While managing blood sugar levels is important for preventing serious health issues, including everything from hypoglycemia to diabetes, unfortunately there are some flaws in traditional blood glucose testing that may skew the results.
A recent report by Precision Nutrition reveals that estimating blood sugar levels can be more challenging than you may have realized, partially due to frequently changing levels that come with eating and exercise.
Additionally, the glucose meters that many type 1 diabetics use are only providing a glimpse at part of the picture rather than revealing how a patient regulates blood sugars over time, which is essential for disease prevention.
Researchers have been trying to find a test that will provide information about mid-term and long-term glucose health, verses a snapshot of what’s happening right now, but no one has found the perfect test yet.
The two top tests measure glycated hemoglobin or hemoglobin A1c and fructosamine, which can provide a better understanding of glucose levels over time, but both have drawbacks that can get in the way of accurate diagnosis, particular in those who are healthy.
The glycated hemoglobin test
The glycated hemoglobin, or hemoglobin A1c test, allows doctors to estimate a patient’s average blood sugar levels across a period of several months, which is why it’s often considered the gold standard for evaluating glucose levels.
Hemoglobin is a protein found inside your red blood cells which carries oxygen from the lungs to all the cells of the body. As red blood cells are always forming and dying, their typical life span is about three months.
This is said to be important because when you eat, glucose enters your red blood cells, linking with the molecules of hemoglobin found inside. Ultimately, the more glucose in the blood, the more hemoglobin gets glycated. And, the reverse is also true.
By measuring the percentage of A1c in the blood, the test provides an overview of average blood glucose control for the past several months. In theory, it should be a good idea, and it can be helpful for those who are already diagnosed with diabetes. Those that have chronically high A1c levels, have a higher risk for certain diabetic complications, like retinopathy which can lead to blindness, nephropathy, possibly leading to kidney failure, and neuropathy.
The flaw with this test is that certain factors can falsely raise or decrease hemoglobin A1c, especially in healthy people which can confuse both the patient and the practitioner.
People who have healthy blood sugar levels may have longer-lived red blood cells than those with poor glucose regulation. The better glucose is regulated and managed, the longer red blood cells survive – and, the longer they live, the higher your circulating hemoglobin which could skew the A1c blood panel, making your hemoglobin A1c appear high even if your blood sugar regulation is outstanding.
According to Precision Nutrition, the opposite can also be true, as poor glycemic control may kill off red blood cells prematurely, which can result in less circulating hemoglobin and a lower hemoglobin A1c measurement, even if glucose levels are on the higher side.
The amount and type of fat you eat can also affect your hemoglobin A1c levels, creating falsely elevated levels that may not reflect actual glucose management. in addition, people with chronic kidney disease frequently have elevated hemoglobin A1c levels, possibly because their serum urea is higher than others.
Antioxidants like vitamin C, vitamin E and coenzyme Q10 may decrease hemoglobin A1c levels, while anemia may also affect hemoglobin A1c.
This doesn’t mean the hemoglobin A1c test is completely useless, but the results need to be taken in context. This means that if your levels appear slightly higher than you expect given your current diet, lifestyle and exercise program, you may want to speak to your doctor and consider whether something else, other than poor glucose regulation, may be playing a role.
This test involves testing fructosamine to evaluate glucose regulation over time. While the hemoglobin A1c test aims to provide a picture of glucose levels over the the past several months, fructosamine levels offer information about the past two to three weeks. The test also measures the amount of glycation, but considers a different protein known as albumin, which is the most abundant protein found in the bloodstream.
Limited research has suggested that fructosamine is a better indicator of carbohydrate intake than the hemoglobin A1c test, but this type of testing is unable to reveal as much about the possible long-term complications of diabetes as hemoglobin A1c testing, which is one reason it’s not as popular with doctors. In certain situations where diabetic treatment protocol is changed quickly, such as diabetic pregnancy, it can be quite useful.
A number of factors can cause a false reading, such as people who are chronically ill, as they often have lower albumin levels. Dehydration may affect fructosamine levels which can lead to a false positive. High levels of vitamin C and hyperthyroidism can also complicate the test results.
The bottom line with glucose testing
If you’re following a healthy lifestyle that includes a nutritious diet and regular exercise but your glucose markers seem “out of whack,” don’t assume that poor glucose regulation is to blame. Talk to your healthcare provider about what may be affecting your readings, before coming to the conclusion that you’re pre-diabetic, or diabetic, to get a clearer picture of your health.
-The Alternative Daily