediately.
However, don't always rely on sugar to bring your blood glucose back up -- eat something healthy (but light) like a sandwich, some steamed spinach, or a green smoothie. These light foods are quickly absorbed and help to raise your blood glucose back up without creating a blood glucose spike caused from taking a glucose tablet.
Eventually, your body will get used to the new normal blood glucose levels and the shakes will subside. This is just another example of why testing is so important. What is "normal" for one person may not be "normal" for someone else.
Author's Sidebar: When I was diabetic, I got the shakes when my BG dropped below 100. This was due to my body not being used to BGs below 110. I actually felt better when my BG was higher (around 120 to 130). This was partially due to my body being inefficient and requiring more glucose to function.
If your body has excess toxins, it may go through a detox process to try to expel the toxins. This can lead to the shakes, headaches, upset stomach, etc. But, gradually, my body got used to the new normal and the shakes went away.
So, be careful and don't over-react or try to "force" your blood glucose below 100 -- as long as you eat properly, your body will readjust and eventually get used to the lower numbers.
WARNING: In my case, my endocrinologist told me to eat more sugar to bring my BG back up! Initially, that's what I did until I realized that I was making things worse! So, be careful not to go for the sugar fix to bring your BG back up. Instead eat something like steamed spinach which is a light vegetable that is absorbed very quickly. Also, a green smoothie, a sandwich or some soup will do the trick.
Normal Blood Glucose Readings
Author's Note: When I was diabetic, I never received a consistent answer concerning what is "normal"? I was told that a normal blood glucose for me would be higher because I was diabetic. So "normal" varies from person to person depending on your health state, but, as an engineer, I found that too confusing.
So, I asked what is normal for a non-diabetic, and I used that as my goal for determining if my diabetes was improving. I also increased my blood glucose testing because I knew that the more data I collected, the better I would understand what was going on in my body.
Unfortunately, some diabetics don't like to test because of the frustration and anxiety associated with the readings. But, blood glucose testing (and the analysis) are the most powerful diagnostic tools available to a diabetic to get his/her diabetes under control.
First of all, whether you're diabetic or non-diabetic, it is normal for your blood glucose, or blood sugar, levels to vary throughout the day and night. So whether you're diabetic or not, it is normal for your blood sugar to rise, especially after eating a meal or during a stressful event.
Normal range (before meals): 80 mg/dl to 100 mg/dl, but ideally you want your average fasting blood glucose level to be consistently below 100 mg/dl, i.e. 90-95 mg/dl.
Normal range (2 hours after meals): 90 mg/dl to 100 mg/dl, but ideally you want your average fasting blood glucose level to be consistently below 100 mg/dl after meals, i.e. 95 mg/dl.
More importantly, you don't want your post-meal blood glucose level to remain above 120 mg/dl for more than 3 hours -- that's when diabetes does its most damage!
The postprandial test is a great indicator of your hemoglobin A1C and is critical to being able to revere your diabetes.
In addition, you don't want your blood glucose to rise more than 50-60 points 2 hours after a meal. Excessively high glucose spikes can be damaging to your arteries.
Healthy, non-diabetic people normally have blood glucose levels of less than 100 mg/dl two hours after a normal meal, rarely exceeding 140 mg/dl. Blood glucose levels usually return to normal within two to three hours.
When your fasting blood glucose level goes far above 125 mg/dl, the excess glucose is converted to fat (triglycerides). When your blood glucose goes far below 80 mg/dl, your body enters starvation mode and will not burn any fat for fuel.
Also, when you blood glucose spikes more than 50-60 points, this can also be harmful to your arteries and other blood vessels.
You've probably noticed that these numbers are different depending on who you talk to or what website you visit. "Normal" for a diabetic tends to be different from a non-diabetic. But, that should not be the case -- especially since it causes a lot of confusion.
The bottom line here is that you want your average fasting blood glucose levels to be consistently in the 80-100 range preferably below 96 on average. And, you want your 2-hour post-meal readings to be consistently in the 90-100 range -- preferably towards the lower end to the middle of the range.
Consequently, it is not normal for your blood sugar to rise above 160 mg/dl or remain above 140 mg/dl two hours after eating; or, to dip below 70 mg/dl.
