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‘Normal’ Blood Sugar Can Hide Prediabetes

Blood sugar can spike to diabetic levels even in healthy people.

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How do you know if you have diabetes? Traditionally, it involves getting a test from a doctor to look at your blood sugar level, either at a specific point in time or over a period of months.

However, new research shows that traditional diagnostic tools might be missing blood sugar spikes in otherwise healthy people, keeping them in the dark about a potential metabolic disorder.

What’s ‘normal’ blood sugar?

In a study published in the journal PLOS Biology, researchers from Stanford University fitted 57 people with continuous glucose monitors to take readings of their blood sugar at frequent points throughout the day. The data showed that even people without diabetes experienced huge shifts in their blood sugar after some meals.

The findings suggest that people at risk of diabetes may be flying under the radar of tests doctors currently use to make a diagnosis. To check a patient’s blood sugar level, physicians typically use a glycated hemoglobin test (which shows a three-month average of blood sugar levels), or a fasting blood sugar sample.

These methods don’t pick up on a blood sugar spike someone might experience after a meal.

“We’ve previously used one measurement taken at a certain point in time to assess someone’s risk of having prediabetes or diabetes. What’s unique here [in this study] is that we’re looking at people’s continuous sugar profiles,” said Dr. Rekha Kumar, attending endocrinologist at New York-Presbyterian/Weill Cornell Medical Center. “The continuous glucose monitor is catching a cohort of patients who may be at risk of diabetes and might have been missed by current measurements.”

In addition to looking at the blood sugar responses from people’s regular meals, researchers also assessed how 30 of the participants responded to standard breakfasts: cornflakes and milk, a protein bar, and a peanut butter sandwich. The data showed that more than half of the nondiabetic participants experienced blood sugar spikes as high as people with prediabetes or diabetes after eating these meals.

Furthermore, around 80 percent of people experienced a big spike after eating the cereal.

“There are many factors that go into how high someone’s blood sugar goes after a meal,” said Kumar. “The most simple factor is how much sugar and what kind of sugar a person ate. But people also have different abilities to make the hormone insulin, which controls blood sugar levels. Muscle mass is also a factor, which further explains why two people who eat the exact same thing may not have the same response.”

A growing health issue in America

Around 1.5 million Americans are diagnosed with diabetes every year, according to the American Diabetes Association. However, the organization also estimates that there are around 7.2 million undiagnosed cases of diabetes, according to a report from 2017.

Fitting people with continuous glucose monitoring devices could help spot early signs of diabetes that might otherwise go unnoticed. However, a medical kit with the machine and supplies can cost up to $1,000, said Kumar, which isn’t affordable for most patients.

“If we could get this continuous glucose monitoring technology good enough and affordable enough, that would help us identify prediabetes,” said Kumar. “It would be great to prescribe it to at-risk patients, such as those who are overweight or have family members with diabetes, for a period of time.”

While blood sugar spikes may be missed by the tests available to most patients, they can be reduced by diet changes.

“Whether you’re at risk of diabetes or not, all of us could focus on eating more whole grains and eating less processed simple sugars, like candy, cookies, cake, white bread, and bagels,” said Kumar. “Diet changes are the first baseline intervention, both for better nutrition and helping to stabilize someone’s blood sugar.”

You should also look out for other warning signs of diabetes, such as excessive thirst, frequent urination, bruises that heal slowly, extreme hunger, and blurry vision.

If you notice any of these symptoms, schedule an appointment with your doctor right away. Even if he or she can’t fit you with a continuous glucose monitor, they can still evaluate your symptoms and use other screening tests to determine if you have diabetes.

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