Talk:Blood sugar level

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Measurement
This article needs information on how blood glucose levels are measured or a link to the same information. Regards.

Afternoon sleepies
Here I see :

The Afternoon Sleepies I used to suffer from this big time. Around two or three in the afternoon, I'd start to get drowsy and nothing I did could fix it. A lot of people suffer from this, but don't know the reason. The most likely cause is low blood sugar. A large lunch, especially with lots of starchy foods, will cause your blood sugar to spike and then crash.

... I don't know how true this is ... I added a short piece about it, that information would be useful in this page. But I don't know how valid it is. Flammifer 08:10, 9 Jun 2005 (UTC)
 * Not at all :) People commonly attribute this to their lunch, but that's a fallacy of corrolation implying causation.  Actually, people naturally have a dip in their circadian rhythm at that point, and it really has very little (if anything) to do with food. —The preceding unsigned comment was added by BennyD (talk • contribs) 15:22, 25 January 2007 (UTC).


 * It's not terribly consistent with the way insulin and glucagon work in nondiabetics who aren't insulin-resistant. There is indeed a spike of insulin immediately after a meal (actually during the meal, as blood sugar spikes), but a few factors ensure that this doesn't result in rebound hypoglycemia. The major one is that the quantity of insulin released is almost never enough to fully correct the postprandial spike in blood sugar-- that's why there is a second, slower release of insulin that comes longer after a meal, and which tapers off very gradually. Reactive hypoglycemia does seem to be a real phenomenon, but it is quite rare-- certainly nowhere near as common as mainstream diet literature would lead you to believe.-- Kajerm

I get the post lunch sleepies too, but only after eating a hot meal. I've been eating half a cold sandwich and fruit for lunch for over a decade and I never seem to develope lethargy after eating. Size of a meal will affect me too. —The preceding unsigned comment was added by Special:Contributions/ (talk)

Determination
Perhaps we should mention here the chemical determination of sugar levels. I found the classical reference for an early method (Somogyi, M. Determination of blood sugar. J. biol. Chem. 1945, 160, 69.) JFW | T@lk  22:57, 17 July 2006 (UTC)

Other Sugars in Blood
I think it would be a good idea to add some more on other sugars found in blood, and how thay are used. I'm not exactly sure what other sugars are in blood or the relative concentrations. Anyone know? User:tcopley 00:10, 4 April 2007 —The preceding unsigned comment was added by 210.4.228.192 (talk) 14:11, 3 April 2007 (UTC).
 * I think this would be confusing. 'Blood sugar' is a common name for blood glucose, not any other type of sugar in the blood. Arripay (talk) 22:41, 22 July 2013 (UTC)

Diabetes and relation to eczema
Is there a relationship of diabetes to eczema? 209.221.206.240 15:44, 5 February 2007 (UTC)

Unit
"Countries that use the metric system use mmol/L. The U.S. uses mg/dL." - Not correct (while not completely false, though). In Germany mmol/l is the common unit used in puplications, science and theoretical medicine, while mg/dl is common in practical medicine (clinical and EMS). As an EMT I'm used to the mg/dl scale (since most glucometers work with it), as a biologist I work with the mmol/l scale. If somebody is going to correct/review the articel, he may consider this. Just sayin. --89.245.7.33 12:11, 12 July 2007 (UTC)
 * You could have fixed that yourself. I went ahead and corrected it a little.  I particularly liked how, as in many Wikipedia articles, someone had clearly tried to spin the sentence in the most anti-US way they could come up with.  I sure hope this bias will taper off a little now that Bush is out. 24.174.30.146 (talk) 01:26, 29 November 2008 (UTC)

