How to Lower Blood Glucose Readings on Fasting Test

Article highlights

This article reviews the standard clinical criteria for normal glucose levels.
Given the growing use of continuous glucose monitors (CGM) in research studies, nosotros requite an overview of information on glucose patterns in nondiabetic individuals wearing CGM.
Standard tests to appraise glucose levels include fasting glucose test, three calendar month average glucose levels examination (hemoglobin a1c), and an oral glucose tolerance test. These data points are momentary snapshots, and do not give insight into what is happening to an individual's highly dynamic glucose level over time and whether these trends are good for you.
CGM goes further by showing continuous data about daily glucose trends, only there is no clinical consensus still on goal 24-hr glucose levels for a nondiabetic individual.
Our analysis of the inquiry literature distills insights well-nigh what may be safe and optimal ranges to strive for throughout a 24-hour bicycle for a healthy, nondiabetic private, and propose a series of glucose ranges that tin can be helpful to orient around when determining what to strive for on a day-to-day ground while using CGM.
Based on the data of healthy individuals wearing CGM, it appears that it is safe and healthy to strive for a fasting glucose between 72-85 mg/dL, a post-repast glucose level 110 mg/dL or lower, and an average glucose of 100 mg/dL or lower.

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What's considered a "normal" glucose level?

Your doctor volition likely test your blood glucose levels every bit a screening test for diabetes during a standard yearly check-up. Additionally, many people track their glucose at habitation with an over-the-counter finger-prick test. When you check blood glucose (also called blood sugar), either at a doc'southward office or with a dwelling finger stick glucose monitor, the results are in milligrams (mg) of glucose per deciliter (dL) of blood. (Note that in many countries, the standard measurement is mmol/L; to convert the values below to mmol/L, divide the mg/dL by 18.)

One of the virtually common glucose measurements is fasting plasma glucose (FPG) or fasting blood glucose (FBG), and it's plant by checking blood glucose levels subsequently non having any calories at least 8 hours before the examination. According to the American Diabetes Clan (ADA), people can be classified into three categories depending on their fasting plasma glucose levels: normal, prediabetes, and diabetes. To be considered "normal," fasting glucose must be under 100 mg/dl.

Post-meal glucose levels are besides meaningful, and high post-repast glucose levels tin worsen glucose control over time and pb to obesity, diabetes, cardiovascular affliction, and impaired exercise and cognitive performance. While it is not unexpected for glucose levels to increase afterward a meal as the glucose from the repast is released into the claret, if this level is likewise high, it is not good for health and tin predispose ane to disease over time. According to the International Diabetes Federation (IDF) guidelines for managing mail-meal glucose levels, nondiabetic people should accept a glucose level of no higher than 140 mg/dl later meals, and glucose should return to pre-meal levels within 2-3 hours. Mail service-meal hyperglycemia (elevated glucose) is divers as a glucose level >140 mg/dl 1-two hours later on the ingestion of food or drinks.

These glucose measurement methods mentioned so far rely on a unmarried indicate-in-time measurement to determine if your levels are normal. Recent advances in continuous glucose monitoring (CGM) technology let you lot to rails your glucose levels over a 24-60 minutes period and proceeds insight into deeper trends associated with wellness, such as glycemic variability, a measure of the up-and-down swings in glucose throughout the twenty-four hour period. Withal, there are no standardized, universally accepted criteria for what "normal" 24-hour glucose values are using CGM technology. Scientists are continuing to gather information virtually glucose levels in healthy people using CGM engineering science.

Of notation, CGM devices measure interstitial glucose levels (glucose from the fluid in between cells) compared to blood/plasma glucose levels (glucose in the blood) measured in the FPG tests. While interstitial glucose and blood/plasma glucose levels correlate highly, they are non precisely the aforementioned, and diagnoses are not made from interstitial measurements.

Beneath is a summary overview of data about 24-hour glucose trends in nondiabetic individuals wearing CGM to gain a meliorate understanding of "what's normal."

