The blood sugar values are included - as are the blood lipids – to the routine values on the laboratory findings. They are mainly used for the diagnosis and therapeutic control of diabetes mellitus. But what do the different measured values say? Why do you have to be fasting for some values? And what does our blood sugar have to do with our life expectancy? In this part of the laboratory series we'll look at exactly that.
Sugar in the blood – why do we need it anyway?
Our bodies need energy – and a lot of it. The main mechanism by which our cells obtain energy is the glycolysis, the citrate cycle and the Respiratory chain. Sugar molecules (glucose) are “burned” with the help of oxygen, thereby producing ATP. ATP is the abbreviation for Adenosinetriphosphate. ATP can also be referred to as the energy currency of the cell. For example, if we want to move our muscles, we need ATP to make our muscle fibers contract. At rest, our brain is the largest consumer of glucose in the entire body. Around 20% of all sugar is consumed by our brain - even at night.
Our cells therefore need “sugar” around the clock so that they can work. For this reason, there are around 5g of glucose in our blood at any time.
Image: shutterstock.com/MattLphotography
So that you can better imagine what your body does every day, here are a few numbers: According to Mergenthaler et al., 2013, the human brain requires about 5.6mg of glucose per 100 grams of brain matter per minute. With an average brain weight of 1400 grams, that's 78.4 mg per minute. There are then 4.7 grams per hour and around 113 grams of glucose per day. And that’s just for your brain!
At least as impressive is the fact how much ATP your body uses per day. On average it is around 65kg or as much as you weigh. Your ATP is recycled around 1000 to 1500 times per day, otherwise we would have to carry around a lot of extra weight.
So that our cells are supplied with glucose, we have sugar stores in the form of glycogen. Glycogen is a molecule consisting of many glucose molecules strung together. If necessary, these can be split off and distributed, for example, from the liver into the blood.
Fasting blood sugar, long-term sugar – what types of measurement are there?
If you want to know your blood sugar level, there are different ways to measure it. The simplest method is a self-test with test strips and the appropriate measuring device. You can usually get both at the pharmacy. For this type of test you need a small drop of blood, which is placed on the test strip and a few seconds later the test device spits out the blood sugar value. The advantage of this method is the ease of implementation. However, it only provides a selective insight into blood sugar metabolism.
A much more informative method is to use glucose trackers, also called Continuous Glucose Monitor (GGM). As the name suggests, these devices continuously measure your blood sugar and send this information to your smartphone, for example. So you can see “live” how your body reacts to different foods. Corresponding sensors are already around approx. 100€ to buy. The lifespan of a sensor is around two weeks - enough time to test the blood sugar reaction to different products!
In addition to these two methods, there are the following options for assessing blood sugar metabolism. This usually requires a blood sample or a few drops of blood:
- Fasting blood sugar (NPG): Fasting blood sugar is when you have not eaten anything for at least eight hours. This value is therefore usually measured in the morning and should not exceed 100mg/dl in healthy people .
- HbA1c: This value is colloquially known as “Long-term sugar”. The concentration of red blood cells that are loaded with a sugar molecule is measured. Since red blood cells have a lifespan of around three months, you can estimate the blood sugar situation over the last eight to twelve weeks. If you make lifestyle changes or changes to your diet, it only makes sense to check your HbA1c value after about three months. High blood sugar levels lead to higher HbA1c levels. There are different limits depending on age. In healthy adults the value should be below 5.7% .
- Casual plasma glucose (GPK): This is the blood sugar value independent of food intake. It varies greatly and is not particularly meaningful. The target value is below 200mg/dl.
It is easy to measure blood sugar and provides specific information about the blood sugar level.
Blood sugar levels that are too high – what’s behind it?
If your blood sugar levels are too high, this can be a sign of diabetes mellitus. Diabetes mellitus is one of the most common diseases worldwide. The most common variants or Types of diabetes are type 1 and type 2. In type 1 diabetes mellitus our own immune system destroys beta cells in our pancreas. The beta cells produce the hormone insulin. To simplify a little you can think of insulin as a key that is needed to bring glucose from the blood into our cells. In type 1 diabetics, this key is missing, which is why the door to the cell interior remains closed and the sugar level in the blood becomes too high.
Type 2 diabetics have a different problem. Your cells have become increasingly “resistant” to insulin. So the key no longer works so well. Insulin resistance is the precursor to diabetes and is a silent epidemic due to the significantly high number of unreported cases. The good news is that insulin resistance or Prediabetes are still reversible.
Do you actually know where the name diabetes mellitus comes from? “Diabetes” comes from Greek and means something like “flow through”, while “mellitus” comes from Latin and “ honey-sweet“ means.
The disease was already known in ancient times - with the main symptom of “sweet” urine. If blood sugar is significantly too high, the body excretes some of the excess glucose through the urine. Since it was not possible to measure blood sugar levels in the past, those affected were identified by their sweet-tasting urine.
