Performing blood glucose tests in the afternoon rather than the morning may mean up to half of all cases of diabetes are missed, new research published in the Journal of the American Medical Association (JAMA) suggests.
This is due to the fact that blood sugar levels vary throughout the day, and have been shown in other studies to be generally higher in the morning.
Researchers from the National Institutes of Health studied about 12,900 adults undergoing blood sugar tests and found that:
Current recommendations for diagnosing diabetes are that patients have their blood sugar tested after an overnight fast of at least 8 hours.
There are several possible reasons for the discrepancy between morning and afternoon testing:
Journal of the American Medical Association, December 27, 2000; 284: 3157-3159
When the blood sugar rises above 100 I become very concerned with respect to future diabetes. Clearly, any fasting blood sugar over 100 suggests insulin resistance and inability to control blood sugar levels.
Diabetes is not formally diagnosed until the blood sugar rises above 126 mg/dL. However, it is my contention that this is far too late in the process. A blood sugar over 100 usually can predict future diabetes up to ten or more years down the road. Why wait until the blood sugar rises above 126? Doesn't make any sense to me to waste time here, as diabetes is such a devastating physical illness. It just destroys the body.
Fortunately following the diet program and a good exercise program virtually eliminates diabetes at this stage in the vast majority of people.
This study is a good fine point though and something that I will incorportate into my practice. It is important to recognize that the thresholds should be a bit lower if the blood draw was in the afternoon.
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