How to define normal blood sugar.

[patliputra]

What should be the criteria and basis on which to define normal .

[patliputra]

Indiacratus and concerned, though the posed what is " normal" blood sugar appears simple to answer,but researchers and different reputed organisations are finding it hard to answer it.

There is general agreement that HYPERGLYCEMIA is harmful,but it is difficult to derive cut point at which level harm is specifically increased and which clearly differentiates diabetes from non diabetes.

Numerous studies have examined the relationship between plasma glucose and mortality and cardiovascular complications but have failed to show a definite threshold which could be used to define diabetes.

Diagnostic cut out points for diabetes has been derived from two sets of information. (1) plasma glucose levels associated with the risk diabetes specific micro vascular complication ,particularly retinopathy. (2) population distribution of plasma glucose.

Despite limitations the current criteria distinguish a group with significantly increased premature mortality and increase risk of microvasculal complication and cardiovascular complications.

The current criteria differs in blood sugar levels . European unions criteria is lower than the WHO criteria.

[patliputra]

You are right. There is no definite bio marker available at present to distinguish diabetics from non diabetics or vice versa . As biology and mathematics are different things,even data ( here blood sugar levels ) are variables in humans ,depending on age, sex, ethnicity etc. Many studies have shown that statistical analysis of data fails to provide answer to large number is cases of diabetes. So clinical and physiological basis is used to arrive at the cut off levels for blood sugar levels.

For us it is only academic discussion. The real object is what blood sugar levels to be used to lebel a person a diabetic ,pre diabetic or normal.

Just for information, DETECT 2 data from 26 countries with plasma glucose measurements found wide variations. The cut off range from different countries ranged from 5.7 mol/ l to 8.5 mol / l ( median 7.1 ) for fasting and for 2 hours plasma glucose ranged from 9.1 to 17.9 mol / l ( median 12.4 mol / l).

[patliputra]

Trying to be practical is a step in right direction and to achieve it should be the goal,but unfortunately all efforts to reach an ideal situation is not forth coming due lack of sufficient relevant data and appropriate methodology.

But I agree with you that target of fasting blood sugar should as low as possible short of hypoglycemia. Same is also true for pp 2 hrs. after food. It is diabetic individual who has to set a target level suitable for him with or without the assistance of health care provider and try to achieve it with repeated blood sugar tests.

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In my opinion the last HbAic should be equivalent or below 4.6% For non diabatic