The Difference Between Standard Cut Offs and Single Time Point Measures for Diabetes and Prediabetes

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About This Episode:

Peaks in blood glucose (or “blood sugar spikes”) are commonly highlighted as something harmful to health. And, of course, an excessively high blood glucose response to a meal can be problematic, or at least indicate there is a problem.

However, elevations in blood glucose after eating are a normal physiological response. And “bad” blood glucose responses are those that stay high for a prolonged period; i.e. after elevating, they don’t return to normal within an appropriate period of time.

But now many normoglycemic people are worrying about normal blood glucose responses, due to information that portrays even moderate elevations in blood glucose as harfmul. To add to the confusion, people are looking at standardized cut-off thresholds for diabetes and pre-diabetes, and mistakenly using them to label their own response to eating as measured by a continuous glucose monitoring (CGM) device.

When it comes to normoglycemic people, there is still a grey area in relation to how much of a glucose spike is a cause for concern. And given that there are still open questions that evidence has not fully answered yet, there is room for different interpretations of how to answer this question.

So what actually is a blood glucose peak that is “too high”? Is it 7.8 mmol/L (140 mg/dL)? 10.0 mmol/L (180 mg/dL)? 11.1 mmol/L (200 mg/dL)? Or do we even need to think about this once standard measures (e.g. HbA1C) are normal?

To discuss this interesting area, Dr. Mario Kratz and Dr. Nicola Guess are on the podcast to offer some perspectives and their conclusions from the current evidence base.

Blood Glucose Unit Conversions:

• 1.7 mmol/L = 30 mg/dL
• 7.0 mmol/L = 126 mg/dL
• 7.8 mmol/L = 140 mg/dL
• 9.0 mmol/L = 162 mg/dL
• 10.0 mmol/L = 180 mg/dL
• 11.0 mmol/L = 198 mg/dL
• 11.1 mmol/L = 200 mg/dL