Wait, what? “Within normal range” glucose doesn’t tell me much?
I am not a doctor, nor have I ever received a medical education, nor am I trying to be one. But I do notice patterns, decompose systems, and distill principles to their core. And I noticed some in at least a handful of people. I thought, if it was useful for my close friends, it could be for you.
There seem to be patterns that, for some reason, are not printed in bold on the walls of medical clinics. Everywhere we look, we’re told that alcohol or tobacco is harmful to our health. But so are other things—like snacking throughout the day, starting a meal with simple carbs, not including enough protein, and on and on.
In this post, I’ll describe one set of markers you might want to check for yourself, or at least discuss with your physician.
Metabolism
Metabolism is how your body uses energy to keep you alive and functioning—breathing, moving, healing, and more. When there is an issue with how your body uses energy to function, it is called a metabolic disorder. Glucose metabolism is one of the most common places this breaks down.
Cluster: HbA1c – Glucose – Insulin – HOMA-IR
By default, we eat a lot of sugar because it is literally everywhere, especially in packaged foods. It is tolerated seemingly well up to a certain age. Then problems usually begin.
What to Check
These blood tests can help you see if your glucose metabolism is disrupted:
1. Fasting blood glucose. This test measures the current level of blood glucose—today’s baseline. Our bodies break down many foods into glucose and release it into the bloodstream.
2. Fasting insulin. Insulin is a hormone the pancreas makes to regulate blood glucose levels. It helps glucose move into the cells. This test measures the amount of insulin in your blood. To get meaningful results, you need to measure insulin and fasting glucose together, as they work in tandem.
3. HOMA-IR is calculated from your glucose and insulin results and gives you perspective on your metabolic health. Above 1.5 suggests early insulin resistance (IR). Above 2 is, conventionally, IR.
IR means problems are beginning.
With IR, your body has a higher risk of developing serious diseases like diabetes, cancer, dementia, and more. (I know this isn’t how you’re supposed to write in a medical setting, but the literature consistently points in this direction.)
The good news is that IR is reversible in many cases when addressed early. Dietary changes are often enough.
You can calculate HOMA-IR yourself or ask your doctor, if you have your glucose and insulin results.
4. Hemoglobin A1c (HbA1c) is a blood test that shows your average blood glucose level over the past two to three months.
While the glucose test is a snapshot, HbA1c reflects long-term exposure to sugar. Your glucose may be good at a given moment, but HbA1c shows the trend over the last few months.
You want HOMA-IR below 1.5 and HbA1c at the lower end of the normal range. This suggests that you are metabolically healthy.
Why This Cluster
This is not a comprehensive assessment of metabolism, and it is far from sufficient on its own. But there is a reason to start here. This cluster is one of the most commonly disrupted ones. By some estimates, roughly every fourth adult shows some degree of insulin resistance.
None of these markers tell the full story on their own, and glucose alone tells the least of it. Insulin is often missing from a standard check-up panel, and HOMA-IR is frequently neglected. The picture only appears when you look at them together. Then you act on what you see, recheck and track your progress.
TBC