Q&A With Dr. Richard Bernstein
What do you believe are normal blood sugars? Do you believe an A1c of 5%, or even 5.5%, is normal?
I have both A1c and blood sugar targets. The A1c target for most people is 4.2% to 4.6%, which is a non-diabetic range. The target blood sugar we seek is 83 mg/dL and is also a normal blood sugar for a non-diabetic.
Now how on earth did I get such an odd ball number like 83? I got it because we used to be located on a major thoroughfare, and we had a sign outside that said DIABETES CENTER. All of the meter salesmen would stop by and demonstrate their meters. I would say, “I have had enough finger sticks today. It’s your turn.”
So we would stick their fingers, and what would we get? It was amazing. People in their twenties and thirties all were around 83. So I said, “That must be what a normal blood sugar looks like.” Since that time, I have looked at the epidemiologic studies. It looks like the minimum point for mortality and heart disease is around 83. So, those above and below 83 have higher relative risks of overall mortality. It looks like what I originally learned by chance is pretty close to the cut-off point that the epidemiologic studies show.
To answer about the A1c, my patients will be worried if they have a 5.5, and will say, “Hey, that’s an average blood sugar of 120 mg/dL, which is about 50 percent above the safest value.”
Richard K. Bernstein, MD is one of the most knowledgeable, committed, and successful pioneers in the field of diabetes today. He invented blood sugar self-monitoring and basal/bolus insulin dosing when he was an engineer.
Dr. Bernstein is Director Emeritus of the Peripheral Vascular Disease Clinic of the Albert Einstein College of Medicine in Bronx, NY. His private medical practice in Mamaroneck NY specializes in treating diabetes and obesity.
He is a physician, research scientist, thriving type 1 for 67 years, and best-selling author of nine diabetes books including Diabetes Solution, The Diabetes Diet and several e-books. This link diabetes-book.com will give you more information about his publications. To sign up for his free monthly tele-seminars, visit askdrbernstein.net