How to Manage Post-Meal Blood Sugar Levels Effectively

Q: How to Manage Post-Meal Blood Sugar Levels Effectively

Dear Mr. Chubby： 1. According to the American Diabetes Association's diagnostic criteria for diabetes： a. Fasting plasma glucose level ≥ 126 mg/dL after fasting for more than 8 hours, b. 2-hour plasma glucose level ≥ 200 mg/dL during an Oral Glucose Tolerance T

How to improve postprandial blood sugar levels?

Dear Dr.
Hsiao,
I recently had a physical examination, and the results are as follows: a.
Fasting plasma glucose level after more than 8 hours is 89 mg/dL, b.
Postprandial glucose level after 2 hours is 162 mg/dL, c.
HbA1c (glycated hemoglobin) is 5.9%.
The postprandial glucose level is elevated, but the other two results are normal.
Does this indicate a high risk of diabetes? How should I monitor and improve this situation?
Best regards,
Xiao Pang

Xiao Pang, 40~49 year old female. Ask Date: 2016/06/14

Dr. Xiao Yongxun reply Internal Medicine

Dear Mr.
Chubby:
1.
According to the American Diabetes Association's diagnostic criteria for diabetes: a.
Fasting plasma glucose level ≥ 126 mg/dL after fasting for more than 8 hours, b.
2-hour plasma glucose level ≥ 200 mg/dL during an Oral Glucose Tolerance Test (OGTT), c.
HbA1c (glycated hemoglobin) ≥ 6.5% (this must be confirmed with a method that is certified by the National Glycohemoglobin Standardization Program (NGSP) and meets the standards of the Diabetes Control and Complications Trial (DCCT)), and the above a, b, c conditions must be confirmed on two separate occasions.
d.
Clinical symptoms of diabetes (such as polydipsia, polyuria, polyphagia, and weight loss) with any plasma glucose level ≥ 200 mg/dL (this condition only needs to be confirmed once).
2.
In normal individuals, postprandial plasma glucose levels are below 140 mg/dL, while individuals with impaired glucose tolerance have postprandial plasma glucose levels between 140 and 180 mg/dL.
If postprandial plasma glucose levels exceed 180 mg/dL, the risk of diabetes should be considered.
Therefore, you may fall into the category of impaired glucose tolerance, commonly referred to as prediabetes.
3.
Prevention or management of diabetes primarily involves dietary control and regular physical activity; medication should only be considered when necessary.
Dietary control includes eating until 80% full, avoiding eating too quickly or overeating, and steering clear of high-sugar, high-fat, and high-calorie foods or beverages, as well as instant coffee mixes, cakes, and fried foods.
Dinner should not be too heavy, and moderate activity should be undertaken after meals before going to bed.
Regular exercise is equally important, aiming for at least three sessions per week, each lasting about an hour; otherwise, at a minimum, a post-meal walk should be taken to avoid sitting down immediately to work.
Additionally, ensuring adequate sleep and reducing life stressors will also aid in blood sugar control.
4.
Please discuss this with your family physician and ensure regular follow-up.

Reply Date: 2016/06/14

More Info

Dear Xiao,
Thank you for your inquiry regarding the management of post-meal blood sugar levels. Based on the information you've provided, your fasting plasma glucose level of 89 mg/dL and HbA1c of 5.9% are within normal ranges, indicating that your overall blood sugar control is relatively good. However, the post-meal blood sugar level of 162 mg/dL is indeed elevated, which can be a concern.

Understanding Blood Sugar Levels
1. Fasting Blood Sugar: A fasting blood sugar level below 100 mg/dL is considered normal. Your level of 89 mg/dL is well within this range, suggesting that your body is effectively managing blood sugar levels after periods of fasting.

2. Post-Meal Blood Sugar: The American Diabetes Association recommends that postprandial (after meal) blood sugar levels should be less than 180 mg/dL two hours after eating. While your level of 162 mg/dL is below this threshold, it is still on the higher side, indicating that your body may be struggling to manage glucose effectively after meals.

3. HbA1c: An HbA1c level of 5.9% indicates that your average blood sugar levels over the past two to three months are slightly elevated. While this is still considered prediabetic (normal is below 5.7%), it does suggest that you should be proactive in managing your blood sugar levels to prevent progression to diabetes.

Risk of Diabetes
Given your elevated post-meal blood sugar levels and HbA1c, you are at an increased risk for developing type 2 diabetes. It is essential to take steps to improve your blood sugar management to reduce this risk.

Strategies for Improvement
1. Dietary Adjustments:
- Carbohydrate Management: Focus on the type and amount of carbohydrates you consume. Opt for complex carbohydrates (whole grains, legumes, vegetables) over simple sugars (sweets, white bread). This can help stabilize blood sugar levels.

- Portion Control: Be mindful of portion sizes, especially for carbohydrate-rich foods. Using measuring cups or a food scale can help you understand serving sizes better.

- Balanced Meals: Ensure that your meals are balanced with protein, healthy fats, and fiber. This combination can help slow down the absorption of glucose and prevent spikes in blood sugar.

2. Physical Activity:
- Regular exercise can significantly improve insulin sensitivity and help lower blood sugar levels. Aim for at least 150 minutes of moderate-intensity aerobic activity per week, along with strength training exercises twice a week.

3. Monitoring Blood Sugar:
- Keep a log of your blood sugar levels, noting what you eat and your physical activity. This can help you identify patterns and make necessary adjustments.

4. Consult Healthcare Professionals:
- Regular check-ups with your healthcare provider are crucial. They can provide personalized advice and may recommend seeing a registered dietitian for tailored dietary guidance.

5. Stress Management:
- Stress can impact blood sugar levels. Consider incorporating stress-reducing activities such as yoga, meditation, or deep-breathing exercises into your routine.

Conclusion
While your fasting and HbA1c levels are within acceptable ranges, the elevated post-meal blood sugar indicates a need for attention. By making dietary changes, increasing physical activity, and monitoring your blood sugar levels, you can effectively manage your post-meal blood sugar levels and reduce your risk of developing diabetes. Always consult with your healthcare provider before making significant changes to your diet or exercise routine.

Best wishes for your health journey!
Sincerely,
Doctor Q&A Teams

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