The Link Between Blood Sugar, HbA1c, Insulin Resistance with Diabetes

Explaining Your Fasting Hemoglobin A1c and Blood Glucose Levels

Fasting blood glucose,  hemoglobin A1c test, and diabetes

Blood sugar, also known as glucose, is the primary fuel for the body and brain of a human. Because of this, controlling your blood sugar levels is crucial if you want to live a long and healthy life. Unfortunately, a number of factors, including a sedentary lifestyle and a standard daily diet, can cause blood glucose levels to rise above normal, eventually resulting in prediabetes and type 2 diabetes. Long-term consequences of untreated high glucose levels include kidney failure, cardiovascular disease, and nerve damage. This article discusses the most popular blood tests for identifying abnormal glucose levels and effective ways to control them (fasting blood glucose, postprandial blood glucose, hemoglobin A1c, fasting insulin level, and HOMA-IR).

Fasting blood sugar: how diabetes correlates?

Throughout the day, particularly after meals, glucose levels naturally fluctuate. Carbohydrates dominate typical diets, which the body converts to glucose for energy. In response to the presence of glucose in the blood, the pancreas releases the hormone insulin. The “key” that unlocks the door for glucose to enter our cells from the bloodstream is insulin, as will be seen below. As this process continues, blood sugar levels gradually return to normal.

The amount of glucose in the blood can be measured using a fasting blood glucose (FBG) test. Results of a fasting blood glucose test can be used to determine how accurately your body controls blood sugar (FBG). It is advised to fast for 8–12 hours prior to an FBG test in order to get a reliable result. The minimal and comprehensive metabolic panels, as well as the standard blood work that your doctor will order, include an FBG test.

Typical Variations in Fasting Blood Glucose to diagnose pre-diabetes and diabetes

• Normal range: 65-99 mg/dL
• Prediabetes: 100-125 mg/dL
• Diabetes: 126mg/dL or higher on two separate tests

Better weight management, more energy, a more positive disposition, and sharper mental performance are all linked to normal glucose levels. If your FBG is still high eight to twelve hours after you last ate, you may have a problem with how your body handles glucose and should see a doctor.

Post–Prandial Blood Glucose

Why should you test your postprandial blood sugar?

Blood sugar levels after meals are a sign of metabolic and general health. You can better understand how food affects you by monitoring your postprandial blood sugar levels. After eating, your blood sugar should rise and then fall as your body uses the sugar for energy or storage in your cells.

A blood sugar level that is too high may indicate type 2 diabetes. Postprandial blood sugar ranges have been suggested by people with diabetes. The current postprandial blood sugar cutoffs are intended to detect diabetes after a sugary beverage. Normal diets don’t have goals.

Is high postprandial blood sugar normal after OGTT?

Blood sugar levels peak 1 to 2 hours after eating when carbs are broken down into glucose and enter the bloodstream. Oral glucose tolerance tests measure postprandial blood sugar (OGTT).

A doctor measures your blood glucose before and 2 hours after you drink a 75-gram glucose drink. Results show:

1. Normal postprandial blood sugar is below 140 mg/dL (7.8 mmol/L).
2. If your levels are 140 to 199 mg/dL, you may have prediabetes.
3. A value of 200 mg/dL (11.1 mmol/L) or higher suggests diabetes, but your doctor may use more than one test to diagnose. These values are for the OGTT test and its sugary drink.

Postprandial blood sugar is important in terms of diabetes

• Postprandial blood sugar is important for diabetics and non-diabetics.
• Postprandial blood sugar, along with fasting blood sugar, is important in managing diabetes. High levels may require a change in treatment.
• Uncontrolled high blood sugar can lead to diabetes complications like heart disease, kidney disease, stroke, and blindness.
• Postprandial blood sugar levels can indicate metabolic health in people without diabetes.
• If your levels remain high two hours after eating, you may have insulin resistance, in which your cells can’t absorb glucose from the blood as well.
• A healthcare professional can do several tests to determine if your postprandial blood sugar levels are healthy.
• Gradual rises and falls in blood sugar after eating are a normal part of digestion.
• If your blood sugar spikes too high or stays high for too long, you could experience immediate and long-term health effects.

