Medical Forum / Diseases and Disorders / Diabetes / January 2006
What is the fasting blood glucose value?
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guy - 15 Jan 2006 01:30 GMT I was asked this question today. I ha to fumble a bit. Maybe someone could give me the real value. Guy
Jennifer - 15 Jan 2006 02:35 GMT I'm not sure what you mean Guy... but here are some fasting numbers and their "meanings".
Anything 126 or above on two separate occasions is a diagnosis of diabetes.
Normal non-diabetic for fasting is under 100.
Between 100 and 125 is impaired glucose tolerance.
Does that help?
Jennifer
> I was asked this question today. I ha to fumble a bit. > Maybe someone could give me the real value. [quoted text clipped - 3 lines] > http://www.newsfeeds.com The #1 Newsgroup Service in the World! 120,000+ Newsgroups > ----= East and West-Coast Server Farms - Total Privacy via Encryption =---- guy - 15 Jan 2006 02:46 GMT I wanted to provoke a discussion. I am looking for the numbers and why they are used for diagnosis. I am a technical crackpot.
I do think I see the reasons for a glucose tolerance test.. Thanks for the post.
>I'm not sure what you mean Guy... but here are some fasting numbers and >their "meanings". [quoted text clipped - 16 lines] >> http://www.newsfeeds.com The #1 Newsgroup Service in the World! 120,000+ Newsgroups >> ----= East and West-Coast Server Farms - Total Privacy via Encryption =---- Jennifer - 15 Jan 2006 03:29 GMT Ah!
So did you mean: What is the value of knowing our fasting blood glucose number?
Jennifer
> I wanted to provoke a discussion. I am > looking for the numbers and why [quoted text clipped - 29 lines] > http://www.newsfeeds.com The #1 Newsgroup Service in the World! 120,000+ Newsgroups > ----= East and West-Coast Server Farms - Total Privacy via Encryption =---- bob - 15 Jan 2006 05:45 GMT I am not answering for Guy, because he might be asking something entirely different. But perhaps his question is the same as mine:
"Normal non-diabetic for fasting is under 100."
Why this number? Why not 90 or 110?
For example, we know the most common and normal body temperature is 98.6F because that can be measured. Okay, some folks are higher, some lower, but it appears the vast majority of people have 98.6.
I am not being facetious here at all, but I have wondered about the basis for that particular number. Another mystery is the recommended number of calories per day. This really is a sort of "range" depending on a great many other factors.
Can this 100 number be the same? A kind of "range" and YMMV?
Or is it set in stone?
> Ah! > [quoted text clipped - 36 lines] > > http://www.newsfeeds.com The #1 Newsgroup Service in the World! 120,000+ Newsgroups > > ----= East and West-Coast Server Farms - Total Privacy via Encryption =---- guy - 15 Jan 2006 06:02 GMT These numbers are empirical and derived from experience. Mother nature gave them to us.
I have noticed that some numbers have tightened when they will sell more product.
I am looking for the reason these tests are used. I guess it is a cheap way to get an idea of a persons status. A glucose tolerance test seems to be a better indicator of diabetes. I am a technical type and look at things that way. I am sure we will get more answers. Guy
>I am not answering for Guy, because he might be asking something entirely >different. [quoted text clipped - 64 lines] >> > ----= East and West-Coast Server Farms - Total Privacy via Encryption >=---- Jenny - 15 Jan 2006 15:22 GMT > I have noticed that some numbers have tightened when > they will sell more product. > > I am looking for the reason these tests are used. Guy,
I have researched this extensively. You'll find the whole history of how these numbers were selected, and why they fail to adequately diagnose diabetes early enough to prevent complications here:
http://www.geocities.com/lottadata4u/misdiagnosis.htm
--Jenny
http://www.geocities.com/lottadata4u Diabetes Info
http://www.alt-support-diabetes.org/newlydiagnosed.htm Get Your Blood Sugar Under Control
Sleepyman - 17 Jan 2006 22:02 GMT >> I have noticed that some numbers have tightened when >> they will sell more product. [quoted text clipped - 15 lines] >http://www.alt-support-diabetes.org/newlydiagnosed.htm Get Your Blood >Sugar Under Control If complications could be predicted on a bg, fbg, or ppbg/complication we might have something. Problem is, complications are a crap shoot. Of course being in control lessens the odds, but they are in no way a guarantee. I can attest to that. I was being screened for diabetes a long time before it arrived upon the scene, and I have a number of complications, but have missed one of the most common, the pain of neuropathy in the extremities.
