A spoonful of sugar

sugarspoon.JPG

Whenever I give a talk and make the statement that a normal blood sugar represents less than one teaspoon of sugar dissolved in the blood, I’m often met with scepticism. It really is true, however.

Let’s go through the calculations so we can see exactly how this plays out.

First, we need some basic measures.

one liter (l)= 10 deciliters (dl)
one gram (gm) = 1000 milligrams (mg)

one teaspoon = 5 grams

According to the American Diabetes Association the line between a healthy fasting blood sugar and a pre-diabetic fasting blood sugar is set at 100 mg/dl (pronounced 100 milligrams per deci-liter). A fasting blood sugar of between 100 mg/dl and 125 mg/dl earns a diagnosis of pre-diabetes, and a fasting blood sugar of over 125 mg/dl is diabetic.

So how much sugar is 99 mg/dl, the highest fasting blood sugar you can have and not be diagnosed as pre-diabetic? Let’s figure it out.

We know that a typical human has about 5 liters of blood, so we need to figure out how much sugar dissolved into this 5 liters of blood will give us a reading of 99 mg/dl.

Since one liter contains 10 deciliters we multiply 99 mg/dl by 10, which gives us 990 mg, the amount of sugar in one liter. Multiply the 990 mg in one liter times 5, the number of liters of blood in the human body, and we have 4950 mg of sugar. If we divide the 4950 by 1000, the number of mg in a gram, we get 4.95 grams of sugar.

Since one teaspoon contains 5 grams, the 4.95 grams of sugar in the blood of a person just short of being pre-diabetic equals a little less than one teaspoon.

If you run all these calculations for a blood sugar of 80 mg/dl, which is a much healthier blood sugar than the 99 mg/dl one that is knocking on the door of pre-diabetes, it turns out to be about 4/5 of a teaspoon.

If you run the calculations for 126 mg/dl, the amount of sugar in the blood of someone just over the line into the diagnosis of diabetes, you find out that it is 6.25 grams, or 1 1/4 teaspoon. So, the difference between having a normal blood sugar and a diabetic blood sugar is about a quarter of a teaspoon of sugar.

What really gets kind of scary is when you look at the amount of carbohydrate in, say, a medium order of McDonald’s fries compared to the sugar in your blood. Remember, it is the job of your digestive tract to breakdown the starch and other complex carbohydrates, which are nothing more than chains of sugar molecules, into their component sugars so that they can be absorbed into the blood. An order of medium fries at McDonald’s contains 47 grams of carbohydrate. 47 grams of carbohydrate converts to about 47 grams of sugar, which is almost 10 teaspoons. So, when you eat these fries you put 10 times more sugar into your blood than that required to maintain a normal blood sugar level. If you figure, as we did above, that one quarter of a teaspoon is all the difference between a normal blood sugar and a diabetic blood sugar, the 10 full teaspoons would be 40 times that amount.

Since your metabolic system has to work very hard indeed to deal with the sugar load from an order of fries, imagine what it has to do when you add a large soft drink, a hamburger bun, and maybe an apple turnover for dessert.

When you see the long lines of cars in the at the drive-through window and the long lines of customers at the counter inside, you can see why the incidence of type II diabetes is skyrocketing?

Please note: I reserve the right to delete comments that are offensive or off-topic.

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133 thoughts on “A spoonful of sugar

  1. I always look at the sugar count on everything I eat. What is the norm for any given day? I am not a diabetic.

    Thank you.

    Hi Janet–

    I suppose the norm is based on whatever diet you’re trying to follow. If you’re following the standard American diet you should consume a little less than a half pound of sugar per day (the average American eats about 150 pounds of sugar per year). If, however, you’re following a healthful low-carb diet such as the one MD and I follow and recommend, your sugar intake should be negligible. You should eat somewhere in the neighborhood of 50-60 grams of carbohydrate (not sugar) per day.

    Hope this helps.

    MRE

    • I disagree, as a Diabetes Educator, carbohydrate recommendation is very indivdiualized. It depends on the persons medical history and exercise habits. My clients lost weight and stablized blood sugar, and those newly diagnosed didn’t have to even take medication. Diabetes controlled strictly through a healthy diet with more than 60 Grams a day. It’s important to note the Quality of the Carbohydrates (Complext) versus Simple. Example: Donut = Bad (Simple) ; Whole Grain Bread = Good (Complex). The Fiber content in the Whole grain helps stabilize the rise in Blood Sugar.

        • Yes, it is possible to eat a very healthy diet without grains. However, it is very irresponsible to tell people that whole grains are as bad for you as donuts and white bread. That’s simply incorrect. Some people don’t tolerate grains well, but for most, whole grains (especially sprouted) help regulate blood glucose, reduce cholesterol and blood pressure, provide lasting energy, and provide numerous essential vitamins.

          Additionally, fiber IS necessary and comes in the grain for a reason. Fiber regulates the extra glycemic response caused by the consumption of carbohydrates. White flour does NOT contain the necessary fiber (the bran), and causes your insulin and glycemic response to spike abnormally. This is why regular consumption of it can lead to insulin resistance, diabetes, not to mention a host of additional adverse effects caused by bromation and bleaching.

          I eat a very low-carb diet, and I agree with you in principle. However, to make the misleading statement that whole grains are no better than enriched, bleached, bromated white flours ( fried in trans fats no less!) in order to promote your low-carb plan is irresponsible and 100% incorrect. I don’t want to be overly dramatic but it is statements like yours that lead people to discount low-carb diets as nutritional quackery. It’s a disservice to those of us who would like low-carb and “whole-carb” diets to be recognized by the mainstream as healthy and viable alternatives.

          • Fiber slows the glycemic response, but it doesn’t change the amount of insulin necessary to metabolize the glucose. Dr. Eades doesn’t say the whole grain is AS bad- he simply says they are both bad– and they are. He could break it down to bad and worse I suppose, but why? We could compare arsenic and strychnine to see which is more toxic, but the bottom line is that you don’t want to eat either.

            When you add in the anti-nutrient content in the hulls of whole grains, you have the added disadvantage of phytic acid (mineral binding) and trypsin inhibitors (inhibits protein absorption). How can that possibly be good?

            Yes “whole-carb” diets are often touted by the mainstream as healthy and viable alternatives- it’s a shame they aren’t. ~Huntress

          • As “Cristy” stated, sprouted grains are the exception. Sprouting the grain reduces or eliminates the phytic acid….this is what our ancestors used to do!!!!…… and allows us to absorb the nutrients, utilize the fiber and sweep out any toxins (call me crazy? but maybe from all that protein?) that have been sitting in our intestinal walls and bowel for years, leading to stomach cancer, bowel disease, etc.

            I choose sprouted grains, seeds and nuts plus lots of vegetables and fruits (grapes WITH seeds please) over animal protein hands down.

            Love and Light.

          • @Moniques: Sprouting produced maltose which has been shown to increase insulin production three-fold. Keeping insulin levels down is the key to good health. Also, the myth of undigested meat in the bowel is just that, a myth. And it just won’t die.

            My husband worked as a diener (autopsy assistant) throughout college and never once was there any pocket of meat sitting around in the bowel. It’s one of those false nuggets that vegetarians like to throw around. As for disease, meat eaters have no less disease than vegetarians. In fact, more than 80% of IBS sufferers using online discussion rooms to ask for help are vegetarians. Considering vegetarians make up less than 5% of the population, that’s a little scary. Time to do some more research. Our longest lived ancestors (hunter-gatherers) didn’t sprout grains- they didn’t even eat them.

            ~Huntress

          • THE PROBLEM WITH GRAINS IS THAT THEY HAVE BEEN SO GENETICLY MODIFIED WE DON’T DIGEST LIKE PEOPLE DID A COUPLE HUNDRED YEARS AGO. LOOK AT THE RISE OF SILLIAC DISEASE & CROHNS DISEASE. TRY TAKING SOME GRAIN THAT YOU MAKE BREAD & GROWING IT! HOW ABOUT FLOWER SEEDS THAT YOU GROW IN YOUR GARDEN, WHEN I WAS A KID, MY MOM ALWAYS KEPT HER FLOWER SEED & PLANTED IT IN THE SPRING. GUESS WHAT I TRIED IT THIS PAST SPRING & IT DIDN’T EVEN SPROUT! I’M DIABETIC &
            ALL OF YOUR GRAIN BREADS SHOOT MY BLOOD SUGAR, & THE ONLY THING THAT SLOWS DOWN THE GLYCIMIC INDEX IS PROTIEN, LIKE CHEESE & APPLE (1/2 APPLE). I NO LONGER EAT ANYTHING PROCESSED BECAUSE OF ALL THE ADDITIVES. THE WORST THING IN THE FOOD LINE EVEN WORSE THAN
            SUGAR IS MSG, ITS IN EVERYTHING. SO IF YOU ARE HAVING A PROBLEM WITH YOUR BLOOD SUGAR LEVELS CHECK OUT THE MSG IN YOUR FOOD. IT IS ALSO HIDDEN IN PRODUCTS SO I DON’T BUY ANY PRE MADE OR PROCESSED FOOD ALL OF IT IS FRESH OR FROZEN.