CGM Studies In Nondiabetic Individuals

One study from 2009 entitled "Reference Values for Continuous Glucose Monitoring in Chinese Subjects" looked at the glucose levels of 434 good for you (nondiabetic, non-obese) adults using CGM and establish the following:

On average, their daily glucose levels stayed between 70–140 mg/dl for 93% of the 24-hour interval, with very pocket-size portions of the twenty-four hour period spent higher up 140 mg/dl or below lxx mg/dl.
Also, their mean 24-hr glucose levels were around 104 mg/dl (± 10 mg/dl)
i-hr post-meal glucose values average 121-123 mg/dl for breakfast, lunch, and dinner
3-60 minutes mail service-repast glucose values were around 97-114 mg/dl.
Peak mail service-meal values appeared to be around lx minutes after eating.
Mean fasting glucose was 86 ± 7 mg/dl.
Hateful daytime glucose was 106 ± 11 mg/dl.
Mean nighttime glucose was 99 ± xi mg/dl.

A 2010 report, "Variation of Interstitial Glucose Measurements Assessed by Continuous Glucose Monitors in Healthy, Nondiabetic Individuals," looked at a salubrious population of 74 individuals that included children, adolescents, and adults during daily living using CGM. This research showed that:

Glucose levels stayed between 71-120 mg/dl for 91% of the day.
Levels were lower than lxx mg/dl for 1.vii% of the time and greater than 140 mg/dl, only 0.4% of the time.
Hateful 24-hour glucose was 98 ± 10 mg/dl.
Mean fasting glucose of 86 ± 8 mg/dl.

Compared to the first study mentioned, these healthy, nondiabetic individuals appeared to have a tighter range of glucose, spending the vast majority of the 24-hr catamenia betwixt 71-120 mg/dl.

A third study, from 2008, entitled "Characterizing Glucose Exposure for Individuals with Normal Glucose Tolerance Using Continuous Glucose Monitoring and Convalescent Glucose Profile Analysis," looked at 32 individuals with normal glucose tolerance wearing CGM for approximately 29 days and showed the following findings:

Amongst all participants, 24-hour glucose average ranged from 94 mg/dl to 117 mg/dl
Overall mean glucose level was 102 +/- 7 mg/dl
Mean daytime glucose was 105 ± 8 mg/dl
Hateful nighttime glucose was 97 ± vi mg/dl
Participants spent 93% of time between glucose values of 70-140 mg/dl, with 3% of the time below seventy mg/dL on average and 4% of the time above 140 mg/dl on average
Looking at individuals in the study, some spent equally little equally .3% of the time (4 minutes per 24 hours) at values > 140 mg/dl
Some healthy individuals in the written report spent approximately 2.8 hours per 24 hours at glucose values <70 mg/dl, and an hour < lx mg/dl

A 4th written report, "Continuous Glucose Monitoring Profiles in Healthy Nondiabetic Participants: A Multicenter Prospective Study," from 2019, examined 153 healthy, nondiabetic children and adults ages seven-80 with normal hateful BMI of 24 ± three.two kg/m2 wearing CGM for up to ten days. This study showed:

Mean glucose levels of 99 ± vii mg/dl
Standard deviation of glucose levels of 17 ± iii mg/dl
Cypher glucose readings >180 mg/dL
89% of glucose sensor values fell between lxx-120 mg/dl
96% of glucose sensor values fell between lxx-140 mg/dl
two.one% of glucose sensor values were >140 mg/dl
i.3% of glucose sensor values were <70 mg/dl

A 2007 study, "Continuous Glucose Profiles in Good for you Subjects under Everyday Life Conditions and after Unlike Meals," looked at 21 healthy young individuals using CGM. These participants were between age 18-35, had a healthy BMI of 22.six ± 1.7 kg/m2, and were examined eating standardized meals as well as regular meals of their choosing. Mean fasting glucose for these participants was lxxx mg/dl. This written report found:

Under everyday life atmospheric condition:

