The Real Normals – Blood Sugar

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The Real Normals – Blood Sugar
I’m an old nurse. Literally. I graduated in 1968. When you spend half a century in the same career, you are uniquely positioned to evaluate the changes that have occurred in the medical field. If you pay attention, you can begin to put things together and identify certain trends. One of those trends is how “normal” health indicators have changed in the course of those fifty years. That is not a good thing – in many cases, what was once considered normal is now considered a disease. And of course, a disease must be treated, preferably with the newest and most expensive medication. While treatment lines the pockets of the drug companies, it often does the patient no good.
Blood Sugar
Your body runs on sugar. Specifically it runs on a form of sugar called glucose. The pancreas secretes a hormone – insulin – that regulates your blood sugar. Blood sugar too high means organ damage and a slow death. Blood sugar too low means organ damage and, in acute cases, a fast death. Diabetes occurs when your blood sugar is chronically high. In 1960 or thereabouts, a fasting blood glucose level of 140 or more indicated diabetes. In 1997, that was redefined. A high of 126 was the new normal – anything above that was diabetes. In the United Kingdom, it’s even lower – there the “normal” range is 72-106.
Glucose Tolerance Tests in 1960
The glucose tolerance test measures your body’s ability to break down sugar. You drink a very concentrated glucose drink and submit to repeated blood tests that measure the level of sugar in your blood. If you are insulin resistant (the cells don’t respond to insulin) or don’t produce enough insulin, you have impaired glucose tolerance/diabetes. Blood glucose tolerance testing in the 1960s indicated that blood sugar numbers were higher in healthy older adults. In men age 30, the average blood sugar after drinking the glucose drink was 101 mg/dL. By age 75, the average was 148 mg/dL. In women aged 30, the average was 110 mg/dL. For women aged 75 it was 170 mg/dL.
The Hemoglobin A1c
In 1976, Anthony Cerami and colleagues proposed using a laboratory test called the hemoglobin A1c (HbA1c) to evaluate blood sugar control over time. Blood sugar varies considerably throughout the day, so a random fasting blood sugar – usually drawn first thing in the morning – might not give an accurate picture. Supposedly, an HbA1c of 5.0 indicates an average blood sugar of 97 mg/dL. At 6.0, the average blood sugar is supposedly 126 mg/dL. In reality, that HbA1c reading could mean an average blood sugar anywhere from 100 to 150 mg/dL. By today’s medical standards, an HbA1c above 6.5 indicates diabetes and “should” be treated.
Treating the Normal
As with other health indicators like blood pressure and cholesterol, the “normal” blood sugar keeps going down in most cases. In order to achieve the new normal, medications are nearly always required. Since many medications have side effects, doctors often treat the side effects with other medications. Nearly all adults in the US take at least one prescription medication daily and a fairly high number take five or more. In the clinic where I work, it’s not uncommon to see patients on a dozen or more medications. One nurse I worked with had brought her HbA1c below six with weight loss, exercise and dietary changes. She was having chronic diarrhea and incontinence from Metformin, a commonly prescribed diabetic medication. Her physician continued to insist that she needed the medication. As Joel Salatin is fond of saying, “Folks, this ain’t normal.” She stopped the medication, continued her lifestyle changes and has been fine, even if her doc isn’t very happy with her.
Today’s Diet
Under normal (pre-industrial) circumstances, humans ate very little sugar. A little fruit when it was in season, a rare treat of honey when someone found a wild bee hive. By 1770, when sugar first became more readily available, an adult ate about four pounds a year. Today, the average American consumes about 160 pounds of sugar every year. It’s no wonder the blood glucose system is out of whack. So what this means is that when your doctor says “You have diabetes,” it may or may not mean you really have a problem. Even if you do, taking medication should not be the first step. There’s plenty of good evidence out there that to correct diabetes (type II or adult-onset, not juvenile onset), we should stop eating sugar. Next, cut or – even better – eliminate refined flours, significantly limit grain consumption and cut overall carbohydrates. Third, exercise regularly. That’s a no-side-effects, lower-cost treatment than medication.
Think about it.