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Guest Post: Testing the Target Range.

I am honored to have Riva Greenberg guest blogging today, and she has some great insight on what might be happening in the bodies of those who don't have diabetes.  Check out her post about testing the target range below, and thanks to Riva for filling in today!

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Riva GreenbergThirty-eight years ago, when I was diagnosed, I remember very clearly lying in my hospital bed being told by my insensitive young male doctor that having a baby was out of the question. Oh, baby, how times have changed. Happy to fill in Kerri as you put up your tootsies.

If I asked you right now where you think non-diabetics’ blood sugar hovers what would you say? I would have guessed around 100 mg/dl and here’s why:

1)    Pre-diabetes is considered anything over 100 mg/dl up to 125 mg/dl
2)    126 mg/dl and up is considered diabetes
3)    The target range prescribed for diabetics is between 80 mg/dl and 130 mg/dl
4)    I must have watched every video on videojug of Dr. Anne Peters, diabetologist and Professor of medicine and director of the USC Clinical Diabetes Programs, whom I respect and admire say we should shoot for 100 mg/dl most of the time.

But based on an unexpected family experiment the anecdotal evidence I gathered is rather different. In fact it seems non-diabetics’ blood sugar rises even above our prescribed target range some of the time. Call me crazy but this was news to me.

My evidence gathering all began a few months ago when my mother told me my 84-year old father had diabetes. I was shocked. Yes, a surprising reaction for someone who blogs and lectures about diabetes, but the thought that one of my parents would actually get diabetes was, frankly, shocking. Maybe I was just being a little possessive? After all, diabetes is my illness.

A few weeks later my mother told me my father no longer had diabetes. The doctor said his blood sugar was O.K. This seemed just a tad fishy to me. My mother was confused as well. “Would you bring your meter with you next time you visit?” she asked. “We’ll test his blood sugar.”

I returned two weeks later with a spare meter, 100 strips and 100 lancets, a lancing device and my intense curiosity. I had my husband in tow and my brother, sister-in-law and niece were there as well to join for a family lunch. Seeing my testing supply-haul, my mother said, “Oh, no, I just thought we’d test one time.” I obviously took this a bit more seriously than she did.

Bringing out the meter the requisite two hours after lunch my father looked at it suspiciously, so my husband volunteered to test his own blood sugar. Then everyone wanted in. My father tested, my brother, my sister-in-law and my 12 year-old niece. The testing results of this group of non-diabetics respectively were: 155, 158 (that’s dad), 131, 130, 102.

Now for the side-story. My husband’s 155 mg/dl made him concerned about his own blood sugar. So he decided to test his blood sugar pre and post meals for three consecutive days. His first day out, his pre-breakfast reading was: 92, two hours after breakfast: 94, before lunch: 83, after lunch: 128. That 128, we guessed was from his French baguette at lunch. We also reflected that his 155 at my parent's house was the result of a lot of bread at lunch. Both numbers seemed to confirm that no one lives at or near 100 mg/dl steadily and that a refined carb meal tips the scales upward even for non-diabetics.

Mind you this is all anecdotal evidence, but it does suggest that non–diabetics’ blood sugar, just like ours, goes up after eating and much higher at times than I would have guessed. It also makes me feel that these limits, bands and ranges we’re all trying to squeeze into throughout the day should come with a clause: “Sometimes no matter what you do your blood sugar will be out of range. Keep breathing and just fix it.”

This experiment may give you some piece of mind, it did me. I know that after struggling and striving to be hovering, like a space-craft, in target range all the time, that even my best efforts won’t always produce blood sugars that sit demurely where they should, and it’s O.K.

Two side notes: 1) My prince among men, my husband, toppled the second day into his blood sugar testing. “Boy, my finger still hurts from this morning! I don’t think I’m going to do this anymore,” he said. Frankly, I think it was the dribble of blood on his keyboard that pushed him over the edge.

And 2) my father does not have diabetes, but pre-diabetes would be a safe bet. As various doctors have told me, if we live long enough most people will develop type 2 diabetes over time as the typical American diet and lifestyle wears out our insulin-producing beta-cells. Good thing I left a meter and 95 test strips at my parent’s house.

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Riva is the author of “50 Diabetes Myths That Can Ruin Your Life: And the 50 Diabetes Truths That Can Save It” and “The ABCs Of Loving Yourself With Diabetes.” Riva presents educational/motivational presentations to fellow patients as a peer-mentor, blogs on the Huffington Post and her web site diabetes stories, and helps others live an exceptional life, not despite having diabetes but because of it, using diabetes as a catalyst to create a healthier, happier, more meaningful life.

Comments

This is really interesting, Riva! It does provide some peace of mind! Thank you!

Thanks for sharing this Riva! I have often wondered myself what the BG trend line of non-diabetics look like.

It's also good to remember that nobody's perfect and that we have a tough job trying to recreate the work of our pancreas! Thanks for the encouragement.

Riva,

I think Kerri made a fine choice of selecting you to be a contributor to her site. I have followed your blog for months now and have listed your site in my "favorite places". I connect with your blog since we are both of the same generation and have been diabetic for about the same number of years.

In referance to the "husband factor". New Years Eve I noticed my husband nodding off in to "diabetic sleep". I pulled my machine and tested him (300) Wow!

I contacted the Dr., made the appointment and his A1C was elevated. 8. The Dr. prescribe Metformin and diet changes. But the biggest surprise was the ranges she wanted him to maintain. She told him 120-160. I looked at the Dr. with a funny look. And I commented to her "why can he be higher than me?" My range is 70-140. Her response was, "you have had Type 1 and for a longer period of your life". Hmmm

She also told him that he only needed to test once in a while.... In defiance to my Dr. I am still having him test regularly.

