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Correspondence to Author: Charles Paul Lambert, PhD, 

3528 E Fall Creek Pkwy N Dr Apt. G, United States.

INTRODUCTION:

Measures used in clinical practice should be indicative of health or disease. Fasting blood glucose and hemoglobin a1c are used routinely in clinical practice to diagnose diabetes but the utility of fasting blood glucose and hemoglobin a1c as measures of tissue sensitivity to insulin is unreliable at best. It has been observed in a number of studies (Table 1.), that fasting blood glucose does not change substantially in response to interventions that substantially change tissue glucose uptake or in other words insulin sensitivity. Kirwan et al. 1 published a representative study where large improvements in glucose disposal were not associated with improvements in fasting glucose. Specifically, insulinstimulated glucose disposal, during the first stage of a euglycemic-hyperinsulinemic clamp, was improve 45.1% after 7 days of exercise (60 min per day). However, fasting blood glucose was relatively unchanged (-5.1%). As shown in several similar studies presented in Table 1 this appears to be “the rule” not an “exception”. With a small change of -5.1% (compared to 45.1% with the euglycemic-hyperinsulinemic clamp) this measure, fasting blood glucose, is not precise enough to detect differences in the fasting blood glucose with exercise training.

Citation:

Charles Paul Lambert. Fasting blood glucose and hemoglobin a1c: measures of insulin sensitivity? Journal of Diabetology Research 2024.