In the national care guidelines of Germany, the diagnosis of type 2 diabetes mellitus is defined as follows:
At least two values of fasting blood sugar, HbA1c or casual blood sugar must be pathological. What exactly does pathological mean? Here too you can find corresponding limit values in the guidelines:
| No diabetes | Increased risk of diabetes | Diabetes | |
| Fasting blood sugar | < 100 mg/dl (<5.6 mmol/l) |
100 – 125 mg/dl (5.6 – 6.9 mmol/l) |
from 126 mg/dl (from 7.0 mmol/l) |
| HbA1c | < 5.7% (< 39 mmol/mol) |
5.7 to 6.4% (39 to 47 mmol/mol) |
from 6.5% (from 48 mmol/mol) |
| Occasional plasma glucose | from 200 mg/dl (from 11 mmol/l) |
If the values are not clear, an oral glucose tolerance test (OGTT) can be carried out.
Sugar comes in many different forms. Basically, they all promote insulin resistance to a similar extent.
OGTT – what does the oral glucose tolerance test say about my blood sugar metabolism?
In the oral glucose tolerance test, you drink a sugar-water mixture, which consists of 75 mg glucose, which is significantly sweeter than soft drinks such as cola. You measure your blood sugar once before taking the drink and then every half hour after drinking. The last measurement takes place after two hours. The purpose of this admittedly somewhat complex test is the early discovery of insulin resistance and thus impaired glucose tolerance. An OGTT is usually carried out during pregnancy in order to detect the occurrence of gestational diabetes as early as possible. The standard values for this test are defined in the National Care Guideline for Type 2 Diabetics as follows:
| No diabetes (normal glucose tolerance) | Increased risk of diabetes | Diabetes mellitus | ||
| Abnormal fasting glucose | Impaired glucose tolerance | |||
| Fasting plasma glucose | < 100 mg/dl (<5.6 mmol/l) |
100-125 mg/dl (5.6 – 6.9 mmol/l) |
< 126 mg/dl (< 7.0 mmol/l) |
from 126 mg/dl (from 7.0 mmol/l) |
| 2-h after oral glucose | < 140 mg/dl (< 7.8 mmol/l) |
– | 140 – 199 mg/dl (7.8 – 11.0 mmol/l) |
from 200 mg/dl (from 11.1 mmol/l) |
Why is blood sugar important for your longevity?
We looked at how we measure different blood sugar levels, how to diagnose diabetes mellitus and what insulin resistance is. But why is the whole thing so important for a long, healthy life?
Diabetes is a disease that does not cause any symptoms for a very long time. We don't necessarily notice when our blood sugar is too high. However, we quickly notice the opposite – namely low blood sugar. We get cold sweats, get ravenous and can no longer concentrate.
According to data from the Robert Koch Institute, around 4.6 million (7.2%) of all Germans in the age group between 18 and 79 have diagnosed diabetes, with the trend increasing. That means almost one in ten people is “diabetic”. The number of insulin-resistant people is significantly larger, but can only be estimated. Experts suspect that the number of unreported cases is extremely high.
Injecting insulin is particularly typical and necessary for type 1 diabetics. Type 2 diabetics only need insulin in the final stages of the disease.
High blood sugar levels and the risk of arteriosclerosis – a deadly combination
Sugar levels that are too high attack the vessels in our body. As a result, diabetes contributes significantly to the number one cause of death in the Western world: cardiovascular disease. Our blood lipids also make a contribution when they get out of balance.
The number of deaths from diabetes is difficult to estimate. According to this report there are more than 100 in the US alone.000 deaths per year. Probably even more so when you consider the role that high blood sugar levels play in the development of cardiovascular disease.
Although the number of deaths from cardiovascular diseases is significantly higher, it is not without reason that Dr. Peter Attia Insul resistance as the basis on which other life-shortening diseases such as cancer, Alzheimer's and cardiovascular diseases can arise. From his point of view, it is important to take action against insulin resistance as early as possible.
The studies show that berberine, a naturally occurring pigment extracted from the bark of the barberry plant, functions to regulate multiple signaling and longevity pathways, including AMPK, NF-κB, Sirtuins and some others, has an effect on the body. Among other things, our sugar metabolism. Berberine (as well as the trace elements Chromium and Zinc) have been shown to have a positive influence on blood sugar levels (especially insulin sensitivity) in several scientific studies . All three substances in combination occur in the berberine mineral complex from MoleQlar .
Blood sugar levels – why don’t we actually measure insulin?
Insulin resistance, as we have already seen, plays an important role in the development of type 2 diabetes mellitus. Wouldn't it then be easier to measure the insulin directly?
In principle this is not a bad idea, but insulin does not stay in our bloodstream for very long and that makes accurate measurement difficult. The C-peptide is much more suitable for this purpose . This is created during the production of insulin. In the pancreas, C-peptide and insulin are still connected. In order for insulin to work, the C-peptide must now be split off.
Doctors measure the C-peptide to get clues about the type of diabetes. Type 1 diabetics produce little to no insulin, so in simple terms their C-peptide levels are also low. Type 2 diabetics are insulin resistant. Here the pancreas produces even more insulin, which is also reflected in a high C-peptide level.
