When we go for our yearly check up, we will hopefully get a blood work up that includes a fasted glucose. Glucose is commonly used as a marker to see how well we are managing our blood sugar, but today’s blog is to explain how this one maker has limitations, and what blood markers should be used to monitor your body’s ability to maintain good blood sugar.
3 reasons why glucose may be considered a poor marker in monitoring our body's ability to regulate blood sugar:
Short-Term Fluctuations:
Missed High Glucose Readings Throughout the Day:
High fasting glucose during the day can also do harm to your body in other ways:
1. Reduced cognitive performance
2. Depression and anxiety
3. Skin issues such as acne
4. Poor sleep
5. Higher stress levels
6. Sexual dysfunction
Insulin Sensitivity:
Glucose levels alone do not always indicate how well the body is responding to insulin. Insulin sensitivity plays a crucial role in blood sugar management, and assessing it requires a more comprehensive approach. When you eat and take in glucose your pancreas releases the hormone insulin, which helps clear glucose from your bloodstream. But if you consistently spike your glucose levels with high glycemic foods then your body has to produce large amounts of insulin to deal with it. Overtime, this can cause insulin resistance, which can lead to a whole host of issues such as heart disease, kidney disease, diabetes, infertility, and Alhemier’s disease.
As one can see, managing our blood sugar is complex, and just getting a measurement for fasted glucose does have its limitations. This next section explains how assessing other biomarkers can provide a more comprehensive evaluation and give more insight into our ability to maintain blood sugar.
Markers I Use in My Practice to Assess Blood Sugar Management:
Hemoglobin A1C
Fasting Insulin
Triglycerides
Apo B
Uric Acid
I use these 5 key markers to assess blood sugar, so we can keep tabs on blood sugar health here AND now AND in the long term!
Hemoglobin A1C (HbA1c)
This test measures your average blood glucose over the past three months. It is expressed as a percentage and an optimal range is between 4.1 - 5.4%.
*** It is important to note that hemoglobin A1c is one of the last things to change in metabolic dysfunction. By the time this rises, you could be well on your way to insulin resistance.
Fasting Insulin
Insulin is the key hormone for maintaining stable glucose. When one consumes carbohydrates, the body secretes insulin to help shuttle glucose from the blood into the cells for storage and energy for the muscles and the brain.
Many may not realize, but insulin affects every single cell in your body, including, your bones, your brain, your muscles and your skin cells. Catching this at an early stage can prevent bone loss, brain health issues, heart issues and more. But it needs to be caught early… by testing early. Optimal levels for insulin are 2.0 - 8.0.
Triglycerides
Yes, triglycerides show us how well your body is regulating your blood sugar! Triglycerides are a type of lipid stored in fat cells. When we eat too much we store these unused calories. High triglycerides are an indication of excessive energy consumption, mostly in the form of processed carbs, alcohol and sugar. Elevated triglycerides increase one's risk of cardiovascular diseases by creating more dangerous plaques within the lining of the blood vessels. When there are excess triglycerides, the plaque within the arteries is more likely to rupture, leading to a cardiovascular event (heart attack or stroke). Optimal triglycerides should be below 100. (And above 50…I will need to do another blog post on low Triglycerides, which can be an issue as well).
Apo B
Apolipoprotein B (apo B) is a protein attached to cholesterol particles in your bloodstream, known as lipoproteins. The particles that have an Apo B attached are more likely to cause plaque build in in your arteries, which can narrow blood vessels. Therefore, knowing your Apo B value can be highly valuable in determining your risk for heart disease, because high levels of Apo B are associated with metabolic syndrome and insulin resistance. High levels of Apo B can also be an indicator of excess consumption of saturated fats and too many omega 6 fatty acids in the diet. Optimal range for Apo B is 0 - 90.
5. Uric Acid
Uric acid is the breakdown of nucleic acids (which come from proteins), as well as alcohol and fructose. When uric acid levels are high, we often see mitochondrial dysfunction, which means that the “powerhouse of the cell” that makes energy from glucose is now shunting to store this energy as fat. High uric acids levels have been found to be a strong predictor for the development of obesity, diabetes, cardiovascular disease, coronary artery disease, stroke, high blood pressure, nonalcoholic fatty liver disease, gout, chronic kidney disease, kidney stones, and Alzheimer's disease, with studies identifying several mechanisms by which uric acid may drive these conditions. In a true “viscous cycle”, obesity and insulin resistance themselves may also raise uric acid levels. Higher levels of insulin increase uric acid by inhibiting its excretion via the kidneys (the main way we excrete uric acid). Optimal levels of uric acid are 3.0 - 5.5 for females and 3.5 - 5.9 for males.
While fasting glucose is commonly used for assessing blood sugar control, it falls short of providing a complete understanding of an individual's metabolic health. It is my hope that this blog post has highlighted the limitations of relying solely on a fasted glucose measurement and emphasizes the importance of considering a range of biomarkers for a more comprehensive evaluation.
In essence, managing blood sugar goes beyond a single measurement, and incorporating a variety of biomarkers enables a more informed approach. This comprehensive perspective not only enhances our ability to detect early signs of metabolic dysfunction, but also empowers individuals to take proactive steps toward optimizing their metabolic health.
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