          • Yes . . . how do vegetarians explain the existence — the HEALTHY existence, I might add — of Inuit? Please explain to me why the Inuit didn’t die out long ago of massive rates of cancer because of all that undigested protein in their guts?

            Need I remind yo that the traditional Inuit diet does not include a SINGLE GRAIN of vegetable matter. Indeed, there is not a single vegetable that grows above the Arctic circle. Could someone please explain that to me? Oh, and while you’re at it, explain Linda McCartney.

          • Somewhere around there, yes. When they started farming though, they lost a quarter of those years. Our current longevity has more to do with science, sanitation and medicine than it does diet.

          • This is a common myth.

            What you have to understand is that most babies and children died as babies and young children. The mortality of women also was high because of pregnancy complications and death in child birth, this also added into the average life span.

            This lowered the average “life expectancy” to 29, but that didn’t have anything to do with nutrition, but rather with lack of modern medicine.

            A person could, and probably often did, die of things we think of as simple childhood diseases or even a simple broken bone or tooth infection.

            What is amazing is that most who reached adult years lived for such a long time!

            Must have been something they ate 😉

          • As mentioned, this average has childhood deaths figured in. If memory serves, people who made it to adult hood used to live longer than those who do today.

          • Italians have traditionally eaten a heavy ‘whole-carb’ diet. They also have a much higher than average life expectancy. All the science you are quoting is great, but it doesn’t seem to accurately predict real-world phenomena. That’s a shame, because it certainly sounds good on paper.

          • I think you need to take a breath and research what dr eades is saying about grains in any form. I’m a pre-diabetic and I test my blood glucose 6-8 times per day, and I can tell you that any grains in any form, even complex fiber rich, are BAD and raise blood sugar to abnormal levels. You can get all the fiber and carbs you need from the right vegetables, preferably eaten raw. Visit Dr. Mercola’s website for a myriad of articles on how and why all grains are not good for most, especially anyone overweight or battling diabetes, insulin resistance, pre-diabetic.

          • All I have read (which is a lot), beginning with Sugar Blues (William Duffy, 1975) and now following drdavidwilliams.com support what you are saying Cristy. The Truth must be found and shared if we are ever to get a handle on the obesity/diabetes pandemic.

        • I have to say that most Grains=bad. I deal with the issue, through health and I am soo sensative to carbs, now I can even eat much oats, so I get fiber through Psyillium husk 100% and flax seeds in water. I get carbs from whole fruit and Veg. My diet has become extremely restricted, but I feel better, look better, sleep better, have less monopausal symptoms and better overall health feels better. Also quit all stimulants, like coffee and tea.
          thank you so much for this info, very helpful and informative!!

      • As a nurse and a diabetic I have mostly cut out all white foods from my diet. The only carbs I usually eat come from vegies. Recently I decided to try a high fiber cereal that contains 40 grams of carbs and 10 grams of fiber per two servings (a bowl). This should equal 30 grams of carbs something diabetics should be able to handle. After fasting all night and only eating a bowl of this cereal my blood sugar was 280. Not a nice feeling. My point is we are not all the same.

      • I disagree. I believe you can cut out sugar completely and use healthy substitutes. Our family has done this b/c he has ADHD behavior when he is on sugar. He has candida yeast infection. I really wonder if ADHD exists. I don’t believe it really does. I think people get too busy to go the distance. Not all but alot. Go to Lucy’s kitchen.

        • candida is related to sugar, I had issues with it years ago and I got a book, somewhere that talks in length about it………sugar and other simulants can make people suffer ADHD, I THINK, But I am not a Doctor, just a Thinker, LOL.
          Best to you!

      • There is a whole more in bread than just whole grain. The same with the donut.
        So you should say “Sugar = bad; whole grain = good.

    • Does it matter what makes up those 50-60 grams of carbs ? or is a carb is a carb is a carb no matter the source? Janet asked how much SUGAR
      When looking at a nutrition label, sugars are listed. Is there a recommended sugar amount per meal , in general health. ?
      Susan

    • First of all cancer thrives on sugar yes it loves it. You must also take into consideration many other factors when you start referring to the digestive system, energy, well being, and a whole host of diseases that are affected by pesticides, toxins, chemical fertilizers, preservatives and so forth that are allowed into the food chain and GMO’s/GEO. The quality of sugars we consume today is not at all the same quality that people ingested 100 years ago.

  2. Of the 50-60 grams of carbs daily that you suggest, how much of it should be sugar? Because, even low carb foods have some sugar in it.

    Hi Odalys–

    None of it ‘should’ be sugar. One can go on a whole food low-carb diet without a single gram of sugar.

    Best–

    MRE

    • Hi, I was reading this information this am because my husband needs to stay away from as much sugar as possible. Cancer loves sugar.
      He is a rancher and loves bread, meat and sweets. I understand that whole wheat bread should be the choice but have some questions. Does fruit and whole grain count? Even the Kashi ceral has sugar. I am confused and worried.
      Also, if molecular all sugar is just that, how does he get the vitamins and minerals from fruit without it going to the cancer?

  3. I know that the recommended per meal grams of carbs are between 35-40; but how many grams of sugar per day are allowed for a non diabetic person; how many grams of cholesterol.

    Hi Mary–

    Actually the recommended carbs per meal are more in the 7-10 grams per meal (35-50 per day). There is no specific recommendation for sugar in terms of how much allowed. I try to eat no sugar per day. And I don’t worry about how much cholesterol I eat because it doesn’t seem to matter as long as I follow a low-carb diet.

    Best–

    MRE

  4. Because of the very high index of DM in my family, I have started to check my blood sugars daily. Fasting is always a little over 100..103-108, except when I really watch it and it drops down to 98. Had a GTT test and doctor told me it was within normal levels. I do not agree. Fasting: 105
    1 hr: 196; 2hrs: 121; 3 hrs; 93; 4 hrs; 83.
    However, i walked in and out of the building after blood drawn. You think I should repeat? I think I’m pre-diabetic–if not diabetic. Thank you.

    Hi Jo–

    According to the numbers you provided, you fall into the normal/non-diabetic/non-impaired glucose tolerance category. At least by the standards of the lab I use. Your lab may differ.

    I don’t know if you’re on a low-carb diet or not, but if you are, it makes a difference in the glucose tolerance test. Typically someone who has been on a low-carb diet for a while then goes for a glucose tolerance test will get numbers that can look diabetic. That’s why people contemplating such a test are instructed to eat plenty of carbohydrates for a few days before the test.

    Best–

    MRE

  5. I’m an active 48 y.o. man 6’1″ 179lbs. My fasting blood sugar had been between 106-111 for several years. My most recent test was 108 with an A1C of 5.2.

    A low glycemic-index diet for the past year has done little to affect my numbers. My doctor says there’s not much more that I can do than I already am doing and to keep at it (watch sugar, carbs, and continue to exercise). Am I headed down the Type 2 Diabetes road?

    Hi S–

    I don’t necessarily believe you’re headed down the road to type II diabetes. Based on a lot of experience I’m not a big believer in the virtues of a low-glycemc-index diet. I’m certain that low-glycemic carbohydrates are better than high-glycemic carbohydrates, but I don’t think low-glycemic carbohydrates are better than simply consuming fewer carbohydrates all together.Were

    Were I in your shoes, before I wrote myself off as inexorably rolling down the diabetic highway, I would forget the low-glycemic bit and try a simply low-carbohydrate diet. Eat plenty of protein and keep your effective carbs below about 30 grams per day for a couple of weeks and see what happens. I would be willing to bet that the blood sugar parameters improve markedly.
    Keep me posted.

    Cheers–

    MRE

  6. Hi
    In Australia we use a different measure. Can you offer a comparison? My husband has been testing for a few months after some health issues is finds he is high first thing in the morning 7 to 8, & lower later in the day 5 -7. Is this normal? Doc wanted him to do a glucose tolerance test but we did not want him eating those high carbs for 3- 4 days (would set his weight loss back kilos)

    Hi Lynne–

    Your way of measuring blood sugar is in mmol/L. You can convert to our old fashioned mg/dL by multiplying your figures by 18 or conversely can convert ours to yours by dividing by 18.

    Your husband is experiencing what is called the dawn phenomenon. The liver produces and releases glucose into the blood unless it is turned off by insulin. The liver tends to make more overnight to compensate for the fact that one doesn’t usually eat while sleeping, yet one’s blood sugar level needs to be maintained. The liver produces enough glucose to keep the blood sugar at a normal level. If the level gets a little high, the pancreas releases a little spurt of insulin that signals to the liver to quit producing sugar for a while. An insulin resistant person’s liver often doesn’t get the signal and keeps on producing sugar leading to elevated sugars in the morning that tend to go down later in the day.

    In my experience, the best treatment is a low-carb diet over the long haul to re-establish insulin sensitivity.

    Hope this helps.

    MRE

  7. I have just been diagnosed with Diabetes. My blood glucose was 192. I have hypertension and take 1 tablet of 100 mg of 12.5 hydrochlorothiazide (Hctz) per day.

    I understand that both the water pill and hypertension medication can contribute to a higher level of blood sugar.

    I have no real symptoms of diabetes, such as thirst or problems with healing.

    I have begun to exercise three times a week. and am trying to have a non sugar diet. However, I find it very difficult because there are grams of sugar in almost everything.

