Best Lab Tests for Detecting Blood Sugar Imbalances
Ok I admit it. I struggled with coming up with a catchy headline - one that would make you want to read more. But I opted for directness over creativity.
I’m hoping with a little more explanation, I can arm you with an understanding of which blood labs to ask your doctor for, and help you understand how to interpret the lab results when it comes to blood sugar balance.
The wisdom that comes along with that ownership can make a huge difference for our health.
That means doing our best to make the right decisions on a daily basis, but also really understanding what our metabolic health panel labs are telling us, as well as asking our doctor for some tests that they normally don’t routinely order.
If you’re like me, I’ve spent my entire adult life not asking what I’m being tested for, and for the most part, never knowing. Because as long as everything came back in the normal range, there was no follow-up discussion, even if a trend line was slowly increasing (and of which I was always unaware).
And if I happened to look at my lab report - well it was primarily all greek to me.
Remember, our healthcare system is mostly set up to diagnose disease when it has finally arrived on our doorstep, and then prescribe medicine. Those in between stages, years of stepping towards some chronic or autoimmune disease, rarely get flagged.
So the reality is that diseases develop over years, sometimes decades … and by raising our consciousness, we have a good chance of taking control and keeping ourselves on a stable continuum of health.
Last week was all about sugar, and the foods that we eat as part of our standard western diet that can cause regular glucose spikes and ultimately insulin resistance.
Our ability to process energy (side note: we have 37 trillion cells in our body that need energy to perform their function) is being compromised by our diet and lifestyle leading to some level of dysfunction in most of us.
The scary fact is that 88% of us most likely have some level of metabolic dysfunction …. which means 88% of us are not processing energy efficiently in our bodies.
As a refresher, after we eat, insulin is released by the pancreas to go into our bloodstream and swoop that glucose into our cells for energy utilization.
But when we put our body on a see-saw of highs and lows (typically caused by eating foods with sugar, processed foods, and simple carbohydrates) - our glucose regularly spikes.
When this happens, insulin is released to bring our blood glucose down to normal. When this continues to happen regularly, with steep glucose swings, the process for controlling the glucose starts getting worn down.
(If you missed last week’s newsletter, which goes into more detail about sugar and blood sugar imbalances, you can read it here on my blog:
It’s estimated that 128 million of us have some level of blood dysregulation, and are either in the pre-diabetes or diabetes 2 stage. The harsh reality is that 9 out of 10 of the leading causes of death (like heart disease, stroke, cancer and alzheimers) are linked to blood sugar dysregulation.
The good news is - you can control it … through your lifestyle.
But you have to establish the awareness of what is happening in your body first, especially if you need this knowledge to help you make lifestyle changes that will be beneficial. And that’s not always easy to do.
If you request the following lab tests, the combination of the results will help you and your doctor determine what’s going on with your blood sugar balance, and if you’re out of range, start you on the right path to figuring out what needs to happen to get numbers back into their normal ranges.
So here’s what you need to know when it comes to playing detective with your blood sugar balance.
The three tests that help you assess what’s going on with glucose regulation are:
Fasting Glucose: This is the most standard lab done as part of your annual physical to measure blood sugar. Before a doctor’s appointment you are asked to fast overnight and not eat until after your blood work has been done.
The result is a number that is unaffected by what you’ve recently eaten, so it should be a good indication of the normal level of your glucose.
If your fasting glucose comes back high, that indicates that you do have insulin resistance (meaning your insulin is no longer able to do its job and help manage glucose spikes), and that you are in a Prediabetes or Diabetes state.
Standard Reference Ranges:
Normal: <100 mg/dL (although many doctors would like to see this below 85 mg/dL)
Prediabetes: 100 - 125 mg/dL
Diabetes: 126 mg/dL
Fasting Insulin: This test measures how your body regulates your blood glucose levels, and it's the most relevant test to measure insulin resistance because it can catch an issue before it becomes a problem.
The primary problem with this test is that most doctors don’t order it as part of their specified standard set of labs.
Why is this an important test to have? First of all, a high fasting insulin indicates your pancreas is working overtime to produce insulin to keep your blood sugar balanced.
And you could have a fasting glucose level that is very much in the normal range, but a fasting insulin test result that indicates you’re headed for some trouble down the road.
That’s the beauty of the test. It is an indicator of future issues, way before our glucose becomes elevated and shows up as a problem on our fasting glucose test).
Because most doctors don’t order this test, we forego having the information at hand that can forewarn us that our blood sugar is out of balance.
This is a very affordable test ($15) - so make sure it’s part of your lab work next time you’re at your doctor’s office.
Reference Ranges:
Standard: <25 mlU/mL
Optimal Ranges: 2-5 mlU/mL
>10 mlU/mL is concerning
>15 mlU/mL is significantly elevated
Hemoglobin A1C (HbA1c): A1C is the percentage of hemoglobin in your blood with glucose molecules attached to it. It measures average glucose in your blood over a 3 month period, and is deemed to be more accurate than fasting blood glucose because it measures the amount of glucose in your blood on average.
Many doctors like this test because if someone has a high A1C result, it shows that there is too much glucose in the bloodstream, and therefore indicative of insulin resistance.
There are some limitations of this test, but your doctor can educate you about potential watch-outs. But if you think of it as another data point that provides a window into what’s going on in your body, it can only be helpful.
Standard Reference Ranges:
Normal: <5.7%
Prediabetes: 5.7-6.4%
Diabetes: >6.5%
Optimal Reference Range:
<5.5%, but <5% is ideal
My intent with this information is to hopefully provide some information to help you better navigate your doctor’s visit - requesting the right labs that will give you good information about what is happening in your body.
As always, feel free to reach out for a conversation to further explore this area - or if you have any lingering questions that aren’t being answered here.
(Reference Sources: Dr. Ben Bickman, Dr. Casey Means, Dr. Mark Hyman, Dhru Purohit)