"In all the work with diabetes technology I’ve done, I’ve worn CGM for long periods of time. I don’t have diabetes, but I’ll eat a dessert and go up to 200 mg/dl. I’ll also drop down to 50 or 60 mg/dl. People with diabetes are comparing themselves to a false standard. The pancreas, for all of the advantages it has, still allows big excursions. It’s crazy to think it’s ideal.”
-Dr. Steven Russell (Massachusetts General Hospital, Boston, MA) urging people with diabetes not to be too hard on themselves at the 14th North American Conference on Diabetes and Exercise in San Diego, CA, August 17-18.
I read this too and was confused. I do agree that people without diabetes have some variability and I think some people with diabetes try to aim for even tighter control than that, but I don't understand how someone can hit 200 after eating and not be considered diabetic.
I wonder how much time he spends at 200. I know that non-diabetics spike (hence my comment above about some T1s and T2s having *super tight* standards), but I'd guess that time above such a threshold would be very little.
maybe???? i've never seen a non-diabetic spike to anything above 120. a non diabetic should not be going low into the 50's, that's indeed hypoglycemia and concerning. IDK??? Interesting that he's saying diabetics should be 'less hard on themselves'....when the reality is, the average A1C is 8%....probably higher with type 2's...and we have epidemic levels of type 2's now...so, i'm not sure that's a point that needs to be made.
Yeah, I can understand the confusion, but being diagnosed with diabetes is not as simple as a one time post meal BG.
The Oral Glucose Tolerance Test, even, doesn't have a max BG associated with. What it says is that if you are over 200 mg/dl at 2 hours post-meal, you are considered diabetic. This would still have to be confirmed by looking at fasting BGs with should not be higher than 120 or so, I believe, and other tests. The most important thing is your ability to metabolize a big glucose load appropriately, not simply if a big load causes a spike.
I think there is a lot of misinformation out there about how much BG variability there is in the general population.
Here's a table of BGs pre and post load from a study I was able to dig up awhile back...
I’d tend to trust his expertise since he’s a doctor and highly renowned enough to be a guest speaker at a diabetes conference. We tend to view these issues through a lens from our perspective that’s a bit biased. I non diabetic can have highly varying glucose levels like he noted and a normal healthy a1c. Having a few cocktails in the evening can easily cause a non diabetic to wake up with bg in the 50s. As long as there is not artificial insulin risking pushing it still lower-- it is not a concern.
Exactly. And I will say that the CGM is not all that accurate for many folks in the first place...and it is not a 'right now reading'. I like the idea that Dr. Steven Russell thinks we should not to be too hard on ourselves. It isn't an easy job and I bet we all do the best we can. Dr Russell is no dummy, just so ya know. He is instrumental in pursuing the artificial pancreas - a product I won't ever consider until the CGM accuracy is much improved.
Excellent table… And just as the doctor noted, bg levels varied from nearly 200 to high 50s. Thanks for posting. I think his point is important and valid-- that the bg of non diabetics fluctuates a lot too even when the body is in no way impaired… Interesting to note though the minimal variance before the glucose and on the far end once things settled out. But it’s undeniable that non diabetics have short duration blood glucose spikes after eating carbs.
One wonders how many studies there are of straight people's BG after they eat a super burrito or DQ basket of chicken fingers (heavily breaded) fries and Texas Toast, with thick, floury gravy dipping sauce and chased with a blizzard. It would be interesting to see them do that!
Jenny Ruhl's website has a great graph of blood sugars in non-diabetics. Here's the (link) to the website. Sorry that I don't know how to link to the actual section of her website. There is also further information about normal blood sugars there.
I understand what this guy is saying about not sweating the highs and lows too much but I do not agree. I'm still going to worry about those highs and lows because it means that I have missed by goals. If I relax myself and not strive for tight control where would I be. I'm reminded of the old saying that if you aim for nothing you will hit it every time.
i've been with my surfer dude brother, who is about as fit and lean as they come, and have watched him chow down just about what you quoted above and more after hitting the 'waves'; his BG's were in the 90's and never spiked. We also have an impaired system and an autoimmune disease, which, of course, non d's don't and they come down quickly if they do spike...again, i've never seen it and i've tested a lot of people close to me. IDK that it's being too hard on ourselves, we have complications; nerve, muscle, cell, organ damage to worry about as well as insulin induced hypoglycemia. IDK about all of you but either one of those on the BG spectrum feels awful. I aim for the middle, has nothing to do with being hard on myself, I've become accustom to my vision, use of my legs, hands, feet, organs, etc... :)
Oh, look at those 4 hour marks, all double digits and so easily with no effort obtained..makes me sad, kind of, ya know. damn this stupid disease.
Even the two-hour mark blood sugars are great. For some reason I was assuming the 200 was at two hours for this guy who was quoted. If he spikes to 200 for half an hour after eating but comes down by two hours, then that's understandable. I tested my mom once after eating a big pasta meal and she was about 133 an hour and a half after eating. That's the highest reading I've ever seen with a non-diabetic.
The vast majority of PWD's aren't meeting that 'false standard', and our higher A1Cs are pretty indicative of the differences.
Having said that, why the don't they do some studies on non-diabetics, and give us some hard numbers to look at? I'd really like to know what the standard is.
I heard Dr. Russell state this at last Thursday's : " Live Interview with Drs. Edward Damiano and Steven Russell, creators of the Bionic Pancreas at TuDiabetes homepage
October 31, 2013 from 1pm to 2pm " ...I am waiting for Emily to post the video so I can hear it in it's entirety ...I don't recall anyone questioning him on the comment
I am in the camp of "don't sweat the numbers too much." I love the motto of the Behavioral Diabetes Institute: maintain the best blood sugar possible, avoid serious lows, and live your life. I think that is some of Dr. Russell's message. Striving for perfection and stressing a lot are just not good for BGs and the soul.