In those cases, you may become pre-diabetic or diabetic if the very high or very low readings persist over a period of years. This is why visiting your doctor and getting tested is so important.
Another key point that the average diabetic overlooks is the importance of consistent readings without a lot of variation -- this is known as a standard deviation in mathematics. It is very important to have a small deviation or swing of readings -- this is known as blood glucose stabilization.
FYI: Most diabetes programs fail to mention "blood glucose stabilization" because most diabetes authors, doctors and other experts don't really understand the "mathematics of blood glucose testing". It takes an engineer to understand this. But, this engineer designed his program so that you don't have to be an engineer or math genius to understand these numbers. :-)
For example, Person A has readings of 60 and 140 for an average of 200/2 or 100. Person B has readings of 100 and 110 for an average of 210/2 or 105. On the surface, you may think that Person A is better off because his average is lower than Person B's. But Person A has a wider swing of 80 points (from the norm of 100), while Person B's swing is much less: 10 points. Consequently, Person B is doing a better job at managing his diabetes and stabilizing his blood glucose.
One more key point from the author: I found that the more readings I took, the better I could interpret the data and draw good conclusions. The more data I had, the better. As a result, when I had one high reading out of 20 versus 1 high reading out of 5, I wasn't overly-concerned with the one high reading.
But, most diabetics don't test that frequently because of the high cost of test strips and because they don't want the constant reminder that they're diabetic ... plus, no one has taught them how to use the data to take corrective actions that can actually reverse their diabetes!
-- Keep your average post-meal blood glucose in the target range
-- Keep any single blood glucose readings below 140 mg/dl
-- Don't allow your blood glucose to remain over target after 2-3 hours
Author Sidebar: As engineers, we, more than any other profession, realize the importance of collecting and analyzing data to figure out how to solve a problem.
Note: Read Chapters 3 and 11 of the Death to Diabetes book for more information about blood glucose testing, or get the Power of Blood Glucose Testing ebook to understand how to leverage the data to help reverse your diabetes.
Note: For more information about blood glucose control, go to the Death to Diabetes Blog.
Frequency of Blood Glucose Testing
The frequency and timing of tests will vary depending on an individual's therapy, goals, and resources. When any changes occur in food, exercise, medications, illness, or travel, more testing should occur.
Type 1: before meals and bedtime, 1-2 hours after meals and during night as needed.
Type 2: before meals, before bedtime (optional), 1-2 hours after meals.
Before you begin testing, have your healthcare provider show you the best techniques. When testing be sure to follow the manufacturer's directions and these helpful suggestions:
- Wash your hands (anything on your hands can change the reading).
- Collect the amount of blood required.
- Test again if reading seems incorrect. Use another meter to double check.
- Clean your meter as often as required.
- Record and date/time your test results.
Here are some tips for accurate readings:
- Be sure to match the code on the meter or the meter's code chip with the code on the strip container (new meters now check the test strips automatically when they're inserted).
- Check the date on the strips for freshness.
- Store strips so they don't deteriorate (protect from heat, light, and humidity)
- Check for low battery if results aren't accurate
- Be sure to keep a good record of all tests. Discuss blood glucose goal ranges with your healthcare provider. Discuss how and when to make changes to your diabetes care -- food, exercise, medications, insulin doses.
Note: In general, high blood glucose readings are usually due to several reasons, including drug dosage, drug-timing, food, beverages, eating or drinking one of the 5 "dead" foods during the past 36 hours, not detoxing, not eating enough raw foods especially vegetables, not juicing, not exercising enough, over-exercising, not getting enough sleep, stress, poor quality supplements, not enough time spent following the Death to Diabetes program, etc.
Hemoglobin A1C Testing
The hemoglobin A1c test is a simple lab test that shows the average amount of sugar in your blood over the last two to three months. It's the best way to find out if your blood sugar is under control on a long period of time.
All people with type 2 diabetes should have a hemoglobin A1c test at least twice a year. If your treatment changes or if your blood sugar level stays too high, you should get a hemoglobin A1c test at least every three months until your blood glucose level improves. Regular testing will help you and your doctor to track your blood glucose levels over time and plan long-term treatment options to reach your target level of control.