Why?
Does anyone know why the US, which uses all imperial units for most things, use the metric system for measuring blood glucose levels? While I'm not one to disagree, most of the metric-using world uses mmol/l. This is practically the one case where the US uses the metric system and everyone else uses a different "variation", if you will, of the metric system. Just wondering if anyone knows why...
 * I wouldn't say the US uses imperial units for most things. It uses imperial units for certain publicly visible things, like speed limits and cookbooks.  Science, medicine, and, to a large extent, engineering in the US are in metric just like everywhere else in the world.  And the metric system doesn't say anything about whether you should measure blood glucose in terms of molarity or mass concentration.  It's up to the doctors to decide which quantity they care about more, that's all.  24.174.30.146 (talk) 01:12, 29 November 2008 (UTC)
 * For what it's worth, the US has been officially metric since not long after the Civil War (ended 1865). That the population has ignored the official declaration by the Federal Government hasn't much to do with it, really. ww (talk) 02:58, 1 December 2008 (UTC)

Table
Can someone please fix the "Chemical Methods" table, so that it is the same width as the rest of the page? I'd do it, but maybe someone else can do it much faster. Thank you to all who contribute to Wikipedia!!!

WriterHound 23:08, 26 September 2007 (UTC)

this article makes several references to various coloured tubes. Since this isn't standardized internationally, either the relevant country should be mentioned (US?) or just remove the information (as I don't really think it's all that relevant). —Preceding unsigned comment added by 204.187.34.100 (talk) 23:42, 2 March 2008 (UTC)

MMOL and other jargon
I'm reading this page because I don't know much about diabetes, glucose, etc. The use of jargon like "mmol" without a link to what "mmol" means might be fine for someone familiar with these units of measure, but for the rest of us, an explanation or a link might be helpful. —Preceding unsigned comment added by 75.166.220.154 (talk) 16:56, 18 April 2008 (UTC)

Difference between serum and whole blood glucose values
Hello.....I’m curious as to why it matters whether your blood is isolated as serum or plasma. What’s your reference for this? From my perspective, it just seems a bit odd. Good article for this. —Preceding unsigned comment added by 193.120.116.185 (talk) 01:00, 9 December 2008 (UTC)
 * Blood without the cells (ie, as serum) has slightly different glucose concentration than whole blood (with the cells). The reason is two fold. First the cells take up volume and so affect the ratios, and second red blood cells don't require insulin to take in glucose. Thus, they will continue to use it, reducing the amount present (sometimes said to 5-7% per hour). Since labs use serum for much of their chemistry testing, it's the serum level which is regarded as definitive when reporting glucose levels. Since few actual people carry around centrifuges for separating out the cells, home meters (and many of those used in hospitals and clinics) just measure using whole blood. There is a conversion factor between typical serum and whole blood readings for the same sample. Some meters have included an option for reporting either (they apply the conversino factor internally). In home use, the common advice is to always use one or the other, but also to remember which in case there is a discrepancy between a lab and your readings. The important issue in the field is the trend if any related to events (food exercise, insulin administration, ...), not the exact value just now or last week. Hb1Ac readings will not be affected, as the issue is one of measurement technique and has nothing to do with anything that's actually going on in one's blood. It knows nothing about whether you're measuring via serum or whole blood or capillary blood or venous blood or in mml or mg/dl. ww (talk) 16:19, 7 February 2009 (UTC)

Red-top tubes
Can I point out that only serum blood-collection tubes sold by Becton-Dickinson are red-topped? Other manufacturers have different colour-coding schemes. --05:21, 10 August 2008 (UTC)


 * You certainly can. And you can certainly be bold and correct the information, since it seems you're well informed on the topic? Please, don't hesitate! ww (talk) 18:59, 16 October 2008 (UTC)

Inaccuacy
The article talks about the target range being 4-6 mmol/L. This is accurate. 4-6 mmol/L translates to 72-108 mg/dl (multiply by 18). To convert from mg/dl to g/ 5 L, we'd divide by 1000 (mg->g), multiply by 10 (dl->L), and then multiply by 5? This gives 3.6-5.4 grams of sugar in the blood stream, not 3.3 to 7g, as reported. Even using the 70-100 mg/dl figure the article mentions, the range is 3.5-5g. 192.75.95.127 (talk) 23:15, 30 March 2008 (UTC)