Mean 24-hour glucose concentration was 89.iii ± vi.2 mg/dL (range 79.ii-101.iii mg/dL)
Mean daytime glucose was 93 ± 7.0 mg/dl
Hateful dark glucose was 81.8 ± 6.three mg/dl
Participants spent ~eighty% of the time between glucose values 59-100 mg/dL, and merely 20% of the fourth dimension between 100-140 mg/dl
Glucose was above 140 mg/dL for only 0.eight% of the day
Mean pre-meal glucose levels were 79.iv ± 8.0 to 82.one ± 7.9 mg/dl
Mean fourth dimension to post-meal glucose tiptop was betwixt 46 and 50 minutes
Hateful height mail-repast glucose levels of 132 ± 16.seven mg/dl at breakfast, 118 ± 13.4 mg/dl at lunch, and 123 ± 16.9 at dinner

Under standardized meal conditions with a moderately low percentage saccharide (50 grams, 26.8%), high fiber (12.8g), high-fat meal (47 grams, 56.7% fat), and high protein (30.9 grams, 16.v%), participants displayed:

Mean peak post-meal glucose levels of 99.2 ± 10.5 mg/dl
Mean post-meal modify from baseline of twenty.2 ± 7.2 mg/dl
Mean fourth dimension to peak was 57.5 ± 24.v minutes

Finally, the 2018 paper, "Continuous glucose monitoring is more sensitive than HbA1c and fasting glucose in detecting dysglycaemia in a Spanish population without diabetes," assessed 254 people with normal glycemic function wearing CGM for 2-5 days. The mean BMI of these participants was overweight, at 27.3 ± iv.7 kg/m2. Their results found:

Means fasting glucose of 84.6 ± seven.2 mg/dl
Mean 24-hr glucose was 104.4 mg/dl
Mean daytime glucose was 106.2 mg/dl
Mean nighttime glucose was 102.half-dozen mg/dl
Participants spent 97% of the time between 70-140 mg/dl
Participants spent 1.6% of the time above 140 mg/dl
nine.7% of participants had mail-repast (breakfast and luncheon) glucose levels that reached >140 mg/dl
12.ane% of participants had post-meal (dinner) glucose levels that reached >140 mg/dl

Summary Of Normal Glucose Ranges

In summary, based on ADA criteria, the IDF guidelines, a person'due south glucose values are "normal" if they have fasting glucose <100 mg/dl and a postal service-meal glucose level <140 mg/dl. Taking into business relationship additional inquiry performed specifically using continuous glucose monitors, nosotros can gain some more clarity on normal trends and can propose that a nondiabetic, healthy individual can expect:

Fasting glucose levels between 80-86 mg/dl
Glucose levels between lxx-120 mg/dl for approximately 90% of the day (and to rarely ever go above 140 mg/dl or below 60 mg/dl)
24-hour mean glucose levels of effectually 89-104 mg/dl
Mean daytime glucose of 83-106 mg/dl
Mean dark glucose of 81-102 mg/dl
Mean mail service-repast glucose peaks ranging from 99.2 ± 10.v to 137.two ± 21.1 mg/dl
Time to post-repast glucose peak is effectually 46 minutes – 1 hour

These are not standardized criteria or ranges but tin serve as a simple guide for what has been observed as normal in nondiabetic individuals.

Beyond "normal" goals: What's an "optimal" glucose level, and why does it matter?

Verbal numbers for what is considered "optimal" glucose levels to strive for while using CGM to reach your all-time health are non definitively established; this is a question that is individual-specific and should be discussed with your healthcare provider. With that said, enquiry shows that there is an increased adventure of wellness problems equally fasting glucose increases, even if it stays within the "normal" range, making finding your "optimal" glucose levels all the more of import.

While the International Diabetes Federation and other research studies accept shown that a postal service-meal glucose fasten should be less than 140 mg/dL in a nondiabetic individual, this does not determine what value for a post-meal glucose height is truly optimal for your health. All that number tells us is that in nondiabetics doing an oral glucose tolerance exam, researchers found that these individuals rarely go above a glucose value of 140 mg/dL after meals.