Sleepy
_______________________________________________________ The ability to simplify means to eliminate the unnecessary so that the necessary may speak. -Hans Hofmann, painter (1880-1966) _______________________________________________________
oldal4865 - 15 Jan 2006 12:51 GMT bob wrote in message ...
>I am not answering for Guy, because he might be asking something entirely >different. [quoted text clipped - 16 lines] > >Or is it set in stone? My SWAG:
It is a wholly arbitrary number based on a "best" estimate by folks skilled in the art. Arbitrary since there is evidence that Type 2 diabetes is a disease that starts years or decades before blood sugars start to rise. The standards for diagnosis of diabetes and pre-diabetes and glucose intolerant are set by committees who take social factors into account as well as science. It's not an easy target to set. If the docs press too hard, the patients "run away". If they back off too much, the patients suffer unnecessary complications.
FWIW, a "normal" non-diabetic FbG seems to be in the low 80's, i.e.
New England Journal of Medicine, 353:1454-1462 October 6, 2005 Number 14
Normal Fasting Plasma Glucose Levels and Type 2 Diabetes in Young Men
". . . We obtained blood measurements, data from physical examinations, and medical and lifestyle information from men in the Israel Defense Forces who were 26 to 45 years of age.
Results A total of 208 incident cases of type 2 diabetes occurred during 74,309 person-years of follow-up (from 1992 through 2004) among 13,163 subjects who had baseline fasting plasma glucose levels of less than 100 mg per deciliter. A multivariate model, adjusted for age, family history of diabetes, body-mass index, physical-activity level, smoking status, and serum triglyceride levels, revealed a progressively increased risk of type 2 diabetes in men with fasting plasma glucose levels of 87 mg per deciliter (4.83 mmol per liter) or more, as compared with those whose levels were in the bottom quintile (less than 81 mg per deciliter. . . ."
See
http://www.diabetesincontrol.com/modules.php?name=News&file=article&sid=3165
for another look at the same cite.
Regards Old Al
Chris Malcolm - 15 Jan 2006 12:20 GMT > I'm not sure what you mean Guy... but here are some fasting numbers and > their "meanings".
> Anything 126 or above on two separate occasions is a diagnosis of diabetes.
> Normal non-diabetic for fasting is under 100.
> Between 100 and 125 is impaired glucose tolerance. It also depends what you mean by fasting. If I turn up the afternoon for a fasting BG test after 8 hrs without food I'm not diabetic. But if I turn up in the morning after 12 hrs without food I am diabetic. If I turn up in the morning after 14 hours I'm not diabetic. And so on.
I now know enough about how my BG works that if fasting BG is the test, just tell me the time and date of the test and whether you want me to test normal, impaired glucose tolerance, or diabetic. I can't guarantee to hit the right result every time, but I certainly could most of the time. With a few weeks notice and bit more research (and lots of test strips!) it wouldn't surprise me if I could then hit the required diagnosis every time.
 Signature Chris Malcolm cam@infirmatics.ed.ac.uk +44 (0)131 651 3445 DoD #205 IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK [http://www.dai.ed.ac.uk/homes/cam/]
Peter - 15 Jan 2006 13:32 GMT > I now know enough about how my BG works that if fasting BG is the > test, just tell me the time and date of the test and whether you want [quoted text clipped - 3 lines] > lots of test strips!) it wouldn't surprise me if I could then hit the > required diagnosis every time. So is the OGTT test completely reliable as a diagnostic tool?