    Am I to cut out sugar completely or is there a minimal amount allowed?

    Thank you for your help.

    Bob
    rmpape@sbcglobal.net

    Hi Bob–

    The human requirement for sugar is zero. I eat zero grams of sugar in a typical day. If you are finding small amounts of sugar in everything, you must be eating a fair amount of processed food because there isn’t much sugar at all in natural, whole foods. In my view the best diet for hypertension and/or type II diabetes is a whole food, low-carbohydrate diet. In your situation, you need to work with your physician–especially if you are taking HCTZ–because a low-carb diet can create a profound reduction in blood pressure very, very quickly.

    Good luck.

    MRE

  8. Hi.
    I’m forty and a glucose test last month gave me a level of 117. Obviously I’m concerned and am now on a combined exercise/low carb diet programme. My worry is that in May my glucose level was only 92, as it was for years before. What’s happened? Twenty-five points in six months seems completely out of control. Am I still in time to stop DM developing?

    Hi Joe–

    I wouldn’t worry about a single elevated glucose reading. Check it a couple of more times to see if it is consistently elevated before you start worrying. If your glucose was 92 six months ago, I’m pretty sure you haven’t reached a point of irreversibility.

    Best–

    MRE

  9. I’m trying to figure out how many grams of carboydrated equals a mg/dc in blood sugar. I know that there are going to be variables, but wonderinf if there is any set formula – i.e. one piece of bread will raise your blood sugar so many points… etc.

    Is this a reasonable question? Thanks.

    Hi Fawn–

    It is a reasonable question, and one that is difficult to answer.  Difficult because insulin knocks the sugar level down so quickly that it’s almost impossible to calculate.  Dr. Richard Bernstein, who is a type I diabetic and produces no insulin of his own, has made the calculations without the influence of insulin.  Apparently 1 gram of carb causes about a 5 mg/dL increase in blood sugar and 1 unit of regular insulin drives blood sugar down by 8 mg/dL.

    Hope this answers your question.

    MRE

  10. If significantly cutting carbs lowers blood pressure, why has no MD ever told me so?

    Mona

    Hi Mona–

    It’s not a secret.  I guess you’ve just been going to the wrong MDs.

    Cheers–

    MRE 

     

  11. Thank you for your quick reply.

    Every M.D. I’ve ever gone to was quick to prescribe pills.

    Would you consider yourself to be a traditional M.D.? Do you think there is value in some of the alternative methods of medicine?

    Thank you.

    Hi Mona–

    I consider myself a sort of traditional M.D. with an eye to what works to get patients well whether it is traditional or not.  I think there is tons of value in much of what folks call ‘alternative’ medicine, but there is also a load of pure quackery.

    Cheers–

    MRE 

  12. I just got some blood test results.

    Cholesterol 208
    Triglyceride 79
    HDL 55
    LDL 81
    Cho/HDL 3.8

    I’ve been eating oats so I’d get better readings. What effect does drinking wine have on these readings?

    Thanks.

    Hi Mona–

    Your results look pretty good.  Drinking can drive triglyceride levels up in the short term and can elevate HDL levels for the longer term.

    Cheers–

    MRE 

  13. I recently went to the doctor to get my blood test, since I was having High BP.
    these are the result:

    Cholesterol: 245
    Triglyceride: 250
    HDL: 39
    LDL: 157
    Chol/HDL: 6.3

    Glucose: 125 mg/dL

    Doctor said I have type II diabetes, which came as very shocking news for me. I have to blame myself for this situation, since I eat a lot of junk food (McDonald’s breakfast is my favourite), No exercise at all, Park my car close to the entrance of a mall, so that I don’t have to walk long distance etc…I guess all that have contributed to my poor health. Is there any way I can bring the values to normal? I don’t know how to improve my HDL level, do you have any suggestion?
    I have made the following changes in my lifestyle:
    1)No Sugar whatsoever.
    2)Don’t know whats low carb foods are, so eating lot of vegetables and fruits like Strawberries, rice and bread.
    3)Cardio-exercise 1/2 hr a day.
    4)Reduced the intake of salt.

    Please suggest me any other useful information or recommendation.

    Truly appreciate your response.
    Thank you.

    Hi Ram–

    It’s beyond the scope of this comment section for me to lay out a complete diet for you.  Your problems can be solved with a low-carb diet, but you need to get a good low-carb book to show you the way.  Try Protein Power or The 30-Day Low-Carb Diet Solution.  In either of these, you will find all the information you need.

    Good luck–

    MRE 

  14. I had my yearly physical in Feb including bloodwork. I had awakened much earlier than usual that day so I checked online and found some articles that suggested drinking unsweetened tea before my tests was acceptable.

    My dr called two days later concerned about an elevated glucose level although she didn’t tell me what it was at the time. That’s when I remembered the green tea also was flavored with blueberries for extra anti-oxidants.

    I took the fasting test again, this time no tea, and the result was about the same as my previous year’s results; 85 in 2006 and 83 in March 2007.

    I have since learned the test result in Feb was 248. Despite the 83 reading I now have to go for a glucose tolerance test. But while reading about preparing for the test I see in Feb I did several other things wrong besides drinking the tea. I exercised for 90 min before the test. I also had been on a low carb diet. Can these factors be responsible for such an elevated glucose level or should I be really concerned about becoming/being diabetic?

    Thanks.

    Hi Marjie–

    If you had a perfectly normal fasting glucose recently and a normal one the year before, I wouldn’t worry about the Feb 248.  It could easily have been a lab error.  Most lab results that are totally out of whack are usually caused by a lab error.  It won’t hurt to do the glucose tolerance test just to ease your (and your doctor’s) mind, but I suspect it will be perfectly normal.  

    Cheers–

    MRE 

  15. I’m concerned about my rising blood fasting levels that in 3 years have gone from 89 to 99 and now 106. My last blood test showed:
    cholesterol:220
    ldl :99
    hdl :120
    tri. :56
    ratio :1.9
    I’m 57 female, had been sitting for 3 weeks without exercise due to lumbar strain, and I eat lots of fish ( no shellfish) some chicken and veal, pork, and lamb chops once in a while ,veggies, and some fruit but not alot. Also have red wine each night, use olive oil, walnuts and almonds,take multi vitamin plus probiotic and digestive enzymes do to acid reflux and general bad stomach.In 1 month I changed my cholesterol profile from 3.2 to 1.9 but now my sugar is up. Why and what can I do to get that down to normal. My father had diabetes in his late 60’s. I’m 5’3 127 lbs. I think I need to be 120 lbs. tops. I have a small frame. Thanks.

    Hi Diane–

    Your labworks looks great.  If you’re worried about diabetes, you should check with your doc about doing a glucose tolerance test to see what’s going on.  I don’t put a lot of reliance on fasting blood glucose levels.

    Cheers–

    MRE 

  16. My sister in law is a Type 2 Diabetic and when she takes her count in the mornings it will vary but will be up around 130. She says that her doctor says this is normal, but I find this hard to believe, when she is on medication. She does not follow a strict diet and has had Tryglercide readings in the upper 700’s. Please tell me if you think a reading first thing in the morning should be considered a normal reading for someone on medication.

    Hi Bill–

    There are too many variables for me to make a call on this.  Your sister-in-law needs to work it out with her physician.

    Cheers–

    MRE 

  17. HI…
    I WAS JUST WONDERING…
    I RECENTLY GOT DIAGNOSED WIT CONGESTIVE HEART FAILURE, AND HAVE MUSCULAR DYSTROPHY.
    I HAVE AN UNCLE WHO HAS DIABETES, AND I DRINK ABOUT 2-3 CUPS OF SODA EACH DAY…
    DOES THE SUGAR EFFECT MY CHF AT ALL?
    DO I HAVE GREATER CHANCE OF GETTING DIABETES SINCE I AM NOT ACTIVE DUE TO MY MUSCULAR DYSTROPHY?

    Hi Cassandra–

    I don’t know if the 2-3 sodas will result in your developing diabetes or not, but it certainly isn’t going to protect you from it.

    Cheers–

    MRE

  18. Dr Mike

    How do you feel about artificial sweetners in place of sugar for non diabetics and or
    diabetics.
    Thank You
    Carol

    Hi Carol–

    I’m all for them. If the diabetic patients have to have sweetened foods (they don’t, but they sometimes think they do), then the artificial sweeteners are much less damaging to them than would be an equivalent amount of sugar.

    Cheers–

    MRE

  19. I was browsing though a so-called health magazine in a book store yesterday (most aren’t worth the paper they are printed on) and was startled to come across an article that claims recent research shows that potatoes are comprised of a ‘newly identified form of fiber’ that helps maintain blood sugar levels and that because of this potatoes are not the villain they were claimed to be by Atkins (it’s interesting that they cited ‘Atkins’).

    On the surface this claim would seem to fly in the face of research that shows potatoes will raise BG as fast as glucose. And potatoes have lots of carbs which is the real issue. But given the fact that potatoes are the most consumed vegetable in North America, it is not unexpected that attempts will be made to portray them in a positive light with carefully worded statements. Have you heard of this new campaign yet?

    Hi David–

    Nope. This is the first I’ve heard of it. But you’re right, it’s not surprising.

