Blood sugar
October 16, 2011 | 20,00 EUR | answered by Christian Welsch
Dear Sir or Madam,
Due to a positive urine sugar test strip, I had myself tested for diabetes by my general practitioner. The fasting blood sugar level (NBZ) was 97 mg/dl (as far as I understand, still good) and the HbA1c was 5.0% (average blood glucose 81 mg/dl). A bit confused by the positive urine sugar test and an alleged average blood glucose of 81 with a NBZ of 97 mg/dl, I purchased a blood glucose meter.
After 'healthy' meals with slower carbohydrates, everything is fine. The blood sugar level rises just slightly above 140 after 30-45 minutes and is back under 100 after 2 hours. However, after a sweet breakfast, I have around 165 mg/dl after 30 minutes. After another 30 minutes (1 hour after the meal), it is already below 140 again. Is this normal or should I rather have an oral glucose tolerance test done? How high can the blood sugar level temporarily rise in healthy individuals? I read so many different and sometimes contradictory statements on the internet that I, as a non-medical professional, simply cannot classify.
I have essential hypertension (well controlled). There are no other risk factors for diabetes. I am in my mid-30s and male.
Thank you in advance.
Dear inquirer,
since it seems that none of the internal medicine colleagues currently have the time to answer your question, I would like to attempt to provide you with an answer.
First of all, I would like to point out that the presence of sugar in the urine does not necessarily indicate a medical condition. Simply detecting sugar in the urine (qualitative test) does not provide much information, as the body may be getting rid of excess sugar in this way. The sugar content in urine of a healthy individual is approximately one-tenth of the content in the blood. Therefore, the sugar content in the urine should not exceed 15 mg/dl or 8.3 mmol/l.
The values you describe (normal HbA1c) clearly suggest that diabetes is not present. To obtain a reliable average blood sugar level, one must measure blood sugar at least 4-6 times a day over a period of 14 days...
According to information from a diabetologist, diabetes can only be confirmed through an oral glucose tolerance test. This test measures blood values through blood withdrawal from a vein, rather than from capillaries like with a blood sugar strip.
Normal blood sugar values can vary between different societies; for example, the Germans have different recommendations than the Americans.
However, the crucial aspect in your case is that a standard glucose meter only monitors the progression of diabetes, it does not diagnose the disease itself. These devices can have variations of up to 15% in measurements, which is simply too imprecise.
If you are still unsure, it would be advisable to undergo an oral glucose tolerance test and test for the excretion of glucose in urine.
