Post by Enchantress on Nov 2, 2004 11:16:11 GMT -5
Some info that will make you distrust what your doctor and the ADA have been telling you:
Healthy Blood Sugar Targets
Preserve Your Eyes, Nerves, Kidneys, Heart and Beta Cells
The Blood Sugar Level at Which Permanent Organ Damage Occurs
Research conducted with human patients, mice, and pancreas beta cell cultures all point to a single threshold at which elevated blood sugars cause permanent damage to your body. What is that level?
140 mg/dl (7.8 mmol/L)
The AACE Recommends Post-Meal Numbers Below 140 mg/dl
The American Association of Clinical Endocrinologists has recently revised its recommendations to say that blood sugar should not be allowed to rise above 140 mg/dl two hours after a meal.
Their published recommendations state,
. . .a large number of highly robust cross-sectional and prospective epidemiologic studies have clearly implicated a close association between postchallenge or postprandial hyperglycemia and cardiovascular risk. These studies encompass diverse populations and disparate geographic regions, from Honolulu to Chicago to Islington to Paris. A recent analysis of 25,000 patients in Diabetes Epidemiology:Collaborative Analysis of Diagnostic Criteria in Europe (DECODE)Study supports the concept of an important link between postchallenge glycemia and macrovascular risk. Furthermore, Hanefeld et al showed that moderate postprandial hyperglycemia (148 to 199 mg/dL) not only is more indicative of atherosclerosis than fasting plasma glucose levels but also may exert direct detrimental effects on endothelium. . . .
In subjects without diabetes, blood glucose levels typically peak approximately 1 hour after the start of a meal and return to preprandial levels within 2 to 3 hours; 2-hour postprandial blood glucose levels rarely exceed 140 mg/dL.
Therefore, the consensus panel recommends a treatment-targeted 2-hour postprandial blood glucose level of 140 mg/dL to facilitate tighter control of glycemia without increasing the risk of hypoglycemia.
Read the whole "AACE Consensus Statement on Guidelines for Glycemic Control"
Most Doctors are Still Recommending Much Higher, Damaging Levels
Because the American Diabetes Association still recommends maintaining blood sugars at much higher levels, as high as 180 mg/dl (10 mmol/L) after a meal, many doctors who are not specialists in diabetes --and some that are--still advise patients that post-meal levels much higher than 140 mg/dl are safe.
The reason doctors recommend this higher, dangerous level is because they believe that patients are too lazy and undisciplined to make the changes needed to bring their blood sugars down to truly safe levels.
The other reason is because it is usually impossible to attain these healthy levels using anti-diabetic drugs alone. These targets can only be reached by cutting way down on your carbohydrate intake.
If your doctor doesn't stress the importance of maintaining truly safe blood sugar levels, print out the AACE guidelines linked above and bring them with you to your appointment. If that doesn't help, find a new doctor.
Remember: It's your eyes that go blind, your nerves that die, and your kidneys that fail, not your doctor's. He can afford to have low expectations for you. You cannot. Keep your blood sugar at safe levels!
Click HERE to see more research that backs up the importance of not exceeding 140 mg/dl (7.8 mmol/L) after meals.
(You don't have to click...here it is):
Research on Blood Sugar Levels and Organ Damage
These studies, some not cited in the AACE guidelines, make a cogent case that post-meal blood sugars of 140 mg/dl (7.8 mmol/L) and higher and fasting blood sugars over 100 mg/dl (5.6 mmol/L) cause permanent organ damage and cause diabetes to progress.
Nerve Damage Occurs when Blood Sugars Rise Over 140 mg/dl (7.8 mmol/L) After Meals
A study conducted in the neurology clinic at the University of Utah examined patients who came to the clinic complaining of peripheral neuropathy of unknown origin. Peripheral neuropathy is the medical term for a kind of nerve damage which causes pain, tingling, "pins and needles" or burning sensations in the hands and feet.