    Cheers–

    MRE

  20. My boy friend is Type II diabetic his blood count is 229 in the morning before he eats..He has a bowl of bran flakes. then 4 hrs. later his blood count is up to 450 sometimes a little lower. His blood count use to be lower in the morning with 130 but now it is over 200 or 300. I did suggest he should contact his Dr. about this but he hasn’t called him. He does eat late every night after he gets home from work at 8pm and eats an or two apple around 10pm, and sugar free pie with sugar free ice cream til late in the evening. He goes to bed around 12:30am. Get up at 10 am. He is over weight and has high cholesterol. I have tried to tell him he needs to get off the things late at night and what he is eating. Am I talking to the wall on this with him? He does take meds for his diabetes.He is 66 yrs. old (maybe no change at his age)He is 5’9″.

    I can’t give medical advice over the internet, but it does sound to me like your boyfriend should have a real heart to heart with his physician.

    Best–

    MRE

  21. Hi MRE,

    I had a blood work done recently and my Blood Sugar is 123. And my A1C was at 6.2.

    The doctor said I am pre-diabetic need to do exercise and have a diet plan or else I will become a diabetic in few months.

    He has recommended a second test after 3 months.

    Just wanted to know whether I am diabetic or a pre-diabetic and what are the chances of me getting my blood sugar and A1C back to normal.

    Thanks and Warm Regards,

    Alam

    Hi Alam–

    Your blood sugar levels and HgbA1c are elevated. I would recommend that you put yourself into the hands of a good doctor who knows how to use a low-carb diet. If you start a low-carb diet you should find your blood sugar and HgbA1c normalizing fairly quickly.

    Good luck.

    MRE

  22. Hello!
    I’m on a diet that subtracts the fiber from the total carbs and then that total is divided by 5 to see how many teaspoons of sugar I am eating per day. I eat soy products for protein and very limited fruit. I do eat veggies. While eating this way has stopped my cravings for carbs, I fear I’m not getting enough fiber. How does this differ from your plan? Any suggestions?

    Thanks!!

    My suggestion is that you not worry about fiber. The data don’t show that it does much of anything beneficial and may even be harmful. Click here and here to see a couple of posts I wrote on the fiber issue.

    Cheers–

    MRE

  23. I have recently been diagnosed with diabetes. I got severely sick and ended up in the hospital with a blood sugar level of 596. I am now out of the hospital but I am having a hard time bring my number down past 250. The hospital gave me some medication and I have been taking it like clock work, I have also been watching what I eat and I only drink water or lemon water. I also started take omega 3 fish pills. I am in desperate need of nutritional advice. I look for food no sugar or very little and also no carbs or very little. Someone also told me I should watch out for my sodium intake. What is the highest I can go in counting the sugar and carb intake daily.

    Since you are not my patient and I don’t know your medical history other than what little you provided (which is far from enough), I can’t possible recommend treatment for you. You need to put yourself in the hands of a physician experience in the use of low-carb diets in the treatment of diabetes. Such physicians usually put their diabetic patients on diets limited to 30-50 grams of carbohydrate per day.

    Best–

    MRE

  24. you mentioned daily carbs of 50-60 per day with no sugar just wondering how you get fruit in your diet at that pace? been watching what i eat a little more lately (bp was 160/105 last reading although think reading was off) and usually have fruit for breakfast and snack in afternoon with an apple and an orange i am already over 50 carbs and 25-30 of sugar.

    Who says you have to have fruit? Other than berries occasionally I almost never eat fruit.

    Cheers–

    MRE

  25. Hi I have visited few website which offers excellent dietary supplements and protein shakes. I used to take Ultimate Nutrition’s “Isocool”. However i have also tasted “Optimum Nutrition’s 100% Whey” and liked it a lot. However while studying the nutritional facts for both of these product i have came across a fact which says both of these product has some level of cholesterol- to be precise 18 mg and 30 mg respectively. I suppose this must be LDL or bad cholesterol. So considering the cholesterol level, is it ok to still consume these product if my cholesterol level is at moderate level?

    I would think so. I wouldn’t worry so much about the amount of cholesterol as I would worry whether the cholesterol was oxidized or not. Since it’s in a powder form, I would think that it was oxidized.

    Best–

    MRE

  26. This is really interesting. Your original post was Aug 31, 2005. I would not be here making a comment if not for the RSS. Quite amazing!

    I remember reading this a long time ago, and have made the point many times to many people that the margin of “error” is extremely slim when in comes to blood sugar. It is always met with disbelief… 100% of the time. I’ve acquired the reputation of being some weirdo health freak sugar-free nut case.

    The epidemic of Type II is tragic, but the epidemic of poor medical advice from the ADA and Docs who specialize in Diabetes care (and who should know better) is downright alarming!

    Over and over they keep saying that Type II’s can eat sugar. Just last week, the “Today Show” nutritionist said Type II diabetics should STAY AWAY from artificial sweeteners and just eat sugar instead! That seems borderline criminal to me… they ought to be avoiding sugar like the plague.

    Hi Karen–

    I don’t have a clue what you mean by the RSS. I know what RSS is, but did it send you this particular post? I’m curious. I thought the posts only went out as I put them up, and as you noted, I put this one up over two years ago.

    Oh, and your commentary is spot on.

    Cheers–

    MRE

  27. Hi Dr. Eades,
    The RSS feed does not send me the original posts, but it does show the 10 most recently posted comments in a bookmark-like format. If you look at the list at any given moment, you may see an interesting comment. Himanshu posted a comment on 12/5, so I clicked.

    I think it’s valuable because it brings you back (albeit occasionally) to interesting topics that you may have forgotten about.

    Hmm. So that’s how it works. I don’t read anything in RSS, so I didn’t have a clue.

    Thanks–

    MRE

  28. This is a great site and thanks in advance for any help. I am a 33 yr old mom of 2 and I’ve been having some troubles over the past 2 years. I’m afraid I’ve developed some condition that renders me utterly incapable of dealing with cold weather (I’m literally nearly debilitated in the winter due to constantly freezing) that is combined with lethargy comparable to depression (but is not), a weight gain of nearly 60 lbs in under 10 months (that started 1.5 yrs ago and I went from 5’8″ and 155 lbs. to 215 lbs. and holding), I now loathe eating and sometimes only remember to do it because if I don’t I get the shakes, nausea, and light-headedness. Here recently, in the past couple of months, I’ve also begun getting very dizzy after almost every meal. My eating habits are absolutely horrible, I freely admit, but I almost feel conditioned to despise food by the poor self-image from the weight gain and the feeling of lethargy and now dizziness that eating produces. I also tend to keep a temperature of around 96.5 to 97.4 degrees throughout the day and into the night.

    I had a series of blood tests done in Feb. 2007 because I suspected hypothyroidism but my thyroid levels came back normal. The only real discrepancy marked was a blood glucose level of 64 mg/dl which they marked as low. The thing is, though I had not eaten when this test was done at 9:15 am, I had drank at least 2 cups of coffee with about 5 tsps. of sugar (and perhaps 3 cups with 7.5 tsps. of sugar) and quite a bit of non-dairy creamer combined in the 1 hr – 1.5 hrs before the blood was drawn.

    I don’t have insurance and I don’t have a lot of money to spend. I’d like a little more information before I go to the doctor or even if there is real reason to go. Is that blood glucose level excessively low, especially considering how much sugar had I had consumed just 60-90 minutes before? I am not in bad health all things considered, I am active, have a hemoglobin count of 15, cholesterol of 174, a hematocrit of 30%, am not on any type of medications and while I don’t recall the exact value my T3 uptake was at the low end of “normal” for what it’s worth. Any advice or bit of expertise would be greatly appreciated. This is a great thing you are doing here. Thank you!

    Hi Paula–

    I would ask for an oral glucose tolerance test at the very least. Your sugars could have been so low after the 7.5 tsp of sugar as a consequence of reactive hypoglycemia, which is a sign of insulin resistance. People who have reactive hypoglycemia shoot their blood sugars up whenever they consume carbohydrates and stimulate a huge insulin response, which then knocks their blood sugar way too low. Which then usually makes them hungry for carbs, which they eat and start the cycle again. If you undergo an oral glucose tolerance test, and you have reactive hypoglycemia it will be obvious.

    Good luck.

    MRE

  29. I recently went through premature menopause – I’m 37. I had a lot of blood work done and my fasting blood sugar was 102. My physician followed up with an ha1c which was 5.3. He seemed to think I had nothing to worry about since I don’t have a family history of diabetes and weigh 118 pounds (5’5”). I have been scared that I might be prediabetic, so I am eating much better and exercising almost every day. Do you think I can relax a little, or am I on the road to diabetes? Could menopause have affected my blood sugar? Could the big bowl of ice cream with brownies the night before the test have affected the results?

    Thanks,
    Mary

    Since I’m not your doctor and haven’t examined you or your labs or taken your medical history I can’t say whether or not you’re on the road to diabetes. I can say that a steady diet of ice cream and brownies will have an effect on your HgbA1c. And I can say that menopause does affect blood sugar. Read Dr. McCleary’s book to learn why or take a look at this blog post to read an excerpt on the subject of menopause and blood sugar.