So, while this number may represent a proposed upper limit of what's "normal," information technology may not indicate what will serve you best from a wellness perspective. Many people may probable do better at lower post-meal glucose levels. Similarly, while the ADA states that a fasting glucose less than 100 mg/dL is normal, it does not indicate what value is optimal for health.

Lastly, there are no specific recommendations regarding the average glucose levels over a 24-hour period using CGMs. This lack of standardization is probable because CGMs are relatively new and not widely used in a non-diabetic population.

The following is a summary of insights from our review of research. Y'all should consult with your doctor before setting any glucose targets or irresolute dietary and lifestyle habits.

Levels Proposed Optimal Glucose Values

Fasting Glucose Goal: 72-85 Mg/dL

Why? Previously we discussed that the ADA considers normal fasting glucose as anything <100 mg/dl. Notwithstanding, multiple inquiry studies show that as fasting glucose increases, there is an increased risk of health problems like diabetes and eye affliction — even if information technology stays inside the normal range. The highlights of some of the study results include:

Men whose fasting blood glucose was greater than 85 mg/dl had a significantly college mortality charge per unit from cardiovascular diseases than men with blood sugars less than 85 mg/dl. (Bjornholt et al.)
Children with fasting glucose levels 86-99 mg/dl had more than than double the risk of developing prediabetes and Blazon two diabetes every bit adults when compared with children whose levels were less than 86 mg/dl. (Nguyen et al.)
People with fasting glucose levels between 91-99 mg/dl had a iii-fold increase in Blazon two diabetes risk compared to those with levels less than 83 mg/dl. (Brambilla et al.)
Among young, healthy men, college fasting plasma glucose levels within the normal range plant an independent risk cistron for Blazon 2 diabetes. This means that as fasting glucose increases, even if the level is still considered "normal," information technology could signal a significantly higher gamble of developing diabetes, and this is peculiarly pronounced if BMI is greater than 30. (Tirosh, et al.).

Pre-Meal (Baseline) Glucose Goal: 72-ninety mg/dL

Why? In a written report looking at healthy, young, nondiabetic adults who had normal BMI (mean of 22.vi ± 1.seven kg/m2), the average pre-meal glucose levels were in the range of 72-90 mg/dl.

Mail-Repast Glucose Goal: Less Than 110 mg/dL, With No More than Than A 30 mg/dL Increase From Pre-Meal Levels

Why? In a report looking at salubrious nondiabetic adults, researchers plant that the boilerplate postal service-meal glucose pinnacle was 99 ± 10.5 mg/dL after a standardized balanced meal. In dissimilarity, meals with less fiber and more than refined sugars caused a higher post-meal glucose fasten (up to an average of 133 ± 14 mg/dl) in the same population. Some other study also looking at good for you, nondiabetic adults found an average post-meal spike of approximately 122 ± 23 mg/dl. Taking the standard deviation of these averages into consideration, aiming for a post-repast glucose level of less than 110 mg/dl with no more than a 30 mg/dl increment from pre-meal levels is a reasonable goal to strive for.

Mean 24-Hour Glucose Goal: 79-100 mg/dL

Why? These numbers correspond the mean 24-hour glucose range in a immature, very salubrious population. We looked at several unlike studies of nondiabetic populations wearing CGMs, and this was ane of the overall healthiest populations under normal living weather. Therefore we think that 79-100 mg/dl is a prophylactic and good for you range to orient towards.

Remember, your "optimal" glucose levels are specific to you, and you should talk with your healthcare provider about your glucose goals.

How can continuous glucose monitoring (CGM) assist you maintain optimal glucose levels?

It is not uncommon for your glucose levels to increase subsequently a meal: you just ate food that may contain glucose, and at present your body is working on getting it out of the bloodstream and into the cells. We know that we want to prevent excessive spiking of glucose levels because studies show that loftier post-meal glucose spikes over 160 mg/dl are associated with college cancer rates. Spikes are also associated with centre disease. Repeated high glucose spikes afterwards meals contribute to inflammation, blood vessel damage, increased gamble of diabetes, and weight gain. Additionally, the data shows that the large spikes and dips in glucose are more damaging to tissues than elevated but stable glucose levels. Therefore, you should strive to continue your glucose levels as steady equally possible, at a depression and healthy baseline level, with minimal variability afterwards meals.

