This article presents a study that showed the best blood test to predict the development of atherosclerosis.
One thousand eight hundred fifty-two patients scheduled for coronary angiography were classified into Normal Glucose Tolerance (NGT), Impaired Glucose Regulation (IGR), and diabetes based on Fasting blood sugar, Post-prandial blood glucose (PBG), and Hemoglobin A1c (HbA1c).[1]
Blood Sugar Tests
Fasting blood glucose (FPG) is typically taken in the morning after at least an eight-hour fast. Normal FBS is < 5.6 mmol/L or 100.8 mg/dl.
A blood sugar converter from mmol/L to mg/dl and vice versa is available at this LINK.
Post-prandial blood glucose (PBG) is a blood test taken two hours after a meal. Normal levels are 140.4 mg/dl or <7.8 mmol/L.
Hemoglobin A1c (HbA1c) or glycosylated hemoglobin measures the three-month average blood sugar. It is a test that is routinely done in people with diabetes.
-
- Normal HbA1c is 4-5.6%.
- Prediabetes is 5.7-6.4%.
- Diabetes – 6.5% or higher
Levels of Glucose Tolerance
Normal Glucose Tolerance applies if the patient has no previous history of diabetes as having an FPG level < 5.6 mmol/L and a PBG level < 7.8 mmol/l.
Prediabetes or Impaired Glucose Regulation (IGR) was defined in patients without a previous history of diabetes and had one of the following:
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- FBG = 5.6 – 7.0 mmol/L; 100.8 – 126 mg/dl
- PBG = ≥ 7.8 mmol/L and < 11.1 mmol/L; 140.4 – 199.8 mg/dl
- HbA1c = 5.7–6.4%
Diabetes was defined either by a previous history or if taking diabetes medication. Typically their Post-prandial blood glucose (PBG) is more than 11.1 mmol/L or ≥ 199.9 mg/dl.
In the study, the prevalence of diabetes and prediabetes were 25.8% and 40.6%, respectively.
The following finding highlights the importance of checking blood sugar, even among those not diagnosed with diabetes.
Many did not know that they had prediabetes or diabetes. 8.2% (113/1377) of diabetes and 47.9% (659/1377) of prediabetics were diagnosed for the first time.
In a way, those people are fortunate to be diagnosed early. Others know when they have a terrible infection or their first heart attack.
The results were correlated with the Gensini score, which measures the severity of coronary artery disease as measured with an angiogram.
Results
Statistical analysis showed that the two-hour after-meal blood sugar levels of more than 140 mg/dl or post-prandial hyperglycemia are the best gauge for the presence and severity of coronary atherosclerosis.[1]
High blood sugars measured two hours after a meal outperformed fasting blood sugar and Hemoglobin A1c for screening coronary heart disease.
The study was consistent with the findings of other researchers. Kataoka et al. studied 534 Japanese patients and found that coronary artery disease is associated with post-prandial hyperglycemia. [2]
The same is true with Saely et al., that studied 1,040 Caucasian patients who underwent coronary angiography. They also found that abnormal glucose tolerance is strongly and independently associated with coronary atherosclerosis.[3]
Take Away Message
Everyone from their twenties up should check their two-hour after-meal blood sugar level. You can do this at home using a glucometer from Amazon, like the Care Touch Glucometer.
Don’t forget to get a needle disposal container for the lancets.
If it is always more than 140.4 mg/dl or 7.8 mmol/L, depending on your glucometer, you might want to inform your physician to see if you need a confirmatory test.
Landmark studies like the Diabetes Control and Complications Trial (DCCT) and Epidemiology of Diabetes Interventions and Complications (EDIC) have shown that early blood sugar control prevents coronary heart disease, even in later life.
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Postprandial Glycemia Related:
- How often do you do the post-prandial sugar test?
- Blood Glucose Spike and its Prevention
- Testing Post Prandial Glucose Level after a Feast
- After-meal blood sugar spikes as a cause of vascular failure
- Veggies Meat Carbohydrate Sequence Prevents After Meal Sugar Spike
- A Healthy Lifestyle is as effective as Voglibose and Nateglinide in Lowering 10-year Cardiac Mortality
- Intermittent fasting Reverses Endothelial Dysfunction
- Walk After Meals to Prevent Sky High Blood Sugars
References:
- Jiang J, Zhao L, Lin L, Gui M, Aleteng Q, Wu B, Wang S, Pan B, Ling Y, Gao X. Post-prandial Blood Glucose Outweighs Fasting Blood Glucose and HbA1c in screening Coronary Heart Disease. Sci Rep. 2017 Oct 27;7(1):14212. Doi: 10.1038/s41598-017-14152-y. PMID: 29079813; PMCID: PMC5660170.
- Kataoka Y, Yasuda S, Morii I, Otsuka Y, Kawamura A, Miyazaki S. Quantitative coronary angiographic studies of patients with angina pectoris and impaired glucose tolerance. Diabetes Care. 2005 Sep;28(9):2217-22. doi: 10.2337/diacare.28.9.2217. PMID: 16123493.
- Saely CH, Drexel H, Sourij H, Aczel S, Jahnel H, Zweiker R, Langer P, Marte T, Hoefle G, Benzer W, Wascher TC. Key role of postchallenge hyperglycemia for the presence and extent of coronary atherosclerosis: an angiographic study. Atherosclerosis. 2008 Aug;199(2):317-22. doi: 10.1016/j.atherosclerosis.2007.11.020. Epub 2008 Jan 9. PMID: 18187138.
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