    Cheers–

    MRE

  30. I’ve been eating an all natural-nonfat Greek yogurt and was wondering what the nutritional benefits are. Here is the nutrition facts as noted on the container; Serving size, 1 container (150 g); Calories 80; Calories from Fat 0; Total Fat 0; Sat. Fat 0; Trans Fat 0; Cholest. 0mg; Sodium 55mg; Total Car. 6g; Fiber 0g; Sugars 6g; Protein 13g. It’s the sugar I’m concerned about.

    The sugar content is about a teaspoon. It’s not really much compared to that in other yogurts, especially the flavored ones.

  31. How much sugars are in fruits? When I drink fruit juices there is always a lot of sugar – like in apple juice – 28g. Eating an entirely plant based diet – what has sugar in it? What about agave syrup?

    There is a lot of sugar in fruits. And a lot in agave syrup. The best fruit choices are berries if you want to keep sugar intake low and still eat fruit.

  32. an organic lemonade is 11% juice, 21g of sugar, and 24g of carbohydrate,
    ingredients are: filtered water, cane sugar, and lemon juice.
    suggested serving size is 8oz.

    question: is if a type 2 diabetic (controlled with diet and exercise), drinks one 8oz cup of this juice per day or every other day, what are the possible affects on blood glucose levels. blood glucose levels are within target range.

    It means that if blood sugar levels are normal the body will have to get rid of about 5 teaspoons of sugar, or about five times what’s already in the blood. In a person with normal insulin function, this is pretty easy; in one with type II diabetes, it’s not so easy and could easily lead to elevated blood sugar.

  33. I RECENTLY HAD SOME ISSUES WITH LOW BLOOD SUGAR. I NOTICED THAT I HAVE BEEN SLUGGISH, VERY TIRED, FATIGUE, SLURRED SPEECH AND COLD HANDS AND FEET, FEELING FAINT AND HUNGRY ALL THE TIME AND NAUSEATED. I WENT TO SEE THE DOC AND HE TOOK A BLOOD SUGAR AND IT WAS 75MG. THE HIGHEST AFTER EATING WAS 99MG, MY CONCERN IS THAT IT IS ALWAYS LOW NO MATTER WHAT I EAT AND I AM ALWAYS FEELING TIRED. HE RAN A PANEL OF BLOOD WORK ON MY LIVER, PANCREAS AND THYROID, BLOOD COUNT WHICH CAME BACK NORMAL. WHAT DO YOU THINK IS WRONG?

    I haven’t a clue. I can’t make diagnoses and give medical advice over the internet to someone I’ve never seen or examined.

  34. Hi – I am not a diabetic but do follow a low carb diet (your site is a great source of inspiration by the way.) I have become convinced over the years that whilst the simple carbohydrate content of ones diet is important to monitor, there is something especially insidious about refined sugar as an added ingredient. My thoughts on this are best summarised in a post I called “We’re all Junkies” (http://paynowlivelater.blogspot.com/2008/07/i-want-you-to-try-something.html).

    I am interested to know how important (if at all) you see this distinction as in terms of impact to the body. For example – I would avoid a savoury food that contains refined sugar in the ingredients list in favour of a handful of dates even though the likely insulin response to the latter would be greater….

    Probably the thing that is most insidious about refined sugar is the fact that regular table sugar (sucrose) is half fructose. It seems that fructose is the major problem. The carbohydrate that you find in breads, pastas, and even fruits and vegetables is glucose or starch, which is simply a bunch of glucose molecules hooked together. Certainly some fruits contain fructose, but nothing on the order of what you find in the normal amount of sugar used for sweetening. You are wise to avoid sugar and especially high-fructose corn syrup, today’s commercial sweetener of choice.

  35. Thanks for replying – I appreciate you probably get a lot of comments to read. People often cite the existence of fructose in fruit as a reason it cannot be bad and this really hampers my attempts to make people understand its (and refined sugar’s) dangers. I will be emailing your comment to them for added weight!

    Sorry, I forgot to make the link in my previous comment a proper link – hopefully this time it will be clickable! We’re all Junkies

  36. Hello, I have been following a low carb diet for about 2 weeks now and my fasting blood sugar is 111. Back in 2001 I was diagnosed with PCOS, however, I was not convinced that I had this syndrome so I did not follow up on it. However as of late, I have gained a massive amount of weight and have experienced some male-patterned baldness and irregular menses. I will be scheduling an appointment with an endocrinologist soon. My question is should I eat carbs a few days before I get the lab work done and if so, why?

    If part of your workup is to have a oral glucose tolerance test, and if you have been on a carb-restricted diet for any amount of time, you should increase your carb intake for several days before your test. Increasing your carb intake for a few days will give you time to produce the enzymes you need to properly metabolize the glucose. If not, your glucose tolerance test may indicate that you are glucose intolerant when you really aren’t. If you do have PCOS, however, I suspect that your test will show some level of glucose intolerance even if you do eat carbs for several days before.

  37. Health food stores (at least in the UK) can be a Trojan horse for sugar-laden foods, and are arguably more culpable than McDonalds because of how they position themselves to the public –

    The Worst Sugar Pushers of all – Health Food Stores

    Do you have a similar situation in the US?

    Methuselah
    Pay Now Live Later

    Yep. We sure do. But don’t worry. The sugar available in our health food stores is all organic pure cane sugar, so it’s got to be okay. Right? :-)

  38. My blood count is Col-119, Trig.-150, LDL-67, HDL-35, Glucose 107..How can I get the glucose down so as not to become a Type 2-Diabetic and the HDL up..I also have just been diagnosed with low testosterone.

    I’m sorry but I can’t give specific medical advice over the internet. I would say that the low testosterone can contribute, so you may want to talk to your physician about the possibility of starting on a testosterone cream in the appropriate dose.

  39. The fact that this post is attracting comments even after three years indicates the popularity of your blogs. It is pleasure combined with education to read them. Also, thanks for answering the comments promptly. I have one difficulty with the blood glucose numbers cited here. I read somewhere that plasma glucose levels are around 12% higher than full blood glucose levels. What do you recommend as healthy and upper limits of fasting and postprandial blood sugar numbers and HbA1c. Are they plasma values?

    Actually plasma/serum glucose is about 15 percent higher than whole blood glucose. I use the serum values (which are about the same as plasma), and I like to see fasting glucose levels in the 70-80 range. Certainly not greater than 100 mg/dl. I like to see HbA1c levels below 5.

  40. hi
    my blood glucose is highest in the morning fasting reading which is between 116 -125.
    after dinner i am between 100 to 110 usually and that is after i walk for about 45 minutes.

    so why should it rise so much while im sleeping?

    im taking metformin 1000 mg at breakfast and 1000mg at dinner.

    i get frustrated because i exercise and deprive myself of so much food and snacks and
    im only at 120 in am which is high normal

    thanks

    The rise in blood sugar early in the morning is called the dawn phenomenon. You can read about it here.

  41. hi doc

    was wondering if i were to ingest 20 gms of sugar as opposed to 20 gms of carbs
    before my workout , what would my result be after i finished with my workout?

    i know carbs are used as fuel for energy and can be burned off but can sugar be burned off just as well and as fast ? after all carbs are long chains of sugars put together as a whole compound which basically seems all the same thing to me, sugar and sugar and sugar.

    so whats worse for a diabetic— sugar or carbs??????????

    i noticed today after i had 1/2 of nectarine fruit before my workout that my sugar
    level remained the same at the end of my workout 2 hours later.
    it was 121 after my workout and usually i get between 85 to 110 after my workouts
    so i wonder if that small nectarine fruit attributed to that poor 121 result after my workout.

    thanks in advance

    im sure that you are not only helping me with your concrete advice but others as well
    facilitating their diabetic progress and knowledge associated with this awful disease.

    You are correct in that carbs are sugar. Some carbs are broken down a little more slowly, but in the end, they are all sugar.

    I would bet that the elevated sugar you found after your workout was as a result of the nectarine, but I can’t be sure. According to the USDA a nectarine contains about 14 g carb, so 1/2 nectarine would have around 7 grams, which is a little more than a teaspoon. Since at a blood sugar of between 85-110 your entire blood volume contains about a teaspoon of sugar, adding this other teaspoon plus could certainly cause a blood sugar rise in someone with type I diabetes. Pure sugar will cause a blood sugar rise a little more quickly, but it will still rise from the carb found in fruit, grains, etc.

  42. would taking metformin at bedtime help reduce the dawn effect so i can get a lower morning fasting reading?

    It should. You would have to try it to see.

  43. hi

    will carbohydrates such as pasta,rice.pizza,and bread that i eat for lunch or dinner
    on monday affect or have an impact on my tuesday morning reading?

    also how long does it take for meals to get absorbed and continue to rise your sugar
    levels? i am type 2 diabetic.

    when i eat bread and pizza i feel so full the whole day and not hungry at all and assuming i dont have the dawn phen/affect i think its the carbs that i eat the day before that
    raises my next morning fasting sugar readings which are in normal range of 120 but not
    below 100 where i would prefer them to be

    thanks again

    Eating carbs for lunch of dinner on Monday should have no affect on your Tuesday morning blood sugars other than the overall deterioration of the body’s ability to handle glucose brought on by the chronic overconsumption of carbs.

