Wake up call

A few days ago, I had a routine blood test performed. These days, one can get most of the results the same day, so that evening, I was able to log on to the appropriate website and see the results. Most of these were fairly similar to my last set of results (although the cholesterol set of tests may have slightly improved), but one result set my alarm bells ringing.

The blood glucose level was 110 mg/dL, where the recommended range is 70-100; looking at the history of results from the site, there is a definite tendency to increasing levels.

Date	Concentration
10/04/2014	97
07/08/2014	92
14/09/2014	98
19/10/2014	90
28/01/2016	103
18/02/2016	94
27/08/2017	95
10/05/2018	99
21/03/2019	110

The statistician in me would prefer more data points taken at more regular intervals but I think that the meaning is clear. Lest I suspect that there was a problem with my recent blood test (like eating ice cream after 8pm the evening before), there is a separate blood test called Hemoglobin A1c %, which evaluates the average amount of glucose in the blood over the last 2 to 3 months by measuring the percentage of glycated (glycosylated) hemoglobin (source). The normal range is 4.0 - 5.7%; my level was 6.1%. I have no history of this test for comparison. It is interesting to compare this level with overseas standards: The American Diabetes Association currently recommends an A1c goal of less than 7.0%, while other groups such as the American Association of Clinical Endocrinologists recommend a goal of less than 6.5%. In 2016, the ADA recommended that an A1c level of 6.5% as a cutoff level to diagnose diabetes (source).

I read somewhere (possibly on the health fund's site) that these elevated levels can be caused by the following factors

1. A sugar rich diet
2. Lack of exercise
3. Some pre-existing condition in the body

I have control over the first two factors, so I will have to do my part with life style changes. I used to speed walk 5km every evening a few years ago, but this stopped after we 'changed' dogs. It's easy to find excuses, such as 'next week I have to travel to Karmiel on Tuesday and Wednesday, and to Haifa on Thursday' or similar. But I have to do something!

I am out of condition. Yesterday I walked just over 1.5km in 17 minutes before my right leg started hurting just above the ankle. Today I walked 2.2km in 23 minutes before the pain started, so at least I am improving. I shall have to force myself to find the necessary 30-40 minutes every day whenever possible.

I suspect that I am also developing lactose intolerance; apparently this increases (i.e. the body becomes less tolerant) as one gets older. One of my brothers in law has lactose intolerance and avoids milk and cheese almost completely. He is of Yemenite stock, which is traditionally lactose intolerant, whereas I am of European stock, which is traditionally tolerant. This is a problem for me as I drink 2-4 glasses of milk a day; I have learned to drink only one glass of milk when I am in Karmiel if I want to avoid pains and hiccups on the way home. It probably doesn't help my digestive system that I am sitting without moving for a few hours.

Fortunately, milk companies in Israel sell 'low lactose' milk with 2% fat; I bought a couple of cartons yesterday and have been drinking the milk with no ill effects. But at work this is going to be a problem: I can't see me taking a carton of low lactose milk to work and leaving it in a refrigerator without someone else using that milk, even if I label the carton. I think that the solution will be to keep it in a non-transparent plastic bag. But I can't see myself traveling to Karmiel (3 hours) with a carton of milk in my bag; I think that I'll ask the secretary there to buy me a carton for next week.

I assume that I will be summoned soon to our family doctor where we will discuss the blood results. I also intend to bring up the lactose problem. From what I have read, intolerance is not normally tested by clinical means but rather by symptoms and reducing exposure to milk. So I'm going to continue with the low lactose milk for a few weeks and see what happens.