What is the significance of doing a fasting blood sugar level when you are a diabetic?-Dr Harold Gunatillake

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Transcript: Normally in a non-diabetic the fasting blood sugar level reading in the morning after an overnight fast is 99 mg/dL or lower is normal. Or 3.9 to 5.5 mmol/L

100 to 125 mg/dL or 5.5 mmol/L to 7 mmols/L indicates you have prediabetes and 126 mg/dL or higher indicates you have diabetes.

Most people having diabetes complain that even with strict control with diet and medication, the morning fasting level seems to be high and worried about the readings.

Fasting blood sugar is more diagnostic to check whether you have excess blood sugar. That would be the routine test your doctor will request on your annual blood check, sometimes with the HbA1C test.

HbA1C test is a memory test which calculates the average blood sugar levels for the past three months. A haemoglobin A 1c test measures the amount of blood sugar attached to hemoglobin in the red cells.

The World Health Organisation (WHO) suggests the following diagnostic guidelines for diabetes: HbA1c below 4.2 mmol/L (6.0%): Non-diabetic. HbA1c between 4.2 and 4.7 mmol/L (6.0–6.4%): Impaired glucose regulation (IGR) or Prediabetes. HbA1c of 4.8 mmol/mol (6.5%) or over for Type 2 diabetes.

The HbA1c develops when hemoglobin, a protein within red blood cells that carries oxygen throughout your body, joins with glucose in the blood, becoming ‘glycated’.

In addition to the fasting blood sugar level the HbA1c test also could be diagnostic to check whether you have high blood sugar.

If you are having an HbA1c test to help diagnose diabetes, a result of 6.5 per cent (48 mmol/mol) or higher is diagnostic of diabetes. A repeat test is often recommended to confirm the result, especially if you have no symptoms.

After diagnosing diabetes, knowing the fasting blood sugar level is not required as it takes you nowhere in your management of diabetes.

Despite that, there is a tendency for most people to check the morning fasting blood sugar level for self-satisfaction.

Why does the morning reading is high in most people, in spite the blood sugar being well controlled?

This early morning jump of sugar level do occur between 2 and 8 a.m.

Normally, whether you are a diabetic or not, due to hormonal changes in your body, there is a boost on your blood sugar in the early hours of the morning.

The hormones that are involved are growth hormone, cortisol, glucagon and epinephrine. They all raise your blood sugar level.

Normally in a non-diabetic more insulin is manufactured to control this increase level of blood sugar.

In a diabetic, since your body does not respond to insulin, your morning blood sugar will be raised, even if you are controlled with medication and a strict diet.

Please read again and again and understand the situation, and not worry about this high morning reading.

This natural boost is necessary to give enough energy to get up and start the day.

In addition to the above natural boost of blood sugar in the morning, there may be other factors that cause this rise.

You didn’t have enough insulin the night before.

Or you may have forgotten to take your tablets the night before

Or you may have gone to dinner to a friend’s or a restaurant and broken all the rules, including an extra drink of wine.

If you are concerned about your raised fasting blood sugar, do an early morning brisk walk for one hour daily (aprox.8,000 steps), your blood sugar will come down below the normal range, you would be thirsty and hungry and your breakfast would be most rewarding and pleasurable.

For daily management of your blood sugar, it is more feasible to do a random blood sugar at about 4pm, and that should read between 7-8mmol/L.

That reading helps more for the control of blood sugar levels.

If you walk about 3-4 hours with short breaks daily, your insulin resistance will drop, and you may need minimal medication or no medication.

Hope this article was useful.

Stay safe Goodbye for now.

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