  44. do sugar alcohols get more absorbed on an empty stomach?

    i noticed a 30 point rise 97 to 127 ( 3 hours after breakfast) which consisted of 3 sugar free oatmeal cookies and 1 slice of sugar free cake both with carbs and carb sugar alcohol.

    Different sugar alcohols are absorbed at different rates and in different amounts, so it’s hard to say. And there is all the rest of the carb in the ‘sugar free’ cookie that has to be dealt with.

    Somehow I think you’ve confused this blog with a doctor question and answer column in a newspaper. I really can’t give specific answers to personal questions. If I did, I would spend my entire day answering personal questions from readers. Why don’t you try the Protein Power forum. It’s populated with intelligent, helpful people who are experienced and can answer a lot of your questions.

  45. Hi Doc,
    I thought you might find this interesting. I was diagnosed back in Jauary as having diabetes. After an inital misdiagnosis of type 2 by my regular doctor, and having more thorough blood work done, I was diagnosed as type 1.5 (I’m 30, skinny) My fasting blood sugar on the first test was 275! Tests I took on my onetouch a few weeks later even showed results of up to 300 after eating. Now after several months of staying away from sugar and high carb foods not even having taken any medicine and being scared to check my blood sugar, I just took my fasting blood sugar this morning before breakfast and it said 108. My blood sugar two hours after eating a big dinner in which I had about 10 grapes, meatloaf, noodle chicken soup, salad and 1/10 cup grape juice was 148. Is this even possible by normal convention?!?!

    Is what possible? Having a morning fasting blood sugar of 108 or having a blood sugar of 148 after a meal with a fair amount of carb. Both are possible.

  46. Hi doc.
    Love what I am reading from you. I do however believe that a completely balanced diet, one with natural carbs (when I am active I eat more) of about 15 per meal and 7.5 per snack a day with a healthy protien and fat ,(butter, sour cream peanut butter etc.) is the best way to go. What do you think? I have much more energy and my hormones and blood sugar stay regular. I have my kids on the same eating plan and they do great. We have diabetes on my side and my husbands side so I am trying to teach them now that it is a better way to eat and live. Keep the yuckies away so to speak. I have also found that if I eat more nonstartchy vegies the less carbs I need from startchy ones and I still have energy and feel great. How does all this sound to you?

    If it works for you, go for it.

  47. how long does it take for 1 gram of sugar to dissolve into the body?

    and how long until sugar takes effect within the body?

    Almost immediately on both counts.

  48. My friend has heart problems & watches his sodium carefully….. no more than 500 mg per meal with no more than 2200 sodiums per day. My brother-in-law is diabetic and says there are no #’s as to how many mg’s of sugar he can have daily. Keeping in mind the food labels, isn’t there SOME # I can pass onto him regarding sugar mg’s per day?

    My recommendation would be to take in as little as possible. I eat no sugar each day, and I’m not diabetic. I’m sure your friend could do that to, and would no doubt greatly improve his diabetes as the same time.

  49. Dear Dr. Eades,

    I’ve been a PP fan since 2002, and have recommended your books to many, many friends and colleagues. I went from 229 to 179 (I’m a 6’1″ male). Unfortunately, I slowly succumbed again to the lure of carbs, thinking I’d be safe in moderation and running half marathons, but just as slowly my weight crept back up to 205. I’ve been firmly back in the low carb, PP fold for three weeks now, feeling great, and now 199. Research led me to this blog post after I got a lab result for fasting blood glucose at 103. The physician’s comment accompanying the result was “borderline, check again in a year” (all other readings, including cholesterol and triglycerides were described as “excellent”), and I wanted to educate myself about the fasting blood sugar test.

    I almost never comment on blogs, but I have to thank you and MD for your thoughtful, thorough, and patient blogging and replies to comments. I am a lawyer by profession, but I have an undergraduate degree in biology — I love science, and I very much appreciate that you take the time and trouble to lay out the science in your books and your blogging. I have learned, and continue to learn, a lot from you and MD. And I also enjoy reading about your family, love of fine food and drink, and interesting travels!

    Thanks again,

    Mike

    Thanks very much for the kind words. I appreciate them. Glad you’ve enjoyed all the material.

  50. when you say 47 grams of carbs eaquals about 47 grams of sugar what do you mean by this? i am doing a science fair project on measure the concentration of glucose in foods and i must be very specific for my research paper.
    thanks so much,
    kayla

  51. Please dont say no amount of sugar should we intake
    Daily, I eat cornflakes with milk along with1.5-2 spoons of sugar, and these days, i have started to drink green tea, twice a day, with two 5g sugar bags in it. I want to reduce my weight because i am seriously overweight of around 100 kgs, i am a 24 year female. Do suggest me please.

  52. Hello, I posted a question back in Dec. of 2007 and thought I’d follow it up. I did indeed have hypoglycemia but it was due to an acute case of hypothyroidism. I suffered memory loss, hypoglycemia, ovarian cysts, chronic fatigue, aches, pains, gained 80 lbs that no amount of exercise could impact, and kept losing words when speaking, I literally couldn’t remember the word I was looking for in conversation. I went to my doctor who tested my thyroid levels and pronounced them fine and quite average. She prescribed a high protein, low carb diet for a month and let’s see what that does. A week later, very irritated since by this time I knew bloody well it had to be hypothyroidism (ya know, walks like a duck etc.) I was at my ob-gyn’s office and mentioned what was going on to her just to keep her in the loop, as it were. She walked out, came back with a scrip for .50 mg of levothyroxine, and it changed my life. It took a while, of course, but after a few weeks I could stay awake all day, the dizziness every time I ate went away, my glucose levels rose and stabilized, and the ovarian cysts disappeared. I’m now on .75 mg of hormone and have dropped 10 lbs and going strong. I hope this helps someone else out there who may be suffering like I was. I wish my doctor had listened to the symptoms instead of the blood test and thank God my ob-gyn did!
    Thank you so much for what you do,
    Paula M.

  53. Hi, I was wondering if you could help me out. Im a strength/power athlete attempting to formulate my own sports drink. Im combining a 50/50 mix of dextrose and maltodextrin into 2 liters of water. Im looking to reach a 6-7% carbohydrate solution, to optimize water absorption. First off, is 5 grams of dextrose/maltodextrin (weight) equal to 5 grams of carbohydrate, or is it more? Secondly, to add in electrolytes, im using Mortons Light Salt, which is 1/4 teaspoon a serving. This provides 290mg of sodium and 350mg of potassium. My goal is to create a solution that has the following profile for an 8 oz serving: between 14-15 grams of carbohydrate, 100-200 mg each of sodium and potassium. The math is driving me crazy and I’d like to nail down this formula. If you can provide any knowledge that would be great.

    PS: Im combining a 4:1 ratio of protein to carbs, but that wont be hard to figure out once ive nailed down the exact amount of carbs in putting in. For flavor im using Wylers Unsweetened lemonade. It doesnt seem to have any calories, etc, so im not anticipating any problems. Thanks a lot, Todd.

    Yes, the 5 grams of dextrose/maltodextrin equals 5 grams of carbs. It looks to me like you would need to add about 3 teaspoons of the dextrose/maltodextrin to a cup (8 oz) of liquid to get the 14-15 g of carb and about 1/8 teaspoon of the Morton’s Lite Salt.

    Since there are about 4.25 cups per liter, to get the 2 liters you want, you would need to multiply the above figures by 8.5. That’s about 25 teaspoons of the carb and just a touch over a teaspoon of the Morton’s Lite.

    This is, of course, assuming the dosages you gave me are correct.

  54. I am hoping you can help me out here as I recently had a couple labs of a fasting glucose of 102 and then 99. My HBA1C was 5.8 and I am 40 years old. Lipids were all within normal range and my height is 5’11 and weight is 145, so I’m thin and exercise almost daily. I follow a pretty good diet and it is already low carb as far as I know. The problem is that I don’t know why I have a FBS of 102?!?! I am doing everything right I think and even my HBA1C is approaching that of pre-diabetes. I suppose I could exercise even more than an hour a day, but I have no more weight to lose. I literally do around 200 sit ups a day and am in fairly good shape by all measures. No family history of diabetes either. My doctor didn’t seem too concerned and I am still falling within the normal range, but I’m worried that the numbers will creep upwards or am I worrying over nothing?

    Without knowing a whole lot more, I couldn’t possibly say what’s going on. But I agree with your doctor (who does know much more about your health than I do) that it’s probably nothing to worry about. Just watch it. If you’re exercising and low-carbing, there’s not a lot more you can do to keep your sugar down.

  55. i am a diabetic and take 1 mg Amaryl mostly twice a day before main meals. my fasting sugar usually is around 150-160. I had cold last week. Since then, my fasting blood sugar has gone up by about 50 points (from 150 to over 200). Now my cold is almost cured but my sugar is not down. In the morning, when it is high, I wait eating to let it go down but it keeps going up. What should I do?

  56. hey i was wondering what a healthy blood sugar level is for me? i eat a lot of carbs, but no trans fat and the fat that i do consume is from monounsaturated fats like from avocados and salmon i drink 5 ounces of wine at dinner and do not fry anything, when i do fry veggies i use very little olive oil like a tbsp to make a long story short i eat things like white rice which has a ton of carbs everything i eat has carbs. what are the good carbs i should eat and what numbers am i shooting for to be a healthy male thank you.

