It is often difficult to understand which lab values mean what. We give you an overview in the series "What do my laboratory values mean?

Blood sugar, urine sugar and HbA1c ("long-term sugar")

Ash Wednesday marks the end of the wild carnival season. Many people make a resolution for Lent that involves some form of abstinence. Less smoking, no alcohol until Easter, abstaining from dinner... Some try to live sugar-free during Lent. This is really difficult. Sugar is a mass product and is found in many, many foods. Sugar addiction as a cause of overweight and obesity is THE worldwide epidemic with the most victims in terms of diseases and deaths.

With the increase in sugary foods, the number of people with diabetes has risen rapidly. Currently, about 10 % of the population in the German-speaking world are diabetics. With the number of undiagnosed diabetes cases, one can assume a total of 15 %, i.e. about 15 million people. There is "juvenile" diabetes type I, an autoimmune disease that accounts for less than 10 % of all diabetics, and so-called "adult-onset" diabetes type II or NIDDM (Non Insulin Dependent Diabetes Mellitus). This metabolic disorder can develop in any age group due to malnutrition, obesity and lack of exercise. However, the incidence of type II diabetes increases with years of life. Worldwide, type II diabetes is the non-contagious disease that spreads most rapidly.

Blood glucose levels

All diabetes diseases have an elevated blood glucose reading in common.

Normal fasting blood glucose: 65 - 100 mg/dl

Critical range fasting: 90 - 100 mg/dl

Normal range blood glucose after eating: 90 - 160 mg/dl

The fasting value is measured in the morning before taking the first meal. The values after eating ("postprandial") are measured between 60 and 120 minutes after the end of a meal. The measured value should never go above 160 mg/dl and should be measured approx. 90 minutes after a meal. If the value does not go below the value measured after 90 minutes even after 120 minutes, one speaks of a lack of sugar utilisation. This is usually due to so-called "insulin resistance". This occurs when the body no longer responds sufficiently to the blood sugar-lowering hormone insulin due to constantly high sugar consumption. Insulin is produced by the pancreas.

Urine sugar

When blood sugar rises to levels above 160 mg/dl, the body tries to get rid of the excess sugar that the cells cannot absorb through the kidneys. This is why measurable sugar appears in the urine when blood sugar levels are high. This is often the first alarm sign of incipient diabetes.

"Long-term glucose" HbA1c

If laboratory tests show fasting blood sugar above 100 mg/dl, measurable urine sugar or postprandial blood sugar above 160 mg/dl, diabetes is highly suspected. The exact diagnosis is made by measuring the protein HbA1c. This protein is part of the blood pigment of the red blood cells "haemoglobin". This sugar-binding haemoglobin makes up 4.0 - 6.0 % of the total haemoglobin in healthy people.

Normal value HbA1c: 4.0 - 6.0 %.

Critical range HbA1c: 5.6 - 6.0 %

Mild forms of diabetes HbA1c: 6.0 - 7.0 %

Diabetes requiring medication HbA1c: over 7%

Intensive diabetes therapy should be sought for all HbA1c values above 7.0 %. In diabetics, the HbA1c value should be measured every 3 months in order to assess the success of the therapy. An elevated HbA1c level should at least be reduced to values around or below 7.0% through treatment (diet, exercise, medication).

What damage does high blood sugar do?

Elevated blood sugar levels express that there is an imbalance between the intake of sugar and carbohydrates on the one hand and the body's ability to use the sugar on the other, which happens mainly during exercise and work. Sugar is the most important quickly usable fuel in the body. If this fuel is excessively supplied in the form of bread, pasta, fruit, fruit juices, soft drinks or sweets, the insulin produced by the body is not sufficient to supply this energy to the cells. The sugar remains in the bloodstream where it doesn't really belong. And this leads to consequential damage throughout the body. Above all, the finest blood vessels, the capillaries, are damaged by increased blood sugar. This leads to a reduced supply of vital substances to important organs. Diabetics have a 2 to 3 times higher risk of dying from a stroke or heart attack than people with normal sugar levels, not to mention the suffering they already go through beforehand. Diabetic nerve damage, which mostly affects the legs, is very painful and leads to problems when walking. The optic nerves of the eyes are damaged, which can lead to visual disturbances or even blindness. The kidneys are also destroyed and can no longer excrete sufficient urine.  

What sugar levels are optimal?

From the perspective of naturopathy and anti-ageing medicine, the lowest possible fasting blood sugar is desirable. Values below 80 mg/dl are indicated as optimal. The brain researcher Prof. Bredesen, who has done a lot of research on how to prevent or cure dementia, calls for a fasting blood sugar around or below 80 mg/dl and an HbA1c value below 5.6% until old age.