The reference range for circulating levels of glucose is 70-130 mg/dL. That’s a wide range, so what’s optimal, especially considering that glucose is one of the variables used to quantify of biological age (https://michaellustgarten.com/2019/09/09/quantifying-biological-age)?

In the largest study published for this subject (12,455,361 adults), risk of death for all causes was maximally reduced for glucose levels between 80-94 mg/dL (Yi et al. 2017). In contrast, mortality risk significantly increased when glucose levels were < 80 or > 100 mg/dL in both men and women:



As glucose levels rise above 100 mg/dL, risk for Type II diabetes increases, which is one potential explanation for higher glucose levels being associated with a higher mortality risk. Why would glucose levels lower than 80 mg/dL also be associated with worse health? Interestingly, glucose levels < 80 mg/dL are associated with an increased risk of death from “total external causes” (left panel below), including unintentional accidents and transport accidents (middle, right panel below) in a relatively large study of 345,318 adults (Yi et al. 2019). In addition, an increased mortality risk from transport accidents involving pedestrians or cyclists was associated with glucose levels below 55 mg/dL (data not shown):

Glucose levels increase during aging (Yi et al. 2017), evidence that adds further merit that lower is better (but not below 80 mg/dL!):

What are my glucose levels? Shown below is my data for the past 13 years:

On the left side of the chart, I measured my glucose levels about once per year from 33-40y, resulting in an average value of 89 mg/dL. Since 2015 I started daily dietary tracking, and tested more often (19x), resulting in an average value of 87 mg/dL. The comparison between these 2 groups of data is not significantly different (p=0.19). Based on the data in Yi et al., my glucose levels should have increased from 92 to 96 mg/dL during the past 13 years. Instead, my glucose levels during that period are relatively stable, with average value (87.5 mg/dL) that would be expected for a 26y old. So far, so good!

If you’re interested, please have a look at my book!

References

Yi SW, Park S, Lee YH, Park HJ, Balkau B, Yi JJ. Association between fasting glucose and all-cause mortality according to sex and age: a prospective cohort study. Sci Rep. 2017 Aug 15;7(1):8194. doi: 10.1038/s41598-017-08498-6.

Yi SW, Won YJ, Yi JJ. Low normal fasting glucose and risk of accidental death in Korean adults: A prospective cohort study. Diabetes Metab. 2019 Jan;45(1):60-66. doi: 10.1016/j.diabet.2018.01.005.

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