  57. I would appreciate a reply, doctor, to my email, if possible. I’m a type 2 diabetic for 17 yrs., non-insulin dependent. I’m 65 YO, male. I only need a neglible amount of med.-(1/2 tab of Glyburide/Met 1.25/250 twice a day); and sometimes even that is too much, and I get a low sugar episode. So I’m always having to calculate what portion of a pill I need to take. I exercise by walking briskly 30 min. every day, and eat as taught in diabetic education classes. (45 or fewer carbs. at meals, and 2 snacks of 15 carbs. daily). I’m not overweight. My question is: if meal time is still not here, and I have a low-sugar episode, is it better to eat 15 carbs. of my upcoming meal, thereby spoiling the enjoyment of the meal, OR just to eat a teaspoon of sugar to bring up my blood glucose without spoiling my upcoming meal??

  58. Hi!

    Your reply to a question about how much sugar we need a day was “none”. So, should we avoid fruit and 100% fruit juices. Is all sugar bad in your opinion?

  59. I am 36 yr female and have dbtes and was recently diagnosed with bp. My last A1c count was 6.2. I wigh 152 lbs. i am on low carb diet and insulin. I do work out but am not losing any weight. its been 6 months. i play badminton for an hour everyday and am not losing weight. i am 5ft2inches tall. i understand if i take less insulin then i can lose weight – here is a typical insulin readin i take
    moning – 10
    afternoon – 15
    night – 20

    is this lot? How can i lose weight? I used to be at 120 – gained weight in pregnancy.

  60. Dr. Eades,
    I have just been reading through your website, because I know I have BIG problems in my health. I am going to change everything I eat and do immediately. My total. cholesterol is 319, LDL cholesterol 225, hemoglobin A1c 6.1
    etc.
    I know that I need to find a progressive MD immediately. My doctor is not doing her job. How do I find a good doctor in North Orange County, CA?. I desperately need a great doctor now. Can you recommend a good doctor to me?
    Changing my life could give me my health back. I have been diagnosed with IDD, sub-class IGG1. I’ve been to Cedar Sinai, been the gambit. No one has ever told me about changing to a low-carb diet. One of my other health issues is major food intollerances. Five years ago I was down to one food.
    Thank you so much.
    Ellie

    jo
    Thank you!

  61. I recently had a gtt done because my hypoglycemia seems to have changed. my home tests after a gatorade-30 grams sugar-are always over 200 a half hour after drinking it and drop to 150 an hour after drinking it. this makes me feel ill. the gtt said my fasting was 85, the one hour was 220, one and a half hours 178, 2 hours 135… ths seemed odd because its lower than i have been testing but i was told this is normal. could you explain this?

  62. Why do some sources say there are 4 grams, 4.2 grams, 5 grams even 6 grams per teaspoon? Don’t people know the exact grams per teaspoon? I bought a box of sugar cubes the other day and it said 4 grams in a teaspoon. Can someone explain that?

    • According to the USDA nutrient database there are 4.2 grams of granulated sugar (table sugar) in a teaspoon. As a rule of thumb, most people figure on about 5 grams per teaspoon, but the actual number is 4.2.

  63. GTT was 151 fasting, over 200 two hours after the glucose. I was diagnosed as diabetic. Have been exercising an hour a day and restricting carbs for 11 days now. Blood sugar this morning was 100, yesterday 98. What gives? How could I have responded to this so quickly?

  64. Would you please help me understand this – for a 61 years woman who has a type II diabetes and is on medicine, pre fasting sugar is 111 is ok? This info is for my mother – she is on meds, does exercise and is on low carb diet. Does this mean that she do not have diabetes anymore? Can continuing the meds is harmful? Thanks!

  65. Hi,

    My wife’s fasting BS readings have been slowly rising the last 5 years. The latest was 117. She’s 60, 220 lbs, OK cholesterol but she is on a statin. She has a desk job and seems to be allergic to any type of exercise! She’s not taking it seriously, as her doctor is just watching as the levels slowly rise.
    My big concern for her is that as she has ulcerative colitis, a future diagnosis of T2 diabetes would make it difficult for her, as she has to avoid most healthy foods like whole grains, most fruits etc.
    Any advice will be really appreciated.

    Thanks,

    Jack

  66. I eat a primarily fruits and vegetables, which I have always believed is the best way to live. I have no health issues.

    Do you think eating fruit is actually bad for your health? That would make me quite sad because I love it and I always thought it was very good for you. What do you eat, if not processed foods, whole grains or fruit, if you don’t mind me asking? Only vegetables and meat?

  67. As a private health chef, I try to limit the amount of sugar in all of my desserts to one teaspoon or less. This seems to work well with fruit based and chocolate creations, such as pot de creme and fruit crumbles. I also try to work with primarily brown rice, buckwhat and quinoa.

    What is your opinion of whole grain flours being used in baking, within reason?

    I love your site!

  68. I loved your article. Can you tell me though how many carbs should I have a day and of these carbs what kind of carbs should they be?

    • To go on a bona fide low-carb diet you need to cut your carbs to below 50 grams per day. There are a large number of books out there that will tell you how to do it.

  69. hi im 27, Last year i went to a doctor who took a blood test and said it was normal. this year a different doctor ordered bloodwork and has said im pre-diabetic, before this news of border-line diabetese i recently lost 70lbs and i dont eat much sugar at all, or carbs, so i dont understand how i could be borderline diabetic, i walk 3 miles a day, have no family history of diabetes and i eat no sugar or carbs now, my next appt. is in 3 months and my doctor put me on metformin 500 2x a day, iron for slight anemia and b12 with omega, i have noticed it makes my feet and hands cold. should i still take it? and will losing weight and diet and exercise stop me from developing diabetes? or is it just going to happen no matter what…i read most prediabetic people will develop diabetes within 10 years, which is scary.

  70. Dr. Eades, My fasting blood sugar was 110 last week; previous tests it has been 90. I have been eating a low-carb diet for the last 6 months or so, with 90% adherence. I am not freaking out about the #, but will get lab work done again in a few months.

    On Jimmy Moore’s blog post about testing low-carb bread, he quoted a Canadian physician who mentioned that 110 is normal for someone following a low-carb diet. Is that true? Can you point me in the right direction for further research?

    Thanks.

  71. Recently I went to the Doctor for pain in my knee and while I was there he did blood work, when I went I did not know he was going to do the blood work and ate right before I went, McDonald’s Double Quarter pounder 2 fries and large Dr-pepper.
    The doctor assistant called me later that same night and said I had a an issue with my blood work and wanted me to make an appointment. I did and when going he stated my blood sugar level was at 193 I said It had to be that I ate right before I came there and I should have never even given blood because I wasn’t fasting.
    He said well even if I had just eaten it should have never been that high. So he said lets take another test(this the very next morning) this time an A1C1 or something like that and lets check everything at the same time.
    The test came back with a 112 blood sugar level and all the rest was good meaning ldl, hdl, total cholesterol 180, but the A1C1 was 6.5 .
    I know I have a lousy diet and sometimes I don’t eat but 1 time a day and he said my water intake was very bad because my urine was real cloudy no other problems with it but he said i have to drink more water. Uric acid came back in the normal range also.
    Can the meds I take help cause high blood sugar?
    I take 2 vicoprophen in the morning and 2 in the afternoon I have taken vicoprophen for the last 14 years started with one a day to now 4 a day, my levels last year for blood sugar were in the 80’s, this year I have started from 2 to the 4 a day with the meds and I had been less active.
    Since the visit I have cut out all soda only water and some small amounts of milk no fast foods and no meds I will deal with any pain my back has, I only eat cheerios in the morning a sandwich for lunch (Ham, lettuce, onion, mustard and cheese on whole grain bread ) and dinner is usually baked chicken and green beans and no salt shaker any more. I also drink V8 juice but not the low sodium one yet.
    I realized I didn’t need the drugs as much as I thought I did every little ache doesn’t need a pill to fix it, exercise is helping more then anything.
    I found your site and wanted to post reading through allot of the post you have given some great advise and seem to know what you are talking about so I thought would write a small book and ask for some of your advise looking for answers to reassure or understand better.
    I am 6.5 and was 316 pounds clothed 7 days ago but I carry my weight well, with just the changes I have made so far in the past 7 days I am at 308 fully clothed I feel much better making sure I drink plenty of water about 144 oz a day or a small amount more.
    Blood pressure was high and I was told it would be from the meds 140/90 to 155/101 I was put on Azor but stopped when given the choice to take the Azor or the vicoprohen now I am at 128/87 and I am working on lowering it even more it has been only 7 days. I am learning more and more each day about the right way to eat and what my body needs to help fix itself any help would be greatly appreciated.
    Thank you
    Brian

