Normal blood glucose graph

[BlueSky]

There has been a lot of discussion about what "normal" is. Here is a graph that gives a good indication of what it should be. The graph below is the average CGMS results of 21 young, healthy non-diabetics. It is from an interesting study. Before meals and at night, the mean BG value trickles along at about 80. And it doesn't go much higher than 120 after meals.

It is interesting that there is such a lot of variability above and below the mean. I guess it goes to show that non-diabetics can also be insulin resistant. I was also interested in the extent of the breakfast post-prandial excursion. To see the presentation and listen to the audio, go here :

www.diabetes-symposium.org (http://www.diabetes-symposium.org)

[DeusXM]

It is interesting that there is such a lot of variability above and below the mean. I guess it goes to show that non-diabetics can also be insulin resistant.

Actually, I think's it's demonstrated the point I've been making consistently all along - even non-diabetics don't have rigid BGs around the 4-5mmol/l mark 24/7, and in fact the human body is quite capable of dealing with 'high' blood sugars without receiving any damage at all, providing the duration of the spike is limited.

Cheers, you've just me right about Bernstein and low-carbing.

[Gary_W]

I wonder how many of these people actually feel dodgy when their BG gets down to a range that we would know as hypo?

I know when I was first diagnosed I'd been running so high for so long that the first time I hit a BG of 7 (around 125) I felt what I now know as hypo warning signs.

Nowadays I don't feel them until I'm 3.x, or occasionally low 4's

For someone who is non-diabetic, do they feel the low? It seems amazing to me these days that so many people without diabetes bang on about how they have to maintain their blood glucose levels, and avoid the low mid morning dip etc etc....

Gary

[HelenM]

I was looking at the presentation and there is a graph that has all the profiles on it which I think shows the individual variability rather than the averages. Unfortunately the presentation moves on before I've had time to study it! How do you get a still shot? (and better still enlarge it as 20+ lines are hard to follow)

[Stuboy]

I wonder how many of these people actually feel dodgy when their BG gets down to a range that we would know as hypo?

I know when I was first diagnosed I'd been running so high for so long that the first time I hit a BG of 7 (around 125) I felt what I now know as hypo warning signs.

Nowadays I don't feel them until I'm 3.x, or occasionally low 4's

For someone who is non-diabetic, do they feel the low? It seems amazing to me these days that so many people without diabetes bang on about how they have to maintain their blood glucose levels, and avoid the low mid morning dip etc etc....

Gary

Yes, a non-diabetic can experience a hypo.

We've tested Lauras BG before when she's had symptoms of a hypo and her BG was low.
You dont have to be diabetic to have a hypo :)

[Cyborg]

Nice graph! :top:

I wouldn't say the bg trickles around 80, but rather bottoms out around 80 (for the mean value). It's real nice to see what happens after meals. Also nice to see that the range can go as low as 60 (the value I treat at usually) and can go as high as 150 or 160 after a meal. Looks like bg should return to normal after about 3 1/2 hours of eating...

[Injecto]

Yes, a non-diabetic can experience a hypo.


Agreed. My wife has always assumed when she get's shaky after not eating for a while she is going a bit hypo because eating always makes her feel better. So, since getting dxd and now I have a BG meter at home we've tested her out when she feels like that and she has easily gone down to 3.4 and getting all shaky.

[HollyB]

The women in my family are all prone to hypos and we get very ugly when they happen (as my husband discovered on our first travelling adventure together -- he liked to get up and drive for two hours before breakfast. He stopped suggesting that very quickly!). I got like that soon after Aaron was diagnosed and checked on his meter -- 3.7. Many people would not even call that hypo but I would have dismembered any one standing between me and food at that point. I can only imagine what a bad one feels like.

Randy Newman wrote a song for me and my sister:

"She may be hungry, she won't say,
But you better get a burger or something into her right away.
If you don't, you gonna pay
At the hand of the one you love."

[Funnygrl]

I wouldn't say that any of those values went into a hypo range. The lowest is like 80. For a non-diabetic the blood sugar has to go below 60 to be considered a true hypo.

I also think it's interesting the blood sugar doesn't go above 120 after a meal. it seems non-diabetics also have a little dawn phenomenon.

[DeusXM]

I also think it's interesting the blood sugar doesn't go above 120 after a meal.

Well, it does, actually. The mean average reading doesn't, but there's a range that goes right up to 160. Also the chart doesn't take into account precisely what is eaten - it's not based on individuals eating the exact same portion size or amount of carbs.

it seems non-diabetics also have a little dawn phenomenon.

They probably do; it's just that their bodies also release insulin at the same time as glycogen, meaning they don't actually have an overall increase in blood sugar.