The article mentions catabolic hormones including growth hormone. Growth hormone is anabolic (NOT catabolic)! —Preceding unsigned comment added by 71.205.31.201 (talk) 16:59, 16 October 2008 (UTC)
 * Be bold. correct it... ww (talk) 02:51, 19 October 2008 (UTC)

removed text
The following text was removed from the very bottom of the article for two reason: it was in the wrong place, and second it's oddly formed. If the poster will try angin, please??
 * Category of a person Fasting Value  Post Prandial
 * Minimum Value Maximum Value  Value 2 hours after consuming glucose
 * Normal
 * 70  100   Less than 140
 * Early Diabetes
 * 101  126   140 to 200
 * Established
 * Diabetes  More than 126   -   More than 200

ww (talk) 02:51, 19 October 2008 (UTC)

article intro
Technical observance from a linguist and book-lover. The introductory paragraphs, while informative, provides more than the essential definition of blood sugar. I suggest the debate over the use of the term, its etymology, etc. be transferred to its own subsection. I will do just that. If anyone has objections, please advise.

The original first graph for your consideration, in which 'Blood sugar' is immediately qualified as a 'term':

Blood sugar is a term which in colloquial usage refers to the amount of glucose present in a mammal's blood. However, the term, if used in a physiological context, is a misnomer and misleading because other sugars besides glucose are always present. However, since these other sugars are largely inert, and only glucose serves as a controlling signal for metabolic regulation, the term has gained some currency and is used by medical persons and lay persons alike. Glucose, transported via the bloodstream from the intestines or liver to body cells, is the primary source of energy for the body's cells.

User:EvanWis 8:52, 26 December 2008 (EST) —Preceding unsigned comment added by 74.95.181.18 (talk)

inconsistency between chart given and text in Normal Values section
"In most humans this varies from about 80 mg/dl to perhaps 110 mg/dl (3.9 to 6.0 mmol/litre) except shortly after eating when the blood glucose level rises temporarily (up to maybe 140 mg/dl or a bit more in non-diabetics)."

This exposition of "normal values" doesn't really match the chart shown from Suckale, et al. for waking hours.

What gives? Plaasjaapie (talk) 03:01, 2 February 2009 (UTC)
 * You are right. It doesn't match most normal humans either. The figure is beautiful, so perhaps asking for truth and beauty is a tall order. The original paper says it is redrawn from Daly in Am J Nutrition. I haven't taken the trouble to look up that reference, but would be surprised if it is data based rather than idealized, since Am J Nutrition is not where we would expect actual continuous glucose monitoring results of normal humans to be published. The peaks at 200 for an hour after meals seem too high. Perhaps user:Jakob Suckale could answer us? alteripse (talk) 11:03, 12 August 2009 (UTC)


 * Hi, the figure is indeed based on the research by Mark Daly and colleagues working in the University of Newcastle, UK, as indicated in the graphic. The study was published 1998 in the reviewed American Journal of Clinical Nutrition. If you want to take a look at the article, it is freely available on the web. Have a look at figure 3 (blood glucose) and figure 4 (serum insulin, note incorrect caption). My graphic (above) combines both into one. I dropped the standard error of the mean whiskers and some intermediate data points to make the diagram easier to read. The highest and lowest points have been copied accurately from the research paper. I then connected the points with a curve instead of the straight lines used in the paper. The study is based on 8 test persons, which means if you repeated the experiment with different people the values could be slightly higher or lower but probably within the standard errors given in the paper (errors are 0.1-0.3 mM for glucose and 10-60 pmol/L for insulin).


