Image Credit: Creative Commons Phillip Jeffrey
The Missing Pieces of Blood Sugar Lab Tests
Sometimes, standard biomarkers don’t tell the entire story about health risks.
Aside from blood sugar (glucose), consider these two additional biomarkers for assessing risk of diabetes — a chronic elevation of blood sugar that can increase risk of heart disease, and dysfunction with the kidneys, nerves, and eyes — (1) insulin and (2) hemoglobin A1c (HbA1c). The tests are performed concurrently on the same individual, and tracked over time.
Diagram 1: Insulin Levels
In the first diagram, there is an increase in insulin, from the “low risk” range to “moderate risk” range. The rise in insulin might indicate an increased risk for diabetes.
Diagram 2: HbA1c Levels
Unlike insulin, HbA1c is a measure of average blood sugar over the last few months. Here, the biomarker falls within the “low risk” range. Notably, Hba1c is tested less commonly than just blood sugar, despite having the advantage of being an average and not subject to the swings a singular blood sugar value can have.
Why is there a contradiction?
Insulin helps lower blood sugar when levels rise, and will fluctuate as blood sugar levels rise and fall.
Some factors that influence blood sugar and insulin levels during the day of a lab test include:
- time of day
- time since the last meal (insulin increases with food intake and gradually decreases a meal)
- macronutrient breakdown (carbs, fats, protein) of the last meal
- caffeine consumption (caffeine intake increases insulin)
- stress levels before or during the test
Since diabetes typically begins with a resistance to insulin in the cells, a rise in insulin as the body tries to overcome this resistance could be an early sign of risk. If insulin levels continue to remain elevated or rise further, concern for diabetes risk would increase. If this rise in insulin levels was further followed by an increase in HbA1c, that suggests that the body’s ability to increase insulin is becoming limited and blood sugar levels are beginning to rise.
How to Better Assess Health Risks
To ensure considerations of the bigger picture in health risk profiles, we must look beyond the standard blood tests (e.g. blood glucose for diabetes risk) and consider additional tests that provide a more accurate risk profile (e.g. insulin and HbA1c).
Insulin shows early diabetes risks while Hba1c provides a more accurate understanding of blood glucose levels than the standard blood glucose test.
Additional Questions for Employers to Consider
- Which factors can affect lab test values in the short term and skew test results in misleading ways?
- Are there other important tests less commonly ordered that could provide a more accurate picture of health risks?
- Are the doctors within your company’s insurance network willing to order these tests?
- If not, is there a way employees can order the right tests and receive reimbursement via HSA/FSA?
How WellnessFX Can Help
WellnessFX tests 30 – 125 different health markers depending on the package, focusing on all of the conventional red flags as well as more nuanced indicators of health risks.
Our Baseline package includes advanced lipid profiles, inflammation biomarkers, vitamin D levels, a comprehensive metabolic panel (CMP), thyroid panel, and newer cardiovascular health markers.
The Premium package includes screenings of genetic markers for the effectiveness of common medications, hormones indicative of reproductive and athletic health, and types of fats in the blood that develop in clogging and can determine the best nutrition for your body.
WellnessFX utilizes the most advanced laboratory testing techniques available.
How often should you test?
We recommend getting tested every 4 months because it takes 120 days to completely recycle the body’s entire blood cell supply.
The posts on this blog are for information only, and are not intended to substitute for a doctor-patient or other healthcare professional-patient relationship nor do they constitute medical or healthcare advice of any kind. Any information in these posts should not be acted upon without consideration of primary source material and professional input from one's own healthcare professionals.