The University of Utah neurologists found that patients who were not known to be diabetic, but who registered 140/mg or higher on the 2-hour sample taken during a glucose tolerance test were much more likely to have a diabetic form of neuropathy than those who had lower blood sugars. Even more telling, the researchers found that the length of time a patient had experienced this nerve pain correlated with how high their blood sugar had risen over 140 mg/dl on the 2-hour glucose tolerance test reading.
It is important to note that this study also showed that only the glucose tolerance test results corresponded to the incidence of neuropathy in these patients, not their fasting blood sugar levels or their results on the HbA1c test, also known as the "hemoglobin" test. This is significant because most American doctors do not offer their patients glucose tolerance tests, only the fasting glucose and HbA1c tests that fail to diagnose these obviously damaging post-meal blood sugars.
Singleton, JR Smith AG, Bromberg, MB Increased prevalence of impaired glucose tolerance in patients with painful sensory neuropathy. Diabetes Care 24 (8) 1448-1453 2001. care.diabetesjournals.org/cg.../full/24/8/1448
A second study performed by neurologists at Johns Hopkins confirmed these findings. Fifty-six percent of their patients who had neuropathy of unknown origin were found to have abnormal results on their oral glucose tolerance tests. When nerve conduction studies were run, doctors sorted their patients into those whose glucose tolerance test results were normal, those with impaired glucose tolerance whose 2-hour glucose tolerance test readings fell between 140 mg/dl and 200 mg/dl, and those who were diabetic, with two hour glucose tolerance test results were above 200 mg/dl (11.1 mmol/L). They found that patients who had impaired glucose tolerance had experienced damage to their small nerve fibers while those with diabetic-level test results had more involvement of the large nerve fibers.
C.J. Sumner, MD, S. Sheth, MBBS MPH, J.W. Griffin, MD, D.R. Cornblath, MD and M. Polydefkis, MD; The spectrum of neuropathy in diabetes and impaired glucose tolerance. Neurology 2003;60:108-111. www.neurology.org/cgi/content/abstract/60/1/108
Healthy Blood Sugar Targets
Preserve Your Eyes, Nerves, Kidneys, Heart and Beta Cells
The Blood Sugar Level at Which Permanent Organ Damage Occurs
Research conducted with human patients, mice, and pancreas beta cell cultures all point to a single threshold at which elevated blood sugars cause permanent damage to your body. What is that level?
140 mg/dl (7.8 mmol/L)
The AACE Recommends Post-Meal Numbers Below 140 mg/dl
The American Association of Clinical Endocrinologists has recently revised its recommendations to say that blood sugar should not be allowed to rise above 140 mg/dl two hours after a meal.
Their published recommendations state,
. . .a large number of highly robust cross-sectional and prospective epidemiologic studies have clearly implicated a close association between postchallenge or postprandial hyperglycemia and cardiovascular risk. These studies encompass diverse populations and disparate geographic regions, from Honolulu to Chicago to Islington to Paris. A recent analysis of 25,000 patients in Diabetes Epidemiology:Collaborative Analysis of Diagnostic Criteria in Europe (DECODE)Study supports the concept of an important link between postchallenge glycemia and macrovascular risk. Furthermore, Hanefeld et al showed that moderate postprandial hyperglycemia (148 to 199 mg/dL) not only is more indicative of atherosclerosis than fasting plasma glucose levels but also may exert direct detrimental effects on endothelium. . . .
In subjects without diabetes, blood glucose levels typically peak approximately 1 hour after the start of a meal and return to preprandial levels within 2 to 3 hours; 2-hour postprandial blood glucose levels rarely exceed 140 mg/dL.
Therefore, the consensus panel recommends a treatment-targeted 2-hour postprandial blood glucose level of 140 mg/dL to facilitate tighter control of glycemia without increasing the risk of hypoglycemia.