The hemoglobin A1c (HbA1c) test, sometimes called a glycated hemoglobin test, measures the proportion of hemoglobin molecules in your red blood cells that have glucose attached to them (and thus are "glycated"). Once glycated, a hemoglobin molecule stays that way throughout the 3- to 4-month life-cycle of its red blood cell. Red blood cells are continually dying and being replaced, so at any given time they have a range of ages in your body.
The hemoglobin A1c goal for people with type 2 diabetes is less than 6%. The findings of a major diabetes study, the Diabetes Control and Complications Trial (DCCT), showed that people who keep their hemoglobin A1c levels close to 6% have a much better chance of delaying or preventing complications that affect the eyes, kidneys, and nerves than people with hemoglobin A1c of approximately 8%.
Author's Note: Because of the variability in blood glucose testing and A1c testing, I increased my testing from the recommended 3-4 times a day to 7-8 times a day, with at least 2 post-meal tests. Of course, this was very expensive, because my insurance only covered 4 tests a day. So, I had to come out-of-pocket for 4-5 additional daily tests. However, the extra testing helped me to better understand my diabetes and the extra data gave me the confidence to make the necessary dietary and lifestyle changes and safely wean off the insulin.
Note: For more information about blood glucose control and testing, refer to Chapters 11 and 14 of the Death to Diabetes book. To learn more about how to use blood glucose testing to control and even reverse your diabetes, get the Power of Blood Glucose Testing ebook.
Blood Glucose Tracking
Tracking your blood glucose can be invaluable and help you determine what you need to do to get your blood glucose back to the normal range.
Another important observation by the author: When you look at the line graph above, it shows a lot of instability in my glucose levels, indicating that maybe I needed to take more insulin to stabilize my readings. However, being an engineer, I decided to take a different cut at the data, creating the bar chart below:
So, instead of concluding that I had a lot of instability, in reality, I had some stability with the midday readings but less stability with the morning readings and a lot more instability and out-of-range readings in the evening.
This indicated that I needed to modify my lunch and dinner meals instead of increasing my insulin dosage. In fact, I believe at this time, my endocrinologist was thinking about increasing my insulin from 4 shots to 5 shots a day!
So, understanding the data was very important as it allowed me to avoid the 5th insulin shot; and, a few weeks later, I was able to reduce my shots from 4 to 3 shots; then, later I went down to 2, then 1, and finally 0!
Sidebar: Actually, when I look back at this, it was pretty easy to go from 4 shots down to 1 because 3 of the shots were tied to the short-acting insulin that I took before meals. It was a little more difficult to go from 1 to 0 shots because that last shot was the 40-45 units of the long-acting insulin that I took at night.
But, because I had had success with the short-acting insulin, it gave me the confidence to stick with it and not become discouraged as I was able to reduce the dosage from 45 units to 40, then, 35, 30 and so on until I got down to 0 units.
Unfortunately, most diabetics are unaware of how to use the data. In fact, doctors, nurses and diabetes educators are also unaware of how to use the data. They primarily use the data to help you determine how much insulin to take.
To make matters worse, because of the anxiety and fear, most diabetics don't test that frequently because they don't want the constant reminder that they're diabetic ... and, because no one has taught them how to use the data to take corrective actions that could improve their diabetes, they become even more discouraged.
-- Keep your average post-meal blood glucose in the target range
-- Keep any single blood glucose readings below 140 mg/dl
-- Don't allow your blood glucose to remain over target after 2-3 hours -- Use the data to your advantage and don't become discouraged
Key Message: Although testing may create some anxiety, once you understand how to control your blood glucose, you'll better understand the readings and what to do. And, by knowing what to do, this will remove the anxiety and the fear.
Testing Tip: In order to take full advantage of blood glucose testing, read Death to Diabetes Chapters 11-12, 14 and use the data and the charts above in conjunction with one of our popular meal/glucose tracking charts on the Blood Glucose Testing & Meal Planning web page.
Note: The accuracy of blood glucose testing also depends on the quality of your meter and test strips. Refer to the Death to Diabetes Blog for more information about glucose meters.
Bottom line: Test, don't guess.
Disclaimer: This site does not provide medical advice, diagnosis or treatment.
Copyright © 2016. Death to Diabetes, LLC. All rights reserved.