[ant hill]

Here is my BG's over 14 days

And i do need some help :(

[owlyn]

That is a great graph. Makes me feel not so bad, seeing that "normal" people hit 160 after a meal. I didn't listen to the presentation, but it would have been interesting to see if there was any correlation with food choices/amount eaten and those who went to 160 vs those who didn't go as high.

[Dan Gato]

I wouldn't say that any of those values went into a hypo range. The lowest is like 80. For a non-diabetic the blood sugar has to go below 60 to be considered a true hypo.

I also think it's interesting the blood sugar doesn't go above 120 after a meal. it seems non-diabetics also have a little dawn phenomenon.

So, what are you saying?
normal is 80 to 120 for non diabetics?
I'm far away of being normal.
The endos say should never be over 110. I guess 10 points is not a big deal. it isn't for me.:)

[LancetChick]

I feel as if I need to hold myself to a standard that doesn't allow for any but the smallest post-prandial blood sugar spikes, even though non-diabetics clearly do spike after eating. I do this because non-diabetics don't get high blood sugars from a surprise hormone or stress incident or from miscalculating an insulin dose or any of a dozen other reasons, and I do! If I accepted a non-diabetic post-prandial BG range for myself, there's no way I'd be able to have an A1c in the non-diabetic range without stumbling through life in a hypoglycemic fog. About 21 years ago my CDE said that she tested her blood sugar after eating a carb heavy Thanksgiving meal, and it was 180. I just can't get away with a spike that high simply because I am a diabetic.

[warner]

Hi all. For the "normal blood sugar graph", how do you guys know that it's showing plasma glucose and not whole blood glucose? The A1Cs quoted in the presentation seem to imply that the graph is showing whole blood values, but it's hard to tell. thanks, warner

[Harold]

Well it's not showing either. What it is showing is the "Continuous subcutaneous glucose monitoring in healthy subjects during daily life conditions." Which means glucose under the skin not from in the blood. Now the question was the CGMS calibrated to a meter as in a plasma or whole blood reading meter, or was it independently calibrated from a know source as in a glucose solution.

[Funnygrl]

Well it's not showing either. What it is showing is the "Continuous subcutaneous glucose monitoring in healthy subjects during daily life conditions." Which means glucose under the skin not from in the blood. Now the question was the CGMS calibrated to a meter as in a plasma or whole blood reading meter, or was it independently calibrated from a know source as in a glucose solution.
I would guess it was calibrated to lab values which are usually plasma.

[Eddy]

I wouldn't say the bg trickles around 80, but rather bottoms out around 80 (for the mean value). It's real nice to see what happens after meals. Also nice to see that the range can go as low as 60 (the value I treat at usually) and can go as high as 150 or 160 after a meal. Looks like bg should return to normal after about 3 1/2 hours of eating...


Personally, I'd say that it asymptotically approaches around 80. ;)


So, what are you saying?
normal is 80 to 120 for non diabetics?
I'm far away of being normal.
The endos say should never be over 110. I guess 10 points is not a big deal. it isn't for me.:)


The bold, blue line is the mean ("normal" people call this the "average"), and the thin lines show plus or minus two sigma. IOW, at least 95% of the population is between the upper and lower bounds.

No wonder I feel better when I awaken around 80. It looks like I've been trying to run my FBG at the high end of normal, +2 SD.

[solox316]

dealing with 'high' blood sugars without receiving any damage at all, providing the duration of the spike is limited.


Exactly. The duration of the spike is exactly what brings up A1C, for anyone. Even a post meal spike for a diabetic, at 180 or higher, isn't going to do damage either, as long as it is brought down within 2-4 hours.

Interesting graph... To me, it shows/confirms that a post meal spike isn't all that bad, esp. if it is also happening in non-diabetics...

[BlueSky]

Exactly. The duration of the spike is exactly what brings up A1C, for anyone. Even a post meal spike for a diabetic, at 180 or higher, isn't going to do damage either, as long as it is brought down within 2-4 hours ....
That seems to be the consensus based on research that has been done on this. Short-lived spikes are not a problem, as long as blood glucose returns to the target range promptly and stays there.

The problem is that this just doesn't happen. Not with me anyway. The bigger the blood glucose spike, the smaller the chance of it getting coming back down and being stable. Blood glucose goes up after a carby meal and just stays there. I end up having to chase it down with more insulin, and so the roller-coaster ride begins ...

Some people maintain that damage is done when BG goes over 140. This may be, but for me the main advantage of achieving near-normal PP blood glucose is that it is stable.

[xMenace]

Keeping carbs reasonable plus my other techniques to keep my spikes minimal also keeps me stable and generally eliminates chances of going hypo. My spikes do tend to fall, but often last four or more hours and drop very slowly. My hypo troubles typically start with correcting a high 2hr pp that is on track for correcting itself. I just don't know it. Four hours after that I bottom out.