Susan - 15 Jan 2006 17:13 GMT > It also depends what you mean by fasting. If I turn up the afternoon > for a fasting BG test after 8 hrs without food I'm not diabetic. But [quoted text clipped - 9 lines] > lots of test strips!) it wouldn't surprise me if I could then hit the > required diagnosis every time. According to Ed Uthman on his pathology website, fasting means 12-14 hours for accurate results.
Susan
Chris Malcolm - 16 Jan 2006 17:54 GMT >> It also depends what you mean by fasting. If I turn up the afternoon >> for a fasting BG test after 8 hrs without food I'm not diabetic. But [quoted text clipped - 9 lines] >> lots of test strips!) it wouldn't surprise me if I could then hit the >> required diagnosis every time.
> According to Ed Uthman on his pathology website, fasting means 12-14 > hours for accurate results. When the fasting interval includes the night, 12 and 14 hours give me significantly different readings, the 14 hour reading being lower and in agreement with inter-meal fasting readings when there's several hours between meals, with no snacks (4.5-4.7). At 12 hours in the morning I'm sometimes over 6 due to the liver dump effect. It needs 14 hours in an overnight fast to be sure of clearing the dump hump.
 Signature Chris Malcolm cam@infirmatics.ed.ac.uk +44 (0)131 651 3445 DoD #205 IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK [http://www.dai.ed.ac.uk/homes/cam/]
Mr. Gantlet - 15 Jan 2006 18:16 GMT > I was asked this question today. I ha to fumble a bit. > Maybe someone could give me the real value. > Guy was it a questioned asked on why it is used to diagnose diabetes or what is its importance to us diabetics?
guy - 16 Jan 2006 00:19 GMT >> I was asked this question today. I ha to fumble a bit. >> Maybe someone could give me the real value. >> Guy > >was it a questioned asked on why it is used to diagnose diabetes >or what is its importance to us diabetics? I write too much with post that does not say what I meant.
When I wrote "value" I meant the value to diabetics, not the numerical value. Yet the replies served a good purpose.
I do now exactly what a glucose tolerance shows. I am not sure I understand what the fasting test means.
Why does the numerical value stop a some elevated number for a fasting person with some insulin production.
IN my case, if I used care and limited food input I could always approach normal. I did keep reasonable numbers by food input BUT I finally went on insulin when I went fromr`175 lbs down to 135 lbs.. I had been told that the insulin caused the complications.
One reason I do not like monolog books. If I say something here hat i very wrong, someone will correct it. The "books" nonsense seems to stick.,
I was so ignorant until I finally found MHD. I am still stupid but a lot less ignorant..
When I can understand the basic principles, It gives me a chance to use my limited brain to see what is happening.
Thanks for the follow up posts.
Ozgirl - 16 Jan 2006 00:49 GMT > I do now exactly what a glucose tolerance shows. I > am not sure I understand what the fasting test means. It can indicate the beginning of impaired glucose tolerance, a pre cursor to diabetes and an indication of insulin resistance, i.e. a good tool for prevention, in my opinion.
Mr. Gantlet - 15 Jan 2006 18:21 GMT Expert Committee Redefines Impaired Fasting Glucose
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- Mathematical Model Accurately Predicts Best Diabetes Treatments -
ALEXANDRIA, Va., Oct. 24 /PRNewswire/ -- The number of adults who have pre-diabetes, a condition that can lead to type 2 diabetes, is expected to rise by roughly 20 percent under new criteria being laid out this month in the scientific journal Diabetes Care. The new criteria are presented in a report compiled by an International Expert Committee to reexamine the classification and diagnostic criteria for diabetes.