Read the whole "AACE Consensus Statement on Guidelines for Glycemic Control"
Most Doctors are Still Recommending Much Higher, Damaging Levels
Because the American Diabetes Association still recommends maintaining blood sugars at much higher levels, as high as 180 mg/dl (10 mmol/L) after a meal, many doctors who are not specialists in diabetes --and some that are--still advise patients that post-meal levels much higher than 140 mg/dl are safe.
The reason doctors recommend this higher, dangerous level is because they believe that patients are too lazy and undisciplined to make the changes needed to bring their blood sugars down to truly safe levels.
The other reason is because it is usually impossible to attain these healthy levels using anti-diabetic drugs alone. These targets can only be reached by cutting way down on your carbohydrate intake.
If your doctor doesn't stress the importance of maintaining truly safe blood sugar levels, print out the AACE guidelines linked above and bring them with you to your appointment. If that doesn't help, find a new doctor.
Remember: It's your eyes that go blind, your nerves that die, and your kidneys that fail, not your doctor's. He can afford to have low expectations for you. You cannot. Keep your blood sugar at safe levels!
Click HERE to see more research that backs up the importance of not exceeding 140 mg/dl (7.8 mmol/L) after meals.
(You don't have to click...here it is):
Research on Blood Sugar Levels and Organ Damage
These studies, some not cited in the AACE guidelines, make a cogent case that post-meal blood sugars of 140 mg/dl (7.8 mmol/L) and higher and fasting blood sugars over 100 mg/dl (5.6 mmol/L) cause permanent organ damage and cause diabetes to progress.
Nerve Damage Occurs when Blood Sugars Rise Over 140 mg/dl (7.8 mmol/L) After Meals
A study conducted in the neurology clinic at the University of Utah examined patients who came to the clinic complaining of peripheral neuropathy of unknown origin. Peripheral neuropathy is the medical term for a kind of nerve damage which causes pain, tingling, "pins and needles" or burning sensations in the hands and feet.
The University of Utah neurologists found that patients who were not known to be diabetic, but who registered 140/mg or higher on the 2-hour sample taken during a glucose tolerance test were much more likely to have a diabetic form of neuropathy than those who had lower blood sugars. Even more telling, the researchers found that the length of time a patient had experienced this nerve pain correlated with how high their blood sugar had risen over 140 mg/dl on the 2-hour glucose tolerance test reading.
It is important to note that this study also showed that only the glucose tolerance test results corresponded to the incidence of neuropathy in these patients, not their fasting blood sugar levels or their results on the HbA1c test, also known as the "hemoglobin" test. This is significant because most American doctors do not offer their patients glucose tolerance tests, only the fasting glucose and HbA1c tests that fail to diagnose these obviously damaging post-meal blood sugars.
Singleton, JR Smith AG, Bromberg, MB Increased prevalence of impaired glucose tolerance in patients with painful sensory neuropathy. Diabetes Care 24 (8) 1448-1453 2001. care.diabetesjournals.org/cg.../full/24/8/1448
A second study performed by neurologists at Johns Hopkins confirmed these findings. Fifty-six percent of their patients who had neuropathy of unknown origin were found to have abnormal results on their oral glucose tolerance tests. When nerve conduction studies were run, doctors sorted their patients into those whose glucose tolerance test results were normal, those with impaired glucose tolerance whose 2-hour glucose tolerance test readings fell between 140 mg/dl and 200 mg/dl, and those who were diabetic, with two hour glucose tolerance test results were above 200 mg/dl (11.1 mmol/L). They found that patients who had impaired glucose tolerance had experienced damage to their small nerve fibers while those with diabetic-level test results had more involvement of the large nerve fibers.
C.J. Sumner, MD, S. Sheth, MBBS MPH, J.W. Griffin, MD, D.R. Cornblath, MD and M. Polydefkis, MD; The spectrum of neuropathy in diabetes and impaired glucose tolerance. Neurology 2003;60:108-111. www.neurology.org/cgi/content/abstract/60/1/108