Keeping your glucose levels abiding is more complicated than just following a list of "eat this, avoid that" foods. Each person has an private response to food when it comes to their glucose levels; studies take shown that two people can have dissimilar changes in their glucose levels afterward eating identical foods. The divergence tin be quite dramatic. One study found that some people had equal and contrary mail-meal glucose spikes in response to the same food.

So how do you lot keep your glucose levels stable? How do you know when you have a carbohydrate spike and which foods caused information technology? That's where CGM comes into play. Continuous glucose monitoring allows yous to run into your blood glucose levels in existent-time and store that data for future reference; this makes CGMs uniquely positioned to assistance you optimize your nutrition and lifestyle. Foods affect each person differently, and information technology is difficult to know what your claret glucose is doing at whatsoever in one case without measuring information technology. CGMs can give you the data you need to optimize your health. Choosing foods and lifestyle habits that consistently go on boilerplate glucose lower and post-repast spikes lower will improve glucose patterns over time.

Studies have shown that the information gathered from CGMs can provide more item and more potential areas for modification than the unmarried glucose level that you go with a glucometer or laboratory blood exam. One report looked at sub-elite athletes and plant that 4 out of ten study participants spent more than than 70% of the total monitoring time above healthy glucose levels, and 3 of 10 participants had fasting glucose in the prediabetic range.

Like results accept been found in other studies: one reported that 73% of the "healthy" nondiabetic participants had glucose levels that were above normal in the range of 140-200 mg/dl at some point during the day.

CGMs tin can non only give you information on your blood glucose, only they can assistance you apply the information to make changes to your diet and do routines. Studies have shown that continuous glucose monitoring can characterize an individual'due south glucose response to specific foods and, in plough, predict their responses to other foods. This technology can allow individuals to create personalized meal plans that suit their unique metabolic needs and improve glucose control.

What are abnormal glucose levels, and why do they matter?

Why is information technology unhealthy for glucose levels to exist as well high (hyperglycemia) or too low (hypoglycemia)?

Hyperglycemia refers to elevated blood glucose levels. This usually occurs because the trunk does not appropriately remove glucose from the blood; this can happen due to many complex reasons. Elevated glucose levels tin harm blood vessels and nerves over time; this can and then pb to problems in the optics, kidneys, and heart, too as numbness in the hands and feet. Very high levels can pb to blackout and even death in some cases. People with fasting glucose levels higher than 100 mg/dl have impaired glucose tolerance and should speak with their healthcare provider.

Some people may think that to avert all these problems, they should simply keep their blood glucose levels as depression as possible. If too high is bad, and then low must be skillful, right? Not exactly. When glucose gets too low, it'south called hypoglycemia. The threshold for hypoglycemia is typically thought to be when glucose falls beneath 70 mg/dl. When this happens, the body may release epinephrine (adrenaline), the "fight or flight" hormone, which can lead to a fast centre charge per unit, sweating, anxiety, blurry vision, and confusion, only likewise helps the body mobilize glucose into the blood. If blood glucose levels stay too low for too long, it tin cause seizures, coma, and in very rare instances, death.

The Nuances Of Depression Glucose

In a recent written report, researchers reviewed the published literature to come across if low fasting glucose levels affected salubrious people's long term risks of health problems, similar strokes and heart attacks. They found that healthy non-diabetic people who had baseline fasting glucose levels of less than 72 mg/dl had a 56% increase in all-cause bloodshed compared to people with normal fasting blood glucose levels. Also, the risks for middle attacks and strokes were college in people with baseline fasting glucose levels less than 72 mg/dl. This consequence is likely due to the torso releasing more epinephrine to counteract the low glucose levels; too much epinephrine for as well long leads to eye problems. Interestingly, people with low fasting glucose levels of less than 83 mg/dl only higher than 72 mg/dl did not have an increased risk of future middle attacks and strokes.