 

Blood sugar spikes and drops can cause:

• Increased appetite: People who experience drastic blood sugar spikes and dips are more likely to feel hungry sooner and eat more calories throughout the day.
• Mood changes: A study linked large blood sugar spikes to 38% more depression and 55% more overall mood disturbances.
• Fatigue: A review of research involving 1,200 participants found that blood sugar spikes are associated with fatigue an hour after eating.
• Inflammation: High postprandial blood sugar levels can cause short-term inflammation in the body, which can have long-term health consequences.

 

High postprandial blood sugar increases the risk of metabolic diseases like:

• Heart disease: High postprandial blood sugar increases the risk of heart disease, whether or not you have diabetes.
• Too-high blood sugar levels can damage your body’s ability to regulate blood sugar, increasing your risk of type 2 diabetes.
• Overweight: A diet that regularly causes blood sugar spikes, such as one high in ultra-processed foods, increases the risk of becoming overweight.
• Repeated postprandial blood sugar spikes can increase your risk of obesity, type 2 diabetes, heart disease, and stroke.

 

HOMA-IR

The Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) is a screening tool used to predict diabetes risk. Insulin resistance is associated with an increased risk of cardiovascular disease and other conditions such as stroke, and its development can be influenced by factors such as being overweight or not exercising regularly. When cells stop responding to insulin, more insulin is secreted to try to bring blood sugar levels back down to normal. Insulin resistance is a condition that may be the first sign of diabetes. Normal-sugar-level individuals who later demonstrate insulin resistance are at risk for developing hyperglycemia.

HOMA-Insulin Resistance Index includes 5 tests

• Insulin (Fasting)

• Fasting Glucose

• Beta Cell Function (%B)

• Insulin Sensitivity (%S)

• HOMA Index

No special preparation is required when you are going to test HOMA-IR. The HOMA-IR test is useful for gauging the extent to which the pancreas must secrete insulin to maintain a healthy blood sugar level and for pinpointing potential avenues for diabetes prevention.

 

Defining Hemoglobin A1c: What Is It?

When FBG levels are elevated, doctors frequently request a hemoglobin A1c (HbA1c) test to obtain a more complete picture of the patient’s health. In contrast to FBG tests, which are only intended to evaluate your health in the near future, your HbA1c value represents your average blood glucose concentration over the previous three to four months.

Hemoglobin, a protein present in red blood cells, forms a bond with blood glucose. Because glucose stays bound to hemoglobin for 90–120 days, your HbA1c reveals your long-term glucose exposure. Your HbA1c will be higher if your blood glucose level is higher because more glucose will bind to hemoglobin as your blood glucose level rises. Higher HbA1c percentages correspond to average blood glucose levels that are higher.

Ranges of Hemoglobin A1c

Normal range: below 5.7%

Prediabetes: 5.7-6.4%

Diabetes: over 6.4%

As a general rule, a shift of 1 percentage point in HbA1c corresponds to a shift of 30 milligrams per deciliter in glucose.

Why does hemoglobin A1c rise?

As was previously mentioned, glucose levels must be tightly controlled by insulin. In contrast, insulin’s effect is undermined by several factors, some of which are discussed below.

1. Morbid obesity

Insulin resistance is exacerbated by having a high body fat percentage. Gaining weight, and especially visceral fat (the kind that surrounds our internal organs), has been shown to have a direct impact on insulin signaling. There is an increased risk of developing type 2 diabetes as a result of the increased glucose and HbA1c levels. One of the most important things you can do to keep your glucose levels under control is to keep your weight where it should be. A small weight loss (even 10 percent) can have a big impact on glucose levels in the body.

      2. Intake of Red meat

Meat consumption has been linked to an increased risk of developing type 2 diabetes, according to several studies. Meat consumption among more than 50,000 people was the subject of a meta-analysis (a study that examines multiple studies at once) published in 2015. Researchers discovered a correlation between eating any kind of meat, processed or not, and increased levels of glucose in the blood while fasting. This may have occurred because of the saturated fat content of red meat. Saturated fat has been shown to increase the risk of developing type 2 diabetes. One possible explanation is that the iron in red meat prevents insulin from doing its job.

       3. High sugar and low fiber consumption

Most people consume far less dietary fiber on a daily basis than is recommended. All plant-based foods contain fiber as a dietary supplement, but the human digestive system lacks the enzymes needed to digest fiber. Eating high-fiber foods has been shown to lessen hunger pangs and extend feelings of fullness because fiber cannot be digested by the body. According to research, people who consume more fiber consume fewer calories, lose more weight, and are less likely to develop diabetes. Obtain 25–38 g of fiber each day.

