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----------------- Normal - US -------- Normal - Canada
------------------- (mg/dl) --------------- (mmol/L )(
Fasting Glucose < 100 * ------------------ < 6.1*
2 hr after eating < 140 -------------------- < 7.8
A1c
(glycosylated
hemoglobin) < 6% (0.060) ------------- < 6% (0.060)
-------------------------------------------------------------

*Note that in the U.S., the value for normal fasting glucose is less than that in Canada. 100 mg/dl converts to 5.6 mmol/L.

In Canada, if you have a fasting glucose of 5.7-6.9 mmol/L the guidelines suggest you have a 75 g oral glucose tolerance test (OGTT) to screen for diabetes. This test requires you drink a sweet liquid and have your blood glucose tested every 1/2 hour for 2 hours. A signficant number of people
can have normal or near normal fasting glucose levels but test positive for diabetes when they have the 2 hr OGTT done.

Canada allows for a higher acceptable fasting value than does the United States. This is because research can be interepreted differently and of course, guidelines are time sensitive. With each new release of guidelines blood sugar levels there is a change (of late, anyway). Notably, the numbers to diagnose diabetes or pre-diabetes drop.

U.S. Glucose Levels to Diagnose
Diabetes & Pre-diabetes


ADA Guidelines Blood Sugar Levels
for Diagnosing Diabetes & Pre-diabetes



----------------- Fasting Glucose ---------- 2 hr after eating or
--------------------(mg/dl) --------------- 75-gram OGTT (mg/dl)
Pre-diabetes: IFG ----100 – 125 ---- and ---------< 140
Pre-diabetes: IGT ---< 100 --------- and ----------140 – 199
Pre-diabetes:
IFG & IGT ----------- 100 – 125 ---- and ----------140 – 199
Diabetes -----------≥ 126* --------- or --------- ≥ 200*
---------------------------------------------------(or random sugar)
-------------------------------------------------------------------

*A confirmatory test of either a fasting blood sugar, OGTT or random blood sugar with symptoms must be made on another day (except in the case of unequivocal hyperglycemia with metabolic decompensation).
ADA= American Diabetes Association

IFG = Impaired fasting glucose

IGT = Impaired glucose tolerance

OGTT = Oral glucose tolerance test

Canadian Glucose Levels to Diagnose
Diabetes & Pre-diabetes



------------------Fasting Glucose ------------- 2 hr after eating or
--------------------- (mmol/L -------------------75-gram OGTT
-----------------------------------------------------(mmol/L)
Pre-diabetes: IFG -----6.1 – 6.9 ------ and ---------- < 7.8
Pre-diabetes: IGT ----< 6.1 ----------- and ----------- 7.8 – 11.0
Pre-diabetes:
IFG & IGT ------------- 6.1 – 6.9 ------and ----------- 7.8 – 11.0
Diabetes ------------ ≥ 7* ------------ or ----------- ≥ 11.1*
-----------------------------------------------------------------

*A confirmatory test must be made on another day (except in the case
of unequivocal hyperglycemia with metabolic decompensation).

IFG = Impaired fasting glucose

IGT = Impaired glucose tolerance

OGTT = Oral glucose tolerance test

The guidelines blood sugar levels for diagnosing diabetes have changed over the years. They're lower now. And we now have a classification called "pre-diabetes".

If you have slightly elevated glucose levels (pre-diabetes) , know this amazing tidbit:

The Diabetes Prevention Study shows that losing 5-7 % of your weight, exercising for 1/2 hr per day and following a healthy diet can reduce your risk of getting diabetes by up to 58%!.

Glucose Guidelines (targets) for Diabetes

------------------- ADA ----------------- AACE ------- CDA
------------------ (mg/dl) --------------- (mg/dl) ----- (mmol/L)

Fasting Glucose ---- 90-130 --------------- < 110 ------ 4 – 7

------------------------------------------------------- (4 - 6 if safe)

2 hr after eating - < 180 as peak ---------- < 140 ------ 5 – 10
------------------ blood sugar after
------------------ eating

------------------ regardless of time ------------------ (< 8 if safe)

A1c --------------- < 7% ----------------- < 6.5% -- <7% (< 0.070)
(glycosylated
hemoglobin)
------------------- (< 0.070) ------------- (< 0.065) -- (< 6% if -----
-------------------------------------------------------safe)
ADA = American Diabetes Association
AACE = American Assoc. Clinical Endocrinologists
CDA = Canadian Diabetes Association

For people with diabetes, national diabetes associations set these guidelines blood sugar levels (but be sure to check with your physician for your specific guidelines - they can be individualized for important reasons). Blood sugar levels in these target ranges help reduce the risk of developing eye, kidney and nerve damage by up to 40-70%. The landmark studies DCCT (for type 1 diabetes) and UKPDS (for type 2 diabetes) showed this. For various reasons your target levels may be set at different values. Remember to verify your targets with your doctor.
 
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