  72. I am 61 and have had Hashitmoto’s thyroiditis for a long time. I’ve been on thyroid hormone since 2007 and lost 40 pounds over 10 months without starvation once I got on thyroid – before that I had no appetite and was gaining on 1400 calories. However I’ve never tended to put the weight on in the waist (more evenly all over), don’t have high blood pressure or bad lipids. After losing the weight my blood sugars went up slightly so they were sometimes slightly over 100 fasting – they never get out of the high 90’s. I actually had a fasting insulin test 3 years ago and it was below normal by more than a couple of points. Recently I gained back about 9 pounds and don’t know why. Now my blood sugars are even higher (my BMI is just under 25 and my waist is 28 – I’m 5’91/2″ tall) Sometimes a piece of fruit pushes the sugar to 170. This morning my fasting BS after 13 hours was 111 – that’s the highest fasting I’ve had. Usually 2 hours after a meal it’s between 125-148. No one in my family has ever had diabetes except my brother when he was about 340 pounds and drinking heavily – he also has had Hep C since his teen years. I’ve never had the bad habits he has and have always been very health conscious. My last blood test showed HDL of 80 and LDL 0f 81, and triglycerides of 78 – nothing seems to point to metabolic syndrome. I can’t seem to get any answers. I’ve never been a big sweet eater but there is no way I can just eat low carb vegetables and meat all the time – in fact when I’ve tried it after awhile I start to feel slightly nauseous. I never eat things like white flour and use xylitol in my coffee in the morning, cup of tea in the evening and drink water the rest of the time – never touch soda or fruit juices but I do like fresh fruit. I had a lot of digestive issues and went on a gluten-free diet 5 weeks ago which seems to be resolving those problems – but do eat a bit of gluten free grain products that I make myself. None of this makes sense to me – especially that early on in insulin resistance one is supposed to have HIGH insulin levels.

  73. Okay, but there are 5 grams of water in a teaspoon, and sugar is less dense than water, so that’s incorrect by about 1.5g (granulated sugar is listed as 0.70 g/mL).

    Second, the study you quote in “A cautionary tale of mucus fore and aft” states that all foods injure the digestive tract, but that fiber does so at a higher rate than other types of food, which says to me, at most, fiber is some slight unknown value worse than other nutrients, but that figure is not likely to be high, considering the fiber content of whole foods, which you promote. However, bread has been consumed for all of human history in some form or another, and it’s been whole grain with all that “bad” fiber in it, and somehow we haven’t been completely exterminated from it. I’ll agree with your point on fiber supplements, because people need to eat their fiber, not drink it or take it as a medication (and that the existence of an issue regarding irregularity is superfluous), but that argument could be made for any supplement. Stating that fiber is “harmful” should be backed up by solid facts, and I don’t see any here.

    You also draw a line between fasting blood sugar and people who eat at McDonald’s, which is neither here nor there to me personally, as I don’t eat fast food, however, one single meal eaten before a fasting blood sugar test doesn’t have any consequence. Rather, it’s the one and two hour after-meal tests that would be significant and worth comparison. Not saying that it wouldn’t also bust through the limits on those, but the whole point of a fasting blood test is to see what the body is doing before you add food, and those are the figures this article quotes.

    I would love to see real studies done to verify your claims, but I’m not sure what the point would be. I don’t make a point to eat whole grain breads because I want to be regular or want to possibly help prevent colon cancer. I eat foods with fiber naturally in them because they are whole foods and are the “natural” diet, if there ever has been such a thing for humans. In fact, fruit, with all that sugar and fiber, is the main source of food for all other great apes, like chimpanzees and gorillas. Besides, the USDA doesn’t even consider fiber to be an essential nutrient, so it’s not like you can have a financial stake in your claims. Or maybe you do and it’s just not obvious to me. Regardless, I find your statements and your hoards of disciples to be quite off base with no evidence to prove otherwise.

  74. I don’t want to take up too much of your time but if you could briefly let me know what your thoughts are on the South Beach diet? Thanks very much.

  75. You can slap me on the wrist for my poor judgement.

    I went to the doctor last year complaining of a dull ache in my right side (about an inch below the ribs) and was worried about kidney problems. Asked for a bunch of tests, never received them at the time and was put on BP medication. So, I decided doing my own diagnostic work (urine test strips, a1c tests). I’ve lost about 70 lbs in the last 8 months. Dropped my a1c from 5.5% to 4.8%. I’ve also gotten my average BP to around 125/70 and my resting heart rate to 50.

    I read that you can do a ghetto at home tolerance test with an OTC blood meter.

    Does the tolerance test have to absolutely be glucose or can I attempt this with sucrose (sugar water)? I’m not even sure where to find pure glucose.

  76. I’ve been following the diet outlined in your book, “The 30-Day Low-Carb Diet Solution” since Aug. 15, 2011. Two days ago I had fasting blood work done during my annual physical exam. The results were: total cholesterol: 250, HDL: 88, LDL: 152 (2.8 ratio), triglycerides: 51, blood glucose: 112. I am really worried about the total cholesterol and blood glucose readings. Last year by total cholesterol was below 175 and my glucose was 89. Can you tell me what might be going on? What are “normal” readings for someone following your low-carb plan? Thank you, Beth.

  77. To all simple answer what ever the doctor says is good. when taking pills from doctor people ask question why should i take ? that is common .. since u know the answer diabetics is one you developed eating more and work out less the opposite is answer for this ..eat less and exercise more . we cant count calories, but eat less and once you feel your stomach is full get out from eating , you are going eat life , it is not a one time chance.So iam diabetic i eat and fro every time i eat i walk half hour.

  78. I am having a glucose tolerance test soon and I have been on a relatively low carb diet for about 2 years, I rarely go over 100 carbs a day and about 25 to 30 would be fiber, from nuts, veggies, a little fruit, I rarely eat sugar except on rare occasions like Thanksgiving which was yesterday. My doc gave me a meter to check my blood sugar a few times half hour after I eat and an hour after I eat, the numbers were mostly in the 80’s even a half hour after eating but just once was 104 after a larger meal. So now she wants me to do the glucose tolerance and now that you state that I should be eating carbs, about how many grams should I be eating per day and can it be from natural foods like fruits, veggies and beans? And for how many days should I eat like this, I don’t want to mess up my body too much, I did lose 90 about 2 years ago but have gone up about 10 within the last year and I eat very healthy. I work out a lot so some if it could be muscle.

  79. Hi, I have a question which I cannot seem to find the answer to. I am recently diagnosed with hypoglycemia and having some trouble controlling it. I do test and limit my sugars but noticed if I eliminate all sugar I seem to have a problem as well. My question is how much sugar is the correct amount to be taken in and how often should I actually eat? I appreciate any help as yesterday while driving an episode cam eon and it was quite scary thankfully I know enough now to know what’s happening and was able to pull over until it passed but also had very little sugar yesterday so it’s a bit confusing to me, please help, thanks a bunch!!

  80. hello,
    I had a glucose test and it was 126.I went to a doctor and she prescribed metformin 850mg .Her intructions were that I cut it in half and take one half in the morning and the other at night.Two days later I took one in the afternoon and the next morning went for another glucose test and yhis time it was 102.My question is the lower reading due to the metformin I took for a couple of days? Or,is there something else happening with me?

  81. I am petrified. My fasting glucose level was 150 and it was never that high. I do have to admit that I have gained weight and the night before, I had a gathering where soda, cheesecake and the like were served. Could this be an anomaly and I should get it tested again in a few days weeks? I really want to do this on my own and don’t want the jump from no issue right into diabetes.

  82. HI,

    I was diagnosed with type 2 in September. I am very active working out at least five times at week. I am in a no carb diet and lost 20 pounds. I am taking 500 ml once a day of metaformin. However, if I eat a piece of whole wheat bread in the morning I see my levels go up at to 200. I am confused and do not know what to eat in the morning. I need some sort of carb in the Am in order to go on with the day. Thanks.

  83. @J. C Mendez

    Step away from the bread, eat meat and eggs for breakfast. Bread is not included in a no carb diet. Once you adapt to low carb you shouldn’t feel the need to eat carbs for energy. Wheat is especially bad for raising blood sugar and morning is the worst time for a PWD to eat grains or other starches.

    http://www.diabetes-book.com/

  84. I’m confused: if 1 teaspoon is maximum we should have in our blood to have normal blood sugar, why am I reading citations of between 0-50 or more grams per day? Also, if a carb is a carb to the body (whether sugar, whole grain, or vegie) then what’s the difference what you eat as long as it meets the maximum carb recommended?? I’ve been following a low-carb diet since the Holidays (was a struggle but I think I gained LOTS less by pushing away from all those sweets and starches), but I’m still confused by what seems like conflicting premises. Thank you.

  85. I am 27 yrs old female who developed gestational diabeties 3 years back and my diabeties remained post pregnancy.I am type 1 diabetic now on insulin.My question is my maternal relatives my aunts,mom,cousin(co age)have diabeties.I dont know what made me to do the testing of diabeties through test strips onto my 3 yr old child a year back and it came out to be 90mg/dl.My question is she just loves to have chochlate make during day time and loves to have fries at Mcdonalds.Does this leads to any chances of developing diabeties in future.

  86. What did Noah and methuselah eat? They made it to 8-900 yrs.
    Did they wash with hand sanitizer before meal?
    Guess that’s the problem with that evolution thing.

    • Depends on the size of the pizza. Typically, ONE PIECE of a standard pizza would convert to about six teaspoons of sugar.