What is a "normal" fasting glucose level

[dcle2021]

I'm starting to test my levels after finding out all metformin does is give me angina.

I get ranges from 6.7mmol/l - 14.3mmol/l

Looking at the primary source of BMJ research on risk, https://www.bmj.com/content/321/7258/405.short, reference [1] on https://www.diabetes.co.uk/type2-diabetes.html (i was looking for information on genetic linkage to Type 2, but all it did was reference this report, which doesnt look at genetic factors)

Anyway, this article states:

"The aim in the group allocated to conventional control (n=1138) was to obtain fasting plasma glucose concentration <15 mmol/l, but if concentrations rose to ≥15 mmol/l or symptoms of hyperglycaemia developed patients were secondarily randomised to non-intensive use of these pharmacological treatments, with the aim of achieving fasting plasma glucose concentrations <15 mmol/l without symptoms. "

So, according to the BMJ, my fasting blood sugar is normal? Yet I am considered a Type 2 by my HBA1C (75) which is the only diagnostic measurement my GP or Diabetic nurse considers relevant. I have never been asked to undergo any other sort of assessment, and despite my asking, they refuse to carry one out. (I am UK, solely NHS treatment, following NHS pathways)

Please can someone confirm what a healthy, normal blood sugar level is in mmol/l ? (Because I think this research by BMJ is considering me "normal" - and I can now tell my GP and the DN to go away and stop harassing me about a measurement that is invalid (HBA1C)?)

 

[Andydragon]

As you mentioned there are a number of ways of testing. For hba1c > 48 is diagnosis which your levels are above

https://www.diabetes.co.uk/diabetes_care/blood-sugar-level-ranges.html

For meter testing, Depends on when and fasting, pre/post meals etc but as per above:

• Between 4.0 to 5.4 mmol/L (72 to 99 mg/dL) when fasting
• Up to 7.8 mmol/L (140 mg/dL) 2 hours after eating

 

[In Response]

My understanding is that hba1c has replaced fasting tests for type 2. This is because hba1c provides an indication of your levels at all times over the last 3 months rather than a single point in time .
You finger prick readings only tell you your levels are ok at the tie of your prick. They give you no indication what happens between pricks

 

[jonathan183]

Yet I am considered a Type 2 by my HBA1C (75) which is the only diagnostic measurement my GP or Diabetic nurse considers relevant. I have never been asked to undergo any other sort of assessment, and despite my asking, they refuse to carry one out. (I am UK, solely NHS treatment, following NHS pathways)

You could suggest they do the antibodies tests to see if your diabetes has an autoimmune component. Treating a type 1 as type 2 could end badly.
C-peptide test would give a good indication of how much insulin your body is producing.

If you are after a test to confirm you are not diabetic I think you are out of luck ... the HbA1c is well into the diabetic range
HbA1c of 42 or above is pre-diabetic, and 48 or above is diabetic see here.

 

[dcle2021]

As you mentioned there are a number of ways of testing. For hba1c > 48 is diagnosis which your levels are above
https://www.diabetes.co.uk/diabetes_care/blood-sugar-level-ranges.html
https://www.diabetes.co.uk/diabetes_care/blood-sugar-level-ranges.html

For meter testing, Depends on when and fasting, pre/post meals etc but as per above:

• Between 4.0 to 5.4 mmol/L (72 to 99 mg/dL) when fasting
• Up to 7.8 mmol/L (140 mg/dL) 2 hours after eating

Those numbers are a dream for me. I only get 6.7-7.6 kind of ranges if I don't eat for days and do 4 hours of exercise a day.

 

[dcle2021]

My understanding is that hba1c has replaced fasting tests for type 2. This is because hba1c provides an indication of your levels at all times over the last 3 months rather than a single point in time .
You finger prick readings only tell you your levels are ok at the tie of your prick. They give you no indication what happens between pricks

I'm not disputing the readings, I'm making the point that the BMJ original research on diabetes uses 15mmol/l as normal. Which I am within, all the time. I would pass that original test.

 

[Mr_Pot]

I'm not disputing the readings, I'm making the point that the BMJ original research on diabetes uses 15mmol/l as normal. Which I am within, all the time. I would pass that original test.

That doesn't sound right, do you have a reference we can look at?

 

[Ronancastled]

 

[Dark Horse]

So, according to the BMJ, my fasting blood sugar is normal?

No. This is a 21-year old study which shows that the higher the degree of hyperglycaemia, the higher the risk of diabetic complications, particularly microvascular complications.

 

[Resurgam]

I'm not disputing the readings, I'm making the point that the BMJ original research on diabetes uses 15mmol/l as normal. Which I am within, all the time. I would pass that original test.

A reading of 15mmol/l for blood glucose is really quite high - My diagnostic levels was 17.1 and I was told that was really bad.
These days I aim to be under 8mmol/l all the time, and under 7 most of the time. Even with those levels my Hba1c is only just at the top end of normal, I can't seem to reduce it.