Question: Thank you for asking how I am.

I am the 67-year-old diabetic who suffers from fatigue,
particularly when my blood sugar readings get higher than
about 6.0 mmol/L.

My doctor has referred me to an endocrinologist. However
there is a waiting list of around four months.

In the meantime, I am aiming to keep my blood sugars in the
3.3 to 5.5 range. Inevitably I will go above this quite a
number of times a week, and my HbA1c will be around 5.5. I
will also go under 3.3 two or three times a week and if I go
below 3.0 or 3.1 the hypo symptoms will come on. When that
happens I test and then treat. My HbA1c has been between 5.5
and 6.0 for two years now (6 tests) and I have never needed
assistance of any sort, let alone been hospitalised, due to
a hypo, so I keep my fingers crossed. [The up side, too, is
that I run less risk of cognitive decline, Alzheimer’s,
dementia or heart attack (let alone the other bad health
outcomes for diabetics).

I still don’t know the answer to what is a dangerously low
hypo (and I guess this may vary from individual to
individual). I am also aware that in our Western
civilisation around 5% of people regularly have blood sugars
of 3.3 (and that goes down to around 2.9). I’d be very
interested to learn the figures for people on a traditional
Japanese, inland Chinese, Okinawan or XXXXXXX diet, as it
wouldn’t XXXXXXX me if well over 5% were at the 3.3 level
on a regular basis. I am keen to get more information about
this.

Thank you for your concern.

Thank you very much for your answer Dr XXXXXXX

In terms of people who were indigenous to Japan, Okinawa, inland China, XXXXXXX etc, I wasn't so much thinking of diet, but of the possibility of such factors as the influence of nutrition on epigenetics and the influence of pre-birth nutrition (or both) in terms of setting the scene for people's blood sugars. At the same time, I see that there may not be much difference from culture to culture (but I do wonder). That's why I'd be very interested to see any figures from populations such as these who are following their traditional cultural diets.

I was also recently talking to an ex-doctor friend and a psychologist (who I contacted in case depression was creating the symptoms I face, which apparently is not the case). Both theorised that people have a natural tendency to be in a particular probably quite narrow range within the wider range of "normal" (with around 90% of people falling in the 3.3 to 5.5 mmol/L fasting range). Both suggested to me that it is possible my pre-diabetic "normal" may well have been closer to the 3.3 or even the 3.0 mark, which is why I operate better and feel better in the 3.3 to 5.5 range. The ex-doctor also suggested the profession may would do well to consider tracking the entire population regarding this, particularly given the increase in incidence of diabetes.

If you do have any thoughts on this, I'd be most interested to hear.

Once again, thank you for your answer.

Thank you very much Dr XXXXXXX
I'd still be keen to get figures of blood sugars in populations following their traditional eating patters, so if you do come across these, please let me know.

thanks