Low fiber consumption frequently coexists with high sugar consumption. Along with these products, sugar can also be found in salad dressings, nut butter, yogurt, and even bread, despite not being as obvious in these items. Numerous studies have demonstrated that eating too much sugar can result in weight gain, especially in the abdomen and liver. Particularly in these regions, excess body fat can increase the risk of diabetes and HbA1c.

I have normal HbA1c levels but my glucose levels are too high; what should I do?

FBG tests measure your glucose levels at a single point in time, making them more susceptible to your daily or weekly actions. Your blood glucose levels may be outside of the optimal range even though your HbA1c is within the normal range for one of the reasons below.

Sleep deprivation

Lack of sleep has been shown to disrupt glucose metabolism. Poorer insulin response to food is one of the consequences of sleep deprivation, leading to higher than normal increases in blood sugar. People who got less than eight hours of sleep per night had higher glucose and insulin levels after breakfast, according to one study. Other studies have found that sleep deprivation increases the risk of insulin resistance.

Stress

In response to extreme stress, the body secretes the steroid hormone cortisol, which triggers the “fight or flight” response. Cortisol causes the breakdown of glycogen, a storage form of glucose, which increases the release of glucose into the blood. Your blood sugar levels may be slightly elevated if you’ve had a stressful week.

Food

Fasting for 12 hours before a blood test is recommended because glucose levels rise and fall after eating. All beverages, including black coffee, must be watered down. It’s impossible to predict how an individual will react to coffee, so it’s best to err on the side of caution and drink only water.

Methods for reducing HbA1c and glucose levels in the blood

Better glucose control is associated with being at a healthy weight, eating less meat, and getting more sleep. Nonetheless, several other adjustments to one’s way of life can be beneficial as well.

Include beans and nuts in your vegetarian diet.

It has been shown that eating a vegetarian diet reduces the likelihood of developing type 2 diabetes. Researchers found that vegetarian diets consistently improved fasting blood glucose and HbA1c in a meta-analysis comparing nine separate experiments. Whole grains, fruits, vegetables, beans, and nuts, along with low amounts of saturated and trans-fat, are typically highlighted. Furthermore, beans serve as a protein source in these diets, often replacing meat.

Beans prevent sudden spikes in blood sugar and insulin because they contain lots of fiber and have a low glycemic index. Therefore, increasing bean consumption to at least one cup per day may significantly reduce A1c levels in people with type 2 diabetes.  Nuts, like beans, are low glycemic and can therefore aid in controlling blood sugar. A recent study found that people whose meals were supplemented with a handful of nuts had better glycemic control and lower HbA1c levels. For the most part, people who regularly incorporate nuts into their diets have a lower risk of developing type 2 diabetes.

Exercising Regularly

Exercise is an essential part of controlling blood sugar and insulin levels. Its effects on blood sugar, insulin sensitivity, and weight maintenance are all direct and beneficial. Resistance training and other forms of exercise are particularly useful for warding off the onset of type 2 diabetes.

Be present and mindful.

Including mindful practices in your daily life has been shown to lower blood sugar and cortisol. Mindfulness can be practiced for as little as 5 minutes a day and built up to 30 or more daily.

Do more meal prepping at home

We know that eating out can raise blood sugar levels because of the increased calorie and saturated fat content of the food. Meals prepared at home, where the cook has complete control over the ingredients, typically result in lower blood sugar and insulin levels.

Supplements should be considered if you are diagnosed with diabetes

As a final point, you can try taking a supplement that may help reduce your blood sugar levels. Water and fat-soluble vitamins are required along with omega-3 fatty acids in most patients. Take the opinion of your treating doctor to start the supplements.

 

For stable glucose and HbA1c levels in diabetes, or for reducing their severity, consider the following.

• Achieve and sustain a healthy weight
• Try to eat less sugar and red meat.
• The recommended nightly sleep time is 8 hours.
• Implement a vegetarian diet and see how you feel (at least a few weeks)
• Be sure to stick to your workout schedule.
• Add more legumes and nuts to your diet.
• Eat in more often.
• Be present and mindful.
• Be sure you’re taking the appropriate supplements.