 * The article text currently (8/09) reads "In most humans this varies from about 80 mg/dl to perhaps 110 mg/dl (4 to 6 mmol/litre) except shortly after eating when the blood glucose level rises temporarily up to maybe 140 mg/dl (7-8 mmol/litre)". The red glucose line in the diagram is exactly in the 4-6mM range (left y axis) except for brief excursions above 6 just after meals, which is also in accordance with the text. You can see that the peaks are worse/higher for sugar-rich than for starch-rich meals. Are these explanations clear? Best, — J.S.talk 14:32, 12 August 2009 (UTC)


 * Thanks for the link. 1. The captions for the Daly figs 4 & 2 are reversed, though the axes seem correctly labeled. 2. The Daly data is not continuous but consisted of 24 glucose measurements in 24 hrs, so interpolating peaks and shoulders of postprandial peaks that change hugely within an hour is an act of imagination. This is a minor nit-pick and would not have a large effect on the figure. 3. Daly's highest postprandial glucose peaks are below 7.5 mM (135 mg/dl). 4. At this instant I realize what misled the anonymous questioner above and myself: your right-side Y axis is not glucose but insulin. Unfortunately, extrapolating from the two of us, many North American readers looking quickly at your figure assume the Y axis on the right side of your figure is the equivalent glucose levels in mg/dL, not insulin. I missed this twice, even though I have published papers using mM units for glucose, and suspect many other will as well. Would it be a lot of trouble to add a second left Y axis in mg/dL immediately beside the present one for this international encyclopedia? Or add sideways labels on the axes that say Glucose and Insulin as the Daly figures do? Alternatively we might add to your caption: Note glucose levels are mM: 1 mM=18 mg/dL. Are any of these acceptable to you? alteripse (talk) 11:08, 13 August 2009 (UTC)


 * Very well spotted. Daly and colleagues indeed switched the captions. The figures' axes are correctly labelled, though. I corrected that in the text above. You are right that the Daly paper takes several time point and does not provide information regarding the time in-between. It would indeed be challenging both ethically and technically to do a study with much higher sampling frequency. The authors chose to connect their time points with straight lines. Putting in a curve is, granted, a step further away from the actual data but I hope justified because it makes the diagram a little easier to read. Regarding point 3 - the Daly data merges 2 experiments into a single figure: starch and sucrose meals. I put in only 1 example of a sucrose meal for lunch, again, to keep it simpler than the original figure. Sucrose meals are much worse regarding glucose excursions. The most extreme one, like you said, shoots up close to 7.5 mM (mmol/L). I like the "extrapolating from the two of us" ;-) These 2 units for glucose are unfortunately leading to a lot of confusion both in research and in the clinics worldwide. Your suggestions are great. I did not realise that the insulin values are in the range of glucose mg/dl values and can therefore easily mislead people. I updated the JPEG  and added a PNG  according to your suggestions. Thanks for the feedback, — J.S.talk 14:24, 17 August 2009 (UTC)


 * Suckale08_fig3_glucose_insulin_day.jpg new version (left) and old version

Animals
As many biological articles, this one is anthropocentric. It should include sections about animals (including invertebrates). --Urod (talk) 12:29, 30 April 2009 (UTC)...


 * What's there so far (the birds and reptiles section) needs some help. Does any of that paragraph have to do with reptiles, or am I missing something?  There's no indication where any of that paragraph came from either.  I'm all for including non-amthropocentric info, but it should be correct, well edited, and well referenced. 65.0.192.41 (talk) 03:04, 16 September 2010 (UTC)

