Western Docs Are Not Prescribing This Critical Test!

blood sugar test image 1Even as the blood sugar epidemic rages on, doctors are still not prescribing all the tests needed to evaluate blood sugar issues. In Europe, a Fasting Insulin blood test is standard, along with a Fasting Glucose and a Hemoglobin A1c.

Optimal fasting glucose ranges should be between 70-85mg/dL, but western labs don’t screen folks until they are over 100mg/dL or higher. Studies now show that if your fasting glucose is 85, you may have a 40% increased risk of a cardiovascular issue. I suggest self-monitoring morning blood sugars to be sure your fasting glucose is not creeping up over time.

Hemoglobin A1c is a measure of the average amount of hemoglobin in the blood that has been damaged by excess sugar through a process called glycation over a 2-3 month period. If this number rises above 6%, the glycation in the body is at an unhealthy level. Under 5% is best.

Fasting Insulin is a test that measures the real culprit – insulin – and is missing in most doctor recommended blood tests. You have to ask for this test. As insulin rises, so does the risk of numerous health concerns including those related to the blood sugar, heart, weight, circulation, cognitive function and fat metabolism in the liver.

When sugar surges into the blood, insulin must also rise to attach to the glucose and take it into the cell. Over time, more and more insulin is needed to deliver the same amount of sugar into the blood. Normally just 1 unit of insulin is needed to deliver 10 mg of glucose into the cell, but as the blood sugars stay chronically high, it can eventually take 10 units of insulin to deliver the same 10 mg of glucose into the cell.

In one survey of over 10,000 health-conscious people, 66% of them had insulin levels above the desired level. A fasting insulin level above 5 micro International units/mL is considered a concern.

Make sure you get a compressive blood sugar screening with your next annual physical exam. You will need to ask for a fasting insulin test and, in many cases, you will need to ask for a Hemoglobin A1c test as well. Make sure that the blood test is scheduled in the morning and that you are following the fasting protocol, otherwise these fasting tests will be inaccurate.




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  • Bart Anthony Staub

    thanks John

  • David Williams MD

    Aloha John, I usually love your articles for their practicality and insight. After this one, however, as a western family medicine practitioner, I dread a rash of patients coming in asking for these tests which to me seem unnecessary. I know that you do extensive research on your articles and my response comes only from my clinical experience. I feel that insulin, glucose and A1C levels are all dependent interconnected variables that are connected to the same pathophysiology and not independent of each other. To me, the real culprit is insulin resistance, that requires increased insulin production and results in hyperglycemia that causes the downstream pathology in the body. As a western physician in over 10 years of practice I have ordered an insulin level a handful of times to look for insulin secreting tumors or to tease out Type 1 vs Type 2 diabetes in cases that do not fit the norm. In my experience the insulin level takes a long time to come back as the tests are generally sent to the Mayo Clinic or larger labs, and I believe they are expensive, and is easy for insurance companies to deny coverage for them. I am unclear how much information or value the insulin level in addition to glucose and A1C would provide, especially since the treatment and prevention will be the same – lifestyle and diet. Maybe in Europe these tests are more readily available and the costs subsidized or included as a panel.