Blood Sugar Levels: When to Test and What to Know

Blood sugar issues?

Hello Doctor, I have been feeling a bit uncomfortable and dizzy after meals recently.
Four months ago, I had my hemoglobin A1c tested, which was 5.4, and my fasting blood glucose was 97.
I did not have a postprandial blood glucose test done.
A few days ago, I had my fasting blood glucose tested again, and it was 90.
Do you think I need to have my hemoglobin A1c and postprandial blood glucose tested? I am 20 years old, and there is a family history of diabetes.
How often do you recommend I should have my blood glucose tested? Thank you, Doctor!

Bo Zhi, 20~29 year old female. Ask Date: 2017/10/30

Dr. Gao Jiankai reply Internal Medicine

Hello, sir, thank you for your question.
Although diabetes has a genetic component, for type 2 diabetes, the chance of children of affected individuals developing diabetes is around 15%.
Therefore, there is no need to be overly anxious.
In other words, if you pay attention to your diet and lifestyle, the risk of developing diabetes in the future is actually low.
As for how often to check blood glucose or even glycated hemoglobin, I believe you can follow the frequency recommendations provided by the National Health Insurance Administration for health screenings.
Currently, the health insurance covers health check-ups for adults aged 40 to 65 every three years.
Since you are only 20 years old, the frequency of checks can be extended, or you could even consider checking every three years.
If you are really concerned, then checking once a year would be my personal recommendation.
Lastly, I want to emphasize that adjustments in diet and lifestyle are very important, and this is what you should pay more attention to.
The Allergy, Immunology, and Rheumatology Department of Changhua Hospital, Ministry of Health and Welfare, cares about you.

Reply Date: 2017/10/30

More Info

Understanding blood sugar levels is crucial, especially for individuals with a family history of diabetes. Your recent experiences with post-meal discomfort and your blood sugar readings raise important questions about your health and the need for further testing.

1. Current Blood Sugar Readings: Your previous HbA1c level of 5.4% and fasting blood sugar of 97 mg/dL are both within the normal range. The American Diabetes Association (ADA) defines normal fasting blood sugar as less than 100 mg/dL. Your recent fasting blood sugar of 90 mg/dL is also normal. However, the symptoms you describe—feeling lightheaded or uncomfortable after meals—could indicate fluctuations in your blood sugar levels that are not captured by fasting tests alone.

2. Need for Additional Testing: Given your symptoms and family history of diabetes, it would be prudent to conduct further tests. Specifically, measuring postprandial (after meal) blood sugar levels can provide insight into how your body is managing glucose after eating. The ADA recommends that individuals at risk for diabetes, such as those with a family history, consider testing their blood sugar levels more frequently. An HbA1c test every 6 months to a year is advisable, but if you are experiencing symptoms, it may be beneficial to check your blood sugar levels more regularly, including after meals.

3. Frequency of Testing: Since you are 20 years old and have a family history of diabetes, it is recommended that you monitor your blood sugar levels regularly. The ADA suggests that individuals at risk should have their blood sugar tested at least once a year. However, if you experience symptoms like the ones you described, or if your healthcare provider recommends it, you may need to test more frequently. Regular monitoring can help catch any potential issues early, allowing for timely intervention.

4. Understanding Blood Sugar Levels: Blood sugar levels can fluctuate based on various factors, including diet, physical activity, stress, and overall health. After eating, it is normal for blood sugar levels to rise, but they should return to baseline levels within a couple of hours. If your blood sugar remains elevated or if you experience symptoms like dizziness or fatigue, it could indicate an issue with insulin sensitivity or glucose metabolism.

5. Lifestyle Considerations: Maintaining a healthy lifestyle is crucial in managing blood sugar levels. This includes a balanced diet rich in whole grains, fruits, vegetables, and lean proteins, along with regular physical activity. Monitoring your carbohydrate intake and understanding how different foods affect your blood sugar can also be beneficial. Additionally, managing stress and ensuring adequate sleep are important factors in maintaining overall health and stable blood sugar levels.

In conclusion, given your family history of diabetes and the symptoms you are experiencing, it would be wise to discuss with your healthcare provider the possibility of additional testing, including postprandial blood sugar and HbA1c levels. Regular monitoring and a proactive approach to your health can help you manage your risk and maintain optimal well-being. Always consult with your healthcare provider for personalized advice and recommendations tailored to your specific situation.

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