Blood Sugar Screening - what the numbers don't say

I am fortunate to have the opportunity to work at multiple health fairs throughout the year in my surrounding community. I always enjoy meeting other healthcare providers and talking with the various employees and participants about their journey to health. It feels particularly good to reach so many individuals during a single day.

A couple weeks ago while spending the day at a health fair, I was concerned by something I overheard a employee say. I thought it would provide a useful and educational anecdote for people concerned about nutritional health.

The story happened something like this:

There was a nurse down at the other end of the room. She was doing finger sticks and checking employee's blood sugars as a basic diabetes screening. It was a simple test and most of the participants that weren't afraid of needles were having their numbers evaluated. A group of women, having just had their blood sugars checked, progressed across the room towards my table. While standing in front of me, a particular woman boasted of her food choices for the day: "Pancakes from McDonalds, hashbrowns, 2 soft drinks, and a cookie from the insurance table just across the way. Guess what? Her blood sugar was only 78." She smiled and gave herself a nod of approval at her excellent number.

In retrospect, I would have slowed my immediate response, but I was so upset by the inefficiency of this test in this particular moment that I jumped right in with an assessment of the situation. The woman was overweight and quite typically carrying the majority of her excess adipose tissue around her abdominal area. What I let her know, was that in order for her body to produce a blood sugar of 78 on this day following the food choices she had made, her pancreatic beta cells had to produce significantly more insulin than required had her food choices been different. Based on the blood sugar reading, it succeeded. But the extra insulin required to control the sugar spike from the foods consumed conveys a message to the body. The abundance of insulin tells the body, we have an excess of easy energy right now, the best thing to do is store it as fat for a later use. In addition to causing the body to store the consumed calories as fat, the insulin is also pro-inflammatory throughout the body. When this message and these signals are repeated day in and day out the end result is always the same => the individual is overweight and on the road to becoming a type II diabetic.

This is the risk with isolated screenings that do not consider the individual within the context of the big picture. Even though the number may look good today, the long term risks are compiling because the lifestyle factors are being neglected.