3) THE BASIC CAUSES OF TYPE 2 DIABETES
c) Tests for Diabetes
Most physicians define diabetes as when the 8 hour "fasting blood glucose level " is above 125 milligrams per deciliter (mg/dl) in the serum of the blood, i.e. the blood sugar meter reads 126 or above in the morning before eating anything. The "fasting blood glucose level" is done as part of the standard battery of blood tests done as a part of any physical exam. These tests also measure cholesterol, triglycerides, and a host of other blood factors. It is all done in a lab in a series of complex pieces of automated equipment and is very accurate. It is important that the test be done without so much as a cup of coffee being ingested in the previous 8 hours, so don't eat or drink anything before going to have your blood drawn.
In the fasting state, as in the morning before breakfast, the "normal" person's blood sugar concentration is between 80 and 100 mg/dl of blood. If it is 100 to 125 mg/dl, a person is "pre-diabetic" and needs to start acting as though they had type 2 diabetes (some authorities define "prediabetic" as over 110), and if the reading is 126 mg/dl or higher the person is considered a person with diabetes by the American Diabetes Association or ADA (note we will use "ADA" as an acronym for only the American Diabetes Association, even though it is also an acronym for the "American Dieticians Association" and the "Americans with Disabilities Act").
Using the "fasting sugar" as the only diagnostic test can be very misleading. A person can have very good fasting levels of sugar and still have extremely high spikes of sugar in the blood. And the high spikes can do damage. As an example, a patient with type 2 diabetes used weight loss, exercise and diet to move his 8 hour fasting blood sugar to 85 to 95. But he can still had relatively severe, long present type 2 diabetes. The type 2 diabetes isn't "cured", type 2 diabetes is never "cured". If the patient eats too much of the wrong carbohydrates (sugars or starchy food materials such as rice, corn, potatoes, wheat flour etc. which readily break down into simple sugars such as glucose), he can get his blood sugar level up to 200 mg/dl, and probably do a lot of damage in the process. But by the definition of many physicians, he doesn't have diabetes. He is not even pre-diabetic!
After a meal containing large amounts of easily digested carbohydrates the blood sugar of a normal person rises, usually reaching a concentration of 120 to 140 mg/dl after 1 to 2 hours and then gradually falls during the third and fourth hours. In other individuals the blood sugar may reach 180 mg/dl and higher one hour after a reasonably balanced small meal. Accompanying this high blood sugar level sugar will typically be found in the urine. This abnormally high concentration of blood sugar indicates diabetes even if the fasting sugar level is well below 126 mg/dl. The old test for diabetes was to eat a meal with a lot of sugar and to then look for sugar in the urine using strips that can be purchased at a drugstore. The sugar will show up an hour or two after the meal.
If a person suspects they have diabetes (i.e. they have metabolic syndrome X and/or they experience several of the symptoms of diabetes) they need to see a doctor. There are ways to confirm diabetes without a doctor but they are dangerous. If you can't afford a medical doctor see if there is a clinic you can go to. Diabetes is a serious disease and must be handled by medical doctors.
The "gold standard" test used by doctors for blood sugar levels is the "A1c". This test is typically done if a blood test has shown "fasting blood glucose levels" over 125. Excess blood sugar attaches itself to certain proteins in the blood and "poisons" them. The so called "A1c" blood test for diabetes is actually is just a measure of the poisoning (glycation) of certain of the blood proteins by sugars over a span of two to three months. If a person with type 2 diabetes has and A1c of "6.0%" then 6% of their red blood cell protein was poisoned (glycated) by sugars in their blood in the past 2 to 3 months. The lower the A1c, the better the blood sugar level has been controlled for two or three months. In someone without type 2 diabetes, the A1c will be 4.6% to 5.7% (note there is some debate on this). In someone with type 2 diabetes about 6.0% is good. The American Diabetes Association says that 7.0% is "good enough". We disagree, 5.7% or "normal" should be the goal of any patient with diabetes. Note that it is important to always get a copy of any blood tests and to look at them yourself as to whether or not they are "acceptable" by the standards which you want to achieve. Don't accept a physician simply telling you "everything is OK" or "everything is good". If anyone really wants to control and even reverse type 2 diabetes they will have to do much better than "OK" or "good". The same goes for blood lipid profiles (cholesterol and triglycerides).
Diabetes is also rarely diagnosed via the "oral glucose tolerance test" (OGTT). For the OGTT test, after a fast of 8 to12 hours, a person's blood sugar is measured before and 2 hours after drinking a sugar-containing solution (typically 75 grams of glucose sugar). The standards for the OGTT are:
1, In normal sugar tolerance, blood sugar rises no higher than 140 mg/dl 1 and 2 hours after the drink.
2, In "pre-diabetes" the 1 and 2-hour blood sugar is between 140 and 199 mg/dl.
3, If the 1 or 2-hour blood sugar rises to 200 mg/dl or above, a person has diabetes.
Current Chapter: THE BASIC CAUSES OF TYPE 2 DIABETES
a) Underlying Mechanism of Type 2 Diabetes
b) Symptoms of Type 2 Diabetes
c) Tests for Diabetes
d) Insulin Resistance
e) The Complexity of Diabetes
f) Poisoning of Body Protein
g) Diabetes, Protein Poisoning and Cognitive Thinking
h) Protein Poisoning and A1c
i) Well Cooked Meat and Protein Poisoning
j) Beta Cell Death in Type 2 Diabetes
k) The Hypoglycemic Spike Effect
l) The "Dawn Phenomenon"
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