Blood Sugar Fluctuations: Symptoms and Testing Insights

Q: Blood Sugar Fluctuations: Symptoms and Testing Insights

Dear Mr. Ming： 1. According to your information, I agree with your attending physician; in other words, there is no evidence indicating the presence of diabetes. 2. Any blood glucose meter can produce inaccuracies; therefore, it is necessary to have the manufact

Blood sugar inquiry?

Hello, Doctor: A few days ago, during lunch, I drank a soda and suddenly felt unwell, experiencing neck pain and fatigue.
After about half an hour, I still felt uncomfortable, so I consumed an oral rehydration solution (8.44 grams of sucrose and 2.8 grams of glucose).
However, I continued to feel unwell.
After researching online, I found that my symptoms were somewhat similar to those of ketoacidosis.
About five hours later, I went to a pharmacy to check my blood sugar, which was 254 mg/dL.
The discomfort resolved completely by the next morning.
I also went to the hospital for an examination.
Since I had consumed unsweetened soy milk and mashed potato egg salad in the morning, I only measured my postprandial blood sugar, which was 102 mg/dL about 1.5 hours after eating.
The doctor asked several questions; I did not experience significant weight loss, and since I have a history of kidney stones, I usually drink plenty of water.
I am not entirely sure about this, but I believe I am not at the point of excessive urination.
Later, I had a fasting blood test, and the results showed a blood sugar level of 97 mg/dL and a hemoglobin A1c of 5%.
The doctor indicated that these results were normal, but he was puzzled as to why my blood sugar had reached 254 mg/dL.
Although I mentioned that I might have consumed glucose (from the oral rehydration solution) after feeling unwell, he said that if someone had diabetes, the level would be even higher due to the direct intake of sugar.
However, I did not inform him that the blood sugar was measured 4.5 hours later.
Is it possible for a blood glucose meter to have such a significant discrepancy, or could there be other factors involved? I am still quite concerned about the symptoms and blood sugar levels from that time.

Ming, 20~29 year old female. Ask Date: 2017/03/23

Dr. Xiao Yongxun reply Internal Medicine

Dear Mr.
Ming:
1.
According to your information, I agree with your attending physician; in other words, there is no evidence indicating the presence of diabetes.
2.
Any blood glucose meter can produce inaccuracies; therefore, it is necessary to have the manufacturer perform calibration when needed.
3.
The discomfort you experience after drinking soda may have many possible causes.
It is not necessarily due to high blood sugar; if it is indeed related to blood sugar, it may not be caused by the soda itself.
The content of the food you consumed that day, its caloric value, the ingredients and composition of the soda, interactions between foods, and even factors like blood pressure and sleep quality could all be contributing factors.
4.
I personally recommend maintaining a balanced diet, avoiding excessive processed foods, ensuring adequate sleep, and engaging in regular exercise, as these are crucial aspects to pay attention to.
If you have any further questions, please discuss them in detail with your attending physician.
I believe his reasoning and concerns are very reasonable and correct.

Reply Date: 2017/03/23

More Info

Understanding blood sugar fluctuations is crucial for maintaining overall health, especially for individuals who may be at risk for diabetes or other metabolic disorders. Your experience of sudden discomfort after consuming a sugary drink, followed by elevated blood sugar levels, raises several important points regarding blood sugar regulation, potential symptoms of hyperglycemia, and the accuracy of blood glucose testing.

Firstly, it’s essential to recognize that blood sugar levels can fluctuate significantly based on various factors, including diet, physical activity, stress, and individual metabolic responses. In your case, consuming a soda, which is high in sugar, could have led to a rapid increase in your blood glucose levels. This spike can cause symptoms such as fatigue, neck pain, and general malaise, which you experienced. These symptoms can be attributed to hyperglycemia, where the body struggles to manage excess glucose in the bloodstream.

The blood sugar reading of 254 mg/dL is indeed concerning, as it indicates hyperglycemia. However, it’s important to consider the timing of your glucose measurement. You mentioned that you consumed an oral rehydration solution containing sugar approximately 4.5 hours before testing your blood sugar. This could have contributed to the elevated reading, as the glucose from the solution would still be affecting your blood sugar levels.
When you tested your blood sugar again after consuming a low-sugar meal and found it to be 102 mg/dL, this reading falls within the normal range for postprandial (after eating) blood sugar levels, which should ideally be below 140 mg/dL. Your fasting blood sugar of 97 mg/dL and a hemoglobin A1c of 5% also indicate normal glucose metabolism, suggesting that you are not diabetic.

Regarding the accuracy of blood glucose meters, it’s important to note that while they are generally reliable, various factors can affect their readings. These include the calibration of the meter, the quality of the test strips, and even user error (such as not washing hands before testing). Additionally, physiological factors such as dehydration or recent food intake can also influence readings.
In your case, the significant difference between the two readings (254 mg/dL vs. 102 mg/dL) could be attributed to the timing of the tests and the influence of the sugary drink and oral rehydration solution. It’s also worth considering that stress and anxiety can affect blood sugar levels, potentially causing temporary spikes.

If you continue to experience symptoms or have concerns about your blood sugar levels, it would be prudent to monitor your glucose regularly and consult with your healthcare provider. They may recommend further testing or a continuous glucose monitor (CGM) to provide more insight into your blood sugar patterns throughout the day.

In summary, while your initial high blood sugar reading was alarming, subsequent tests indicate that your glucose metabolism is functioning normally. It’s essential to maintain a balanced diet, monitor your blood sugar levels, and stay hydrated, especially if you have a history of metabolic issues. If symptoms persist or worsen, seeking medical advice is crucial for proper evaluation and management.

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