Merge with Glycemia
Should this page be merged with Glycemia? 71.90.4.141 (talk) 02:12, 12 August 2009 (UTC)
 * There is little content in that article at present, and so I oppose a merge. Furthermore the term is most commonly used as hypo+ or hyper+ and is unusual alone. Rather than a merge, I'd favor someone extracting the addable content from glycemia, adding it to blood sugar, and setting glycemia to be a redirect to blood sugar. ww (talk) 06:28, 12 August 2009 (UTC)
 * I agree with ww for all the same reasones, but actually we are both endorsing a merge of glycemia into this article. alteripse (talk) 10:52, 12 August 2009 (UTC)
 * I'm the original suggester of the merge, and I also support merging glycemia into this article. I didn't know there was a directionality to it is all. And I certainly don't know how to go about merging the two or what the proper procedure is for doing as much.71.90.4.141 (talk) 21:21, 12 August 2009 (UTC)
 * The procedure I outlined would do it. Setting the redirect is the only magical bit, and if you do the rest I'll provide that magic. (Now where's my copy of the Admin's Book of Spells...) ww (talk) 23:28, 12 August 2009 (UTC)
 * Done. However, rather than redirecting only to blood sugar, I made it a disambiguation page to either hyper- or hypoglycemia. Mikael Häggström (talk) 07:45, 8 January 2010 (UTC)

Apparent inconsistency - normal range
From the second sentence of the intro':
 * Normally, in mammals the blood glucose level is maintained at a reference range between about 3.6 and 5.8 mM (mmol/l).

From the second sentence of the body of the article:
 * "In most humans this varies from about 82 mg/dl to perhaps 110 mg/dl (4.4 to 6.1 mmol/l)"

I know nothing about this stuff. If you do, and this is indeed inconsistency, would you please correct it? Anthony (talk) 10:33, 4 December 2009 (UTC)

diabetes ac? pc?
why my doctor writes as tests ac & pc for diabetes test? what is it? —Preceding unsigned comment added by 59.92.15.47 (talk) 14:41, 25 March 2010 (UTC)


 * It might be "before meal" and "after meal" in latin (ante caenam and post caenam if I recall correctly). alteripse (talk) 19:41, 26 March 2010 (UTC)


 * "Before meal" and "after meal" is correct, although the Latin is usually taken to be ante/post cibum. (Caena is more "dinner" than meal in general). ABehrens (talk) 02:59, 11 June 2010 (UTC)

Metabolic weight disorder: obesity, diabetes, CFS, and sarcopenia
Currently, medical science does not recognize common metabolic disorders other than Inborn error of metabolism, Inborn errors of carbohydrate metabolism, and so forth. It has no good explanation either for type 2 diabetes or for the pandemic of obesity, particularly among those who are poor.

There are, however, a few doctors who are interested in and have researched these topics. Some have even formed associations. This is still far away from mainstream approval, so these topics cannot be covered in WP.

I feel moved to write something anyway, out of compassion for all those suffering from these conditions (particularly type 2 diabetes and morbid obesity). I myself have suffered all my life from sarcopenic obesity (which can masquerade as Chronic fatigue syndrome) and wish I could reach other sufferers with news of a possible cure.

During most of the evolution of Homo sapiens humans ate little or no sugary or starchy foods. A few notable exceptions, such as honey, were usually a special treat, not a staple of the diet. In most early societies, the diet was dominated by meat, fat, blood, milk, eggs, berries, nuts, ground wild grains and roots, and maybe a few other foods I'm forgetting.

Now we eat many foods our bodies were not designed to process: candy, cookies, bread, french fries, trans-fatty acids (from partially-hydrogenated vegetable oils) and so on. It is documented that in native societies like those of modern Alaska the introduction of sugar and flour were inevitably followed by increases in disease (particularly diabetes, obesity, tooth decay, and alcoholism). Of course, there are many other factors than just diet, as the influence of "Western" diets are always accompanied by other influences (such as the diseases that wiped out most indigenous populations of the USA starting perhaps 500 years ago).

My cardiologist, who is one of the leaders in the emerging field of dietary metabolic disorders, prescribed a diet similar to the well-known Atkins diet, which is very low in digestible carbohydrates and high in everything else (vitamins, oil, saturated fat, protein, fiber). My limit is 20 grams of carbohydrate a day. This is a Ketogenic diet, which means it burns stored fat instead of ingested carbohydrate. Important: I'm not talking about Ketoacidosis, which is a life-threatening condition that can occur in type 1 diabetes.