I realize that she is not my endo, but I would think that her number guidelines would be similar.

P.S. My husbands respose his new found diabtes life is also, i.e. oohh my fingers hurt, OMG i had a good day BS 100 in the am, he tells me that I am a "diabetic police" when tellhim "I suggest you do not eat that", I cannot believe that you have tolerated this bull s%$# for so many years, OMG my BS is 250! What do you think I should do? My response is. Don't eat so much food!.

Wonderful story, I love how the whole family wanted to be a part. In my industry, Life insurance underwriters use the a1c test to backwards figure your daily glucose level. Their goal is a1c 6.5 or less which translates into a glucose of 150 mg/dl over a 3 month period.
Your goal would bring your a1c down into the 5.5 range and below the diabetic diagnosis level. In essence you have created a non-diabetic state in your body.
Excellent job!

Wow! Very interesting results! Thanks for this post, Riva, and I look forward to reading your books!

Awesome post! Yes, this does give me some peace of mind. It's good to know that it's pretty much impossible to be in the target range all the time, even for those who aren't diabetic. I work as hard as I can to stay in that range, but it doesn't always work out. Thanks Riva! :)

That is REALLY interesting. I guess we should cut ourselves some slack from time to time :)

How fun to see Riva on guest blogging! Excellent choice Mrs. Sparling! :-)

It's very interesting to see post-meal BG's on a small sample of non-diabetic folks. Maybe we can hook up a CGM to one of them some day?

Is it Ok that I chuckled about your hubby bailing out on the testing?

Riva- awesome post! I have had a similar experience! I work as a head counselor at a diabetes camp, and we always tell our non-diabetic staff to feel free to check their blood sugars alongside the diabetic staff and campers at each meal and whenever else we are checking. We don't do an actual "two hours post meal check" (even though I think we should!) for everyone, but we have lots of campers and staff check at that time anyway. Last summer, several of our non-diabetic staff were surprised and concerned to see high numbers on occasion (an occasional 130-150). Sometimes, higher than range numbers just seem to happen- diabetic or not!

Great post! I might have my non-diabetic husband test his blood sugar a few times in one day b/c this has me interested now!

About a year or so ago, we did some finger sticks on my husband. He had been complaining about not feeling right off & on, sometimes after eating so of course the diabetic in me whipped out my glucose meter. He had a couple of disturbing results, I think one reading was even over 200. I was very concerned but of course my doctor hating husband brushed it off. But since then both his finger stick readings and a1c performed by his pcp have all been in normal range. I often wondered if non diabetic people have bg spikes from time to time. Thanks for posting this.

Riva, thanks for this great information. It tells me that our bodies are used to variable blood sugar levels and that if I go up after a meal that's somewhat normal. Of course with T1, my post meal (post prandial) levels are more likely to be 180+, though knowing that 'normal folks' is around 150 is very reassuring.

Great article! Doctors are so quick to put you on medicine at the first abnormal sign. I’ve often had to rattle off how I went off the “healthy eating track” to avoid the prescription pad.

I’ve been using food to ward off my family’s history of diabetes. There’s a wonderful movie out called Simply Raw: Reversing Diabetes in 30 Days at www.addsomeraw.com. While I don’t go to that extreme, (how can you give up warm soups in the winter?) I know my diet has kept me from the needle and adding fresh raw fruits and vegetables to at least one meal a day helps.

FYI - Diabetes Action Week is April 25-30 and the movie is 50% off for the week.

Wow, very interesting. I've often fantasized about putting my family through this sort of test, but so far no dice. I'd like to take more comfort from it than I do, however. It would be one thing if non-diabetics didn't ever develop any of the problems that diabetics do (heart disease, kidney failure, blindness, etc). But they do. And it's quite possible that one of the reasons they do is because the modern refined carbohydrate diet is more than ANYONE'S body can handle. If 150 isn't a desirable number for a diabetic, what makes it better for a non-diabetic? Hypoglycemia can be just as dangerous for a non- diabetic as for a diabetic, why not hyperglycemia? I don't mean to be coming off as a glass half empty person here, but if our goal is to avoid long-term complications, then we still WANT our sugars to be in a safe range, not just in the same range as everyone else at the table. Even if we know that's not always possible (and that it's not a reason to beat ourselves up).

When I worked as an ICU RN, we frequently saw elevated BG's in our non-diabetic patients. In fact, it's common for non-diabetics to require insulin injections for a few days post cardiac surgery due to the stress on the body.

As the non-diabetic mother of a girl with Type 1, I often check my own BG level and have found it to be above 140 several times after eating too many refined carbs. In fact, I once logged a 203! My A1C is 5.7 and my fasting levels remain well below 100, but I am convinced the non-diabetic American population frequently sees higher blood glucose levels than previously thought or reported. Thanks for this very interesting blog post!

Want to thank everyone for their comments. I always learn as much from all of you as I share. I forgot to mention, but it's also an interesting side-note that my husband, whose blood sugar rises so after consuming refined carbs, is 6' tall and 128 pounds. (Dutch-Indonesian). So he's not at all the characteristic overweight type 2. And, I'll never be thinner than him, boo hoo.

Great topic. I wonder what the true normal is. The more I think about it, given the U.S. population, normal may not be healthy.

Our targets need to be even better than normal.

Cheers

Awesome post. Will someone show this to the uptight endos/perinatologists/PCPs/other MD) who harangue people with diabetes over single blood sugar readings? Like the doc who viewed a friend's logs and whipped out a highlighter and marked every high or low...despite the fact that most of her readings were in range. Are you kidding me? She was there because SHE HAS DIABETES. Sometimes her blood sugars aren't going to be between 70 and 120! And neither are yours or mine. So there.

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