While at that place has been an association betwixt low fasting plasma glucose levels and worse health outcomes, it is non clear whether transient dips in glucose levels (less than 70 mg/dL) during a continuous 24-hour period are unhealthy for nondiabetic individuals. Part of the reason that this is unknown is that continuous glucose monitoring is a relatively new technology and has been studied more extensively in diabetic individuals than in healthy individuals.

Long-term health outcomes relating to 24-60 minutes glucose contour metrics are notwithstanding existence evaluated. In ane study looking at not-diabetic, salubrious individuals wearing CGMs over a 24-hour period, data showed that glucose dips below 70 mg/dL actually occur quite frequently. In fact, 41% of these healthy individuals experienced glucose levels less than lxx mg/dL in a 24-hour period, and the men'due south levels were below 70 mg/dl for 2.7 +/- 6.1% of the 24-hour period (2.1 +/- 4.four % in women). Based on this information, healthy individuals tin can reasonably spend an average of 39 minutes with glucose values less than 70 mg/dL (in men). Furthermore, considering one standard deviation higher than the average, information technology could reasonably be considered "normal" to spend upward to 126 minutes (8.8% of a 24-hour period) with CGM-measured glucose values less than 70 mg/dl. The clinical significance of these depression glucose levels is unknown. However, research suggests that many healthy individuals wearing CGMs spend some amount of fourth dimension with glucose levels less than 70 mg/dL.

Inquiry also shows that glucose levels subtract by an boilerplate of 5% during REM sleep compared to not-REM sleep stages, which may contribute to periodic dips seen at night in nondiabetic people. In fact, healthy people who have glucose dips beneath 70 mg/dl have twice as many dips at night as compared to during the day. Additionally, force per unit area on the CGM sensor from laying on it can crusade abnormal depression values.

Lastly, glucose dips below seventy mg/dL that occur just after a postal service-meal glucose fasten may indicate reactive hypoglycemia; which is an exaggerated insulin response to a high carbohydrate meal, causing an overshoot in the corporeality of glucose that is captivated out of the bloodstream and into cells and is non good for health. Again, we don't want loftier highs and low lows; stable glucose appears to be amend for the torso. These glucose dips are typically characterized by symptoms including fatigue and lack of energy. They can be avoided past a low-carbohydrate/low-glycemic eating pattern with reduced postal service-meal glucose spikes.

Even though there is no defined low signal for nondiabetic fasting blood glucose levels, keeping your blood glucose levels to a higher place a minimum threshold of 72 mg/dl may be beneficial for healthy, non-diabetic people.

Determination

What does all this mean? Information technology means that while in that location are well-established "normal" ranges of fasting and postal service-repast glucose levels, these don't give clarity into what glucose trends should exist throughout a 24-hour catamenia. They besides don't specify what ranges are optimal for the best health.

Fifty-fifty people with "normal" glucose levels may be at higher risk of health bug than they realize considering of frequent glucose spikes and dips or elevated fasting glucose, even if in the normal range. Your optimal glucose levels depend on many individual factors, and setting those ranges should include a discussion with your healthcare provider.

The studies show that keeping your blood glucose in the normal range is important, just also that preventing besides many spikes and dips are key to maintaining your health. A personalized dietary and lifestyle plan that promotes metabolic health should also reach three chief goals:

Minimize mail-meal increases in glucose levels
Keep glucose levels as stable as possible and minimize swings in glucose throughout the day
Try to proceed fasting glucose in the low end of the "normal" range

Figuring out which diet and lifestyle choices will allow yous to attain these goals is an iterative process; no one-size-fits-all plan works for everyone to keep blood glucose in their optimal range. Continuous glucose monitoring can assist you plant your optimal diet and lifestyle choices past serving equally a continuous feedback mechanism, endmost the loop betwixt specific actions and the body'due south reaction, and paving the way for improved current and future health.

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Source: https://www.levelshealth.com/blog/what-should-my-glucose-levels-be-ultimate-guide

How to Lower Blood Glucose Readings on Fasting Test

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