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Originally Posted by Stuboy  I was told that even a non diabetic can go into double figures after a meal... .. |
It is also true that a lot of "normal" non-diabetics are suffering from the harmful effects of high blood glucose. The big DCCT and UKPDS trials showed that the risk of complications only starts increasing significantly when HBA1c goes over 6%. And everyone latched onto that figure as the the "normal" benchmark. But it has more recently been shown that heart disease and mortality risk increases when HBA1c goes over 4.8%. (You can read all about it in Regina Willshire's
latest blog ). Here is a table relating CHD, CVD and mortality risk to HBA1c :
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Percentage of men with CHD events at, with relative risk at:
Less than 5% = 3.8% (95% CI; RR = 1)
5% to 5.4% = 6.4% (RR 1.56 [1.09-2.24])
5.5% to 5.9% = 8.7% (RR 2.00 [1.39-2.88])
6% to 6.4% = 10.2% (RR 2.13 [1.35-3.35])
6.5% to 6.9% = 14% (RR 3.34 [1.78-6.63])
7% or higher = 28.4% (RR 7.07 [3.96-12.62])
Percentage of men with CVD events at, with relative risk at:
Less than 5% = 6.7% (95% CI; RR = 1)
5% to 5.4% = 9% (RR 1.23 [0.92-1.64])
5.5% to 5.9% = 12.1% (RR 1.56 [1.16-2.09])
6% to 6.4% = 15.2% (RR 1.79 [1.24-2.60])
6.5% to 6.9% = 25% (RR 3.03 [1.73-5.31])
7% or higher = 34.8% (RR 5.01 [2.95-8.51])
All-cause mortality (death within the six years of the study) in men at:
Less than 5% = 3.8% (95% CI; RR = 1)
5% to 5.4% = 5.5% (RR 1.25 [0.88-1.82])
5.5% to 5.9% = 7.5% (RR 1.57 [1.08-2.29])
6% to 6.4% = 9.9% (RR 1.80 [1.13-2.86])
6.5% to 6.9% = 19% (RR 3.49 [1.83-6.66])
7% or higher = 18.5% (RR 3.38 [1.74-6.53])
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This emerged from a study on the effects of BG on cancer. It shows pretty hefty increases in risk and you need to get your HBA1c
below 5% to get rid of it alltogether! So we are playing a risk-minimisation game here. And you have to decide how far you want to go with it. But don't delude yourself that BG spikes are normal and don't affect you.
To the extent that BG spikes increases HBA1c, CVD, CHD and mortality risk goes up. If these spikes last a couple of hours three times a day, the effects are likely to be substantial. And you don't have to be a diabetic for this to be an issue.