Lately I've tried bolusing for high spikes then dropping my basals, but mostly it has resulted in bad roller-coaster rides.

[Janlaton]

Very interesting presentation. Of course anyone can go low. That is called Hypoglycemic and many people are diagnosed with the problem. Others just do not realize what is going on in their bodies. Just run grab coffee and sugar.

Think we all need to teach a nuturion course to those around us. Don't get me on my soap box.:D

[solox316]

Blood glucose goes up after a carby meal and just stays there. I end up having to chase it down with more insulin, and so the roller-coaster ride begins ....

Exactly... my problem is that the darn insulin doesn't bring it down as fast as my mind wants it too... eventhough I know this, and know how the insulin peaks and whatnot, I chase it, then drop too low a few hours later... then the liver kicks in... yadda yadda yadda... so avoiding those spikes is definitely preferred. I just simply cannot (won't more like it) give up some carbs, so I just try to learn to deal with em better....

[BlueSky]

... I just simply cannot (won't more like it) give up some carbs, so I just try to learn to deal with em better....
Tell me about it ... ;) . I think the trick is to eat carbs at a time of day when you are able to deal with it the best. Carbs send my BG through the roof in the morning, so I eat a very low carb breakfast. I am able to deal with carbs a lot more easily at lunch time, when I eat fruit or something starchy. I limit carbs at night because I want my BG to be stable and in the target range when I go to bed.

[solox316]

Carbs send my BG through the roof in the morning, so I eat a very low carb breakfast. I am able to deal with carbs a lot more easily at lunch time, when I eat fruit or something starchy. I limit carbs at night because I want my BG to be stable and in the target range when I go to bed.

Agreed! Breakfast is the worst! One serving of low cal yogurt is about my breakfast... Sometimes I have a mini-bagel, whole grain with some egg and cheese.

Today was bad... a yogurt w/berries and a muffin from Tim Hortons... bad spike! And to think... I only went for a coffee! I will call it a treat though...

Evening is bad too... which is even harder, coz I love to snack in the evening. Peanuts and cheese only sound good for so long!

Glad I am not alone...

I did just get finished splitting a just under a cord of logs (6-7:15 PM), so a nice starchy treat is in order!

[RobiJo]

The graph shows the truth about a common misconception: that a non-diabetics bgs are steady all day. I know a number of people that exhibit hypo symptoms (usually shaky or weak) if they have gone a long time without eating such as skipping breakfast.

Yeah, my problem is my love of carbs too. If I would just be better about bolusing 10-15 minutes for at least a part of the carbs, I'd be better off. I do have my sensor set at 130 now. Started at 200 last August, then 180, then 160, 150, 140 now to 130. For the most part I've seen my spikes stay lower and not last as long. I owe a lot of this to using the sensor on a regular basis. Starting to see the drop in my A1c according to monthly home tests. I now look forward to the first of every month when I can check it again.

[solox316]

I do have my sensor set at 130 now. Started at 200 last August, then 180, then 160, 150, 140 now to 130. For the most part I've seen my spikes stay lower and not last as long.

Wow, that's great! I am still set at 200, although it doesn't get there nearly as often... My spikes are minimal with Symlin, I just forget to give it, or am too low before eating to give it...

[RobiJo]

Wow, that's great! I am still set at 200, although it doesn't get there nearly as often... My spikes are minimal with Symlin, I just forget to give it, or am too low before eating to give it...

It's set at 130...that doesn't mean it's not alarming constantly! I also have it set for only 30min snooze. I was finding that it would hit the high alarm and keep going up up up, so I set it to a short 30min. I almost want a second alarm point, I'd put one at 130 and the other around 180 or 200. That one would scream YOU DIDN'T COUNT YOUR CARBS RIGHT!!!

[Scrabblechick]

Great graph! Thanks for posting it. My DH isn't diabetic, but if he goes too long without eating, he gets all the symptoms of a hypo--particularly the grouchy part!

Right now, and in general, my BG gets back to pre-fasting levels fairly quickly, usually 3-4 hours PP. Again, can't say it happens every time, as is usually the case with this disease, but it does happen most of the time.

[Janlaton]

I think the worse one is the hypo migraine. I used to get them before the days of so much easy to carry food. All the prepackage stuff makes not going too low a lot easier. It was a number of years into my marriage before my husband really believed going too long without food was one of the triggers for the migraines. Now he says, Jan go eat something.

My diabetic ed person did some neat charts from my meter last week. Don't know if you have the software with your meter or not by it was interesting all the different facts she charted. Me I just keep up with the #s on a piece of paper.:D