Under the new definition, the cutpoint for normal fasting blood glucose levels was dropped from 110 mg/dl to 100 mg/dl, meaning that a value of 100 mg/dl or above would lead to a diagnosis of impaired fasting glucose (IFG), which is included in the term pre-diabetes. Pre-diabetes is the state that occurs when a person's blood glucose levels are higher than normal but not yet high enough for a diagnosis of diabetes. Studies show that many people who fall in the pre-diabetic range will go on to develop diabetes within 10 years.
"Lowering the threshold should help pick up more people who are at increased risk for developing diabetes," said Saul Genuth, MD, Professor of Medicine at Case Western Reserve University, who chaired the Expert Committee. "What's important about that is that we now know -- through studies such as the Diabetes Prevention Program (DPP) and the Finnish Diabetes Study -- that we can prevent or delay the progression to diabetes from impaired glucose tolerance (IGT), the original component with the term pre-diabetes, through intensive lifestyle treatment, such as exercise and diet therapy. We hope, but don't yet know, that intervening earlier might also reduce the risk of diabetic complications, including cardiovascular complications."
People with pre-diabetes have an increased risk of cardiovascular disease, compared to people with blood glucose levels in the normal range. The DPP and other studies have shown that people with pre-diabetes can prevent or delay the development of type 2 diabetes by up to 58 percent through changes to their lifestyle that include modest weight loss and regular exercise.
The Committee did not redefine the criteria for the diagnosis of diabetes and recommended against using the A1C (a test that measures average blood glucose levels over 2-3 months) as a routine diagnostic test for diabetes. There are currently two tests used to diagnose diabetes: the fasting plasma glucose (FPG) or the oral glucose tolerance test (OGTT). The Committee recognizes both tests as valid but continued to recommend the FPG as the preferred diagnostic tool because it is more convenient and less expensive. The Committee found there is currently inadequate clinical evidence that either test is superior.
Dr. Genuth said anyone who is at high risk of developing diabetes from risk factors such as obesity, family history, or gestational diabetes, and who has not been tested within the past few years, should ask for a diabetes/pre- diabetes screening. The American Diabetes Association recommends that anyone 45 years or older, particularly if they are overweight or obese, be tested and, if normal, retested every three years.
Mathematical Model Accurately Predicts Best Treatment Options In the first study of its kind, researchers have shown that a mathematical model called Archimedes can accurately predict the outcomes and most successful treatment options for people who have diabetes. Two studies in the November issue of Diabetes Care compared analyses run by Archimedes against actual clinical trial results. In both studies, involving a total of 18 clinical trials and 74 clinical outcomes, Archimedes was 99 percent accurate in its predictions. The November issue also includes two editorials on this topic.
Archimedes, developed and owned by Kaiser Permanente, a non-profit managed care organization, can be used to analyze numerous types of health care problems, such as the design of a clinical practice guideline, the implementation of a disease management program, the design or extension of a clinical trial, or the prediction of outcomes people can expect from various treatment options. Using Archimedes, people with diabetes will be able to ask specific questions (such as those they might ask of a doctor) and get back answers that draw upon the best available information from clinical trials, tailored to their particular cases. Kaiser Permanente, in partnership with the American Diabetes Association, is working to make Archimedes available at no cost to physicians and to the public.
Diabetes Care, published by the American Diabetes Association, is the leading peer-reviewed journal of clinical research into the nation's sixth leading cause of death. Diabetes also is a leading cause of heart disease and stroke, as well as the leading cause of adult blindness, kidney failure and non-traumatic amputations. For more information about diabetes, visit the American Diabetes Association Web site www.diabetes.org or call 1-800-DIABETES (1-800-342-2383).
Web site: http://www.diabetes.org/
> I was asked this question today. I ha to fumble a bit. > Maybe someone could give me the real value. [quoted text clipped - 6 lines] > ----= East and West-Coast Server Farms - Total Privacy via Encryption > =----
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