What is classed as elevated BS levels?

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Carina1962

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I have yet another question - we keep reading about how elevated BS levels cause problems in the long term but what would you class as elevated? is it figures that run into double figures? I am a T2 and i try and keep by post-meal levels to 7.8 or below but obviously on occasions i do hit the double figures ie if i eat too much or have a high carb meal etc but is it more concerning if we have post meal readings of double figures on a regular basis? ie every day rather than say a couple of times a week?
 
Northerner said:
I believe that the latest thinking is that it is the big swings that can cause more long term damage, and that higher than 'normal' but stable levels are less damaging.

There's a huge amount of information on Jenny Ruhl's website:

http://www.phlaunt.com/diabetes/14045678.php
Click to expand...

I started to have a look at the info on this link but I aint reading anymore its freaking me out :(
 
hello Northerner, when you mean the 'big swings' do you mean that it is not good and damaging if say your 2 hr post-meal bg's are in double figures? and would this be of concern if it happened regularly like every day? I did start to read the link you pasted but it is quite scary and i will go back to it when i feel in the mood to but thanks for the info.
 
Hi Carina,

In my opinion, you really ought to be trying to avoid having double figures at anytime.

Best wishes - John
 
carina62 said:
hello Northerner, when you mean the 'big swings' do you mean that it is not good and damaging if say your 2 hr post-meal bg's are in double figures? and would this be of concern if it happened regularly like every day? I did start to read the link you pasted but it is quite scary and i will go back to it when i feel in the mood to but thanks for the info.
Click to expand...

Hi, yes, I'm sorry, that link does have rather a lot to take in! From what I hae read elsewhere the jury is still out on whether it is the larger fluctuations or the constantly elevated levels that cause most problems. Most probably, it is down to many other things too, and everyone is different as far as diabetes is concerned unfortunately - we cannot rely on any one study or theory as yet, just do the best we can to look after ourselves.

The comparison might be:

Often 5.x pre-meal, often 10+ post meal
Or:
Often 8.5 pre-meal, often 8.9 post meal.

Totally spurious figures, but I'm sure you get the idea 🙂
 
Hi I started reading the link too, but it freaked me out way too much. I have big swings on a daily basis and dont seem to be able to do anything about it - and believe me I have been trying.

Very very worrying.
 
some scientists suggest that spikes cause inflammation at the cell level and may cause future complications but as Northerner says, the jury is still out. So here is some info from another point of view, it is though only really applicable to type 1.

The DCCT followed type 1s for 10 years and was then extended for another 5. During the trial quarterly HbA1cs were taken and, at the same time, the subjects had 7 fingerprick blood glucose tests taken during the day then analysed in a lab. Not the best evidence (no continuous monitoring then) but the best we have.
Eric Kilpatrick has analysed this data and writen several papers on it. Here are some of his conclusions (taken from a powerpoint presentation.
Obviously the results showed that some people had wide variations during the day, others a more stable profile.

Do 2 patients with the same MBG (mean blood glucose) but different variability have the same HbA1c?
Yes (though I think this is just to make a point there are some things that mean that this may vary between two people, HM)
Do 2 patients with the same MBG but different variability have the same risk of retinopathy?
Yes
Does increasing glucose variability lead to:
? A large increase in retinopathy risk
? A small increase in retinopathy risk
? No increase in retinopathy risk

The mean blood glucose determines the HbA1c, no matter how the mean is arrived at.
The mean blood glucose value determines diabetes microvascular complication risk, no matter how the mean is arrived at.
In other words the daily ups and downs don't ,according to Kilpatrick and the DCCT data, make a difference , what does matter is the overall average. He gives a similar breakdown for macrovascular complications, athough here the best predictor is actually the daily average and not the HbA1c (there are reasons for this, but I won't try to explain)

http://www.york.ac.uk/healthsciences/diabetes/2008conf/ekilpatrick.pdf
Its not mentioned during this presentation but elsewhere Kipatrick using the same data found that variability between HbA1cs (ie big variations in HbA1c rather than short term daily changes) is implicated in potential complications.

http://care.diabetesjournals.org/content/31/11/2198.full.pdf+html
I think that the best thing that any of us can do is to try to keep our levels on as even a keel as possible, watching for those spikes and attempting to do something about them, aiming for a reasonable, but not necessarily too low HbA1c. This evidence doesn't back up the doom and gloom merchants who scare the life out of people for having short term spikes above 140mg/dl /7.7mmol (or even as I read on one forum yesterday110mg/dl /6.1mmol😱) .
 
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