Step two: test your blood sugar

1. Test your blood sugar first thing in the morning after fasting for at least 12 hours.
Drink a little bit of water just after rising, but don’t eat anything or exercise before
the test. This is your fasting blood sugar level.
2. Test your blood sugar again just before lunch.
3. Eat your typical lunch. Do not eat anything for the next three hours.Test your
blood sugar one hour after lunch.
4. Test your blood sugar two hours after lunch.
5. Test your blood sugar three hours after lunch.

Record the results, along with what you ate for lunch. Do this for two days. This will tell
you how the foods you normally eat affect your blood sugar levels.

On the third day, you’re going to do it a little differently. On step 3, instead of eating
your typical lunch, you’re going to eat 60 – 70 grams of fast acting carbohydrate. A
large (8 oz) boiled potato or a cup of cooked white rice will do. For the purposes of this
test only, avoid eating any fat with your rice or potato because it will slow down the
absorption of glucose.

Then follow steps 4-6 as described above, and record your results.

Step three: interpret your results

If you recall from the last article, healthy targets for blood sugar according to the
scientific literature are as follows:

Marker Ideal*
Fasting blood glucose (mg/dL) <86
OGGT / post-meal (mg/dL after 1 hour) <140
OGGT / post-meal (mg/dL after 2 hours) <120
OGGT / post-meal (mg/dL after 3 hours) Back to baseline
Hemoglobin A1c (%) <5.3

*To convert these numbers to mmol/L, use this online calculator.

Hemoglobin A1c doesn’t apply here because you can’t test it using a glucometer.
We’re concerned with the fasting blood sugar reading, and more importantly, the 1- and
2-hour post-meal readings.

The goal is to make sure your blood sugar doesn’t consistently rise higher than
140 mg/dL an hour after a meal, but does consistently drop below 120 mg/dL two
hours after a meal, and returns to baseline (i.e. what it was before you ate) by three
hours after a meal.

There are a few caveats to this kind of testing. First, even reliable glucometers have
about a 10% margin of error. You need to take that into account when you interpret
your results. A reading of 100 mg/dL could be anything between 90 mg/dL and 110
mg/dL if you had it tested in a lab. This is okay, because what we’re doing here is trying
to identify patterns – not nit-pick over specific readings.
Second, if you normally eat low-carb (less than 75g/d), your post-meal readings on the
third day following the simple carbohydrate (rice or potato) challenge will be abnormally
high. I explained why this occurs in the last article, but in short when you are adapted
to burning fat your tolerance for carbohydrates declines. That’s why your doctor would
tell you to eat at least 150g/d of carbs for three days before an OGTT if you were
having that test done in a lab.

If you’ve been eating low-carb for at least a couple of months before doing the
carbohydrate challenge on day three of the test, you can subtract 10 mg/dL from your
1- and 2-hour readings. This will give you a rough estimate of what your results would
be like had you eaten more carbohydrates in the days and weeks leading up to the
test. It’s not precise, but it is probably accurate enough for this kind of testing.

Third, as I said above, an occasional spike above these targets in the context of other
normal blood sugar markers is usually no cause for concern.

Step four: take action (if necessary)

So what if your numbers are higher than the guidelines above? Well, that means you
have impaired glucose tolerance. The higher your numbers are, the further along you
are on that spectrum. If you are going above 180 mg/dL after one hour, I’d recommend
getting some help – especially if you’re already on a carb-restricted diet. It’s possible to
bring numbers that high down with dietary changes alone, but other possible causes of
such high blood sugar (beta cell destruction, autoimmunity, etc.) should be ruled out.

If your numbers are only moderately elevated, it’s time to make some dietary changes.
In particular, eating fewer carbs and more fat. Most people get enough protein and
don’t need to adjust that.

And the beauty of the glucometer testing is that you don’t need to rely on someone
else’s idea of how much (or what type of) carbohydrate you can eat. The glucometer
will tell you. If you eat a bowl of strawberries and it spikes your blood sugar to 160
mg/dL an hour later, sorry to say, no strawberries for you. (Though you should try
eating them with full-fat cream before you give up!) Likewise, if you’ve been told you
can’t eat sweet potatoes because they have too much carbohydrate, but you eat one
with butter and your blood sugar stays below 140 mg/dL after an hour, they’re probably
safe for you. Of course if you’re trying to lose weight, you may need to avoid them
anyways.

You can continue to periodically test your blood sugar this way to see how you’re
progressing. You’ll probably notice that many other factors – like stress, lack of sleep
and certain medications – affect your blood sugar. In any case, the glucometer is one
of your most powerful tools for preventing degenerative disease and promoting optimal
function.