My cardiologist includes an exercise program and meditation as important parts of my treatment, to counteract the sarcopenia and the emotional and stress factors, respectively.

To make a long story short, even though I was diagnosed with type 2 diabetes, my serum glucose is now always in the normal range without medicine. More importantly, I have NO cravings for carbohydrates. This is quite a contrast to all my past life, in which I preferred candy, cookies, and ice cream to "good food".

As I said, none of this is admissible in WP, since WP aims to portray the current state of knowledge, reliably, and not speculate on the future. I hope no one will delete this comment; if I can help even one person with CFS, incipient diabetes, or obesity to improve their life, I will consider the time I spent writing this today as highly productive. David Spector (talk) 14:33, 2 September 2010 (UTC)

Normal values
One set of 'normal values' is attributed to a book called "Dr. Bernstein's Diabetes Solution". I think it would be best to stick to academic or professional sources for this sort of information. Should this be deleted? Arripay (talk) 22:45, 22 July 2013 (UTC)

Hypoglycaemia
The 'low blood sugar' section says:
 * "In healthy individuals, blood glucose-regulating mechanisms are generally quite effective, and symptomatic hypoglycemia is generally found only in diabetics using insulin or other pharmacological treatment"

This is tagged dubious - discuss. Strictly speaking, symptomatic hypoglycaemia is unusual in *healthy* individuals. However, there are many other illnesses that can cause hypoglycaemia that are not related to diabetes or insulin treatment. The article is confusing at the moment. Could be worth mentioning the other possible causes?Arripay (talk) 23:00, 22 July 2013 (UTC)

I've changed the according lines regarding reasons for hypoglycemia. Prior (Bayes) for diabetes is high, but possibilities are many. Roland Puntaier (talk) 19:46, 23 January 2023 (UTC)

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Gastric Dumping Syndrome
May I humbly propose a new section entitled "Gastric Dumping syndrome" linked to the WP article of the same name (https://en.wikipedia.org/wiki/Gastric_dumping_syndrome). I do not feel qualified to write any text (this is my first-ever contribution to WP, but likely not my last) but I do feel, as a survivor of multiple gastric surgeries that have left me with 'late dumping syndrome' (see linked article above), that links to and from this article would be an enhancement.

I also respectfully submit that the grammar of some of this article could use review. Were I a more experienced WP conributor I would cheerfully offer suggestions.

Sincerely Nick_BritNick Brit (talk) 00:06, 9 July 2017 (UTC)

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Really only 4 grams on glucose in blood it seems to be low
Approximately 4 grams of glucose, a simple sugar, is present in the blood of a 70 kg (154 lb) human at all times. It seems low considering most foods with sugar have more then 4 grams of sugar and table sugar is half glucose and half sucrose Qwv (talk) 16:02, 23 August 2022 (UTC)

Healthy value range
Currently, our article says:
 * "restores the blood sugar level to a narrow range of about 4.4 to 6.1 mmol/L (79 to 110 mg/dL) (as measured by a fasting blood glucose test)"
 * "Normal blood glucose level (tested while fasting) for non-diabetics is between 3.9 and 7.1 mmol/L (70 and 130 mg/dL)"
 * "Blood sugar levels for those without diabetes and who are not fasting should be below 6.9 mmol/L (125 mg/dL)"
 * "Despite widely variable intervals between meals or the occasional consumption of meals with a substantial carbohydrate load, human blood glucose levels tend to remain within the normal range. However, shortly after eating, the blood glucose level may rise, in non-diabetics, temporarily up to 7.8 mmol/L (140 mg/dL) or slightly more."

So what is the healthy normal range during a day (min to max)? 4.4 to 6.1 mmol/L? 3.9 to 7.1 mmol/L? "below 6.9 mmol/L"? "up to 7.8 mmol/L"? Should we rewrite that section to be more consistent and clearer? a455bcd9 (Antoine) (talk) 07:01, 16 February 2023 (UTC)