Managing High Blood Sugar: When to See a Doctor and Dietary Tips

Q: Managing High Blood Sugar: When to See a Doctor and Dietary Tips

Dear Mr. Ahong： 1. According to the diagnostic criteria for diabetes set by the American Diabetes Association： a. Fasting plasma glucose level ≥ 126 mg/dL after fasting for more than 8 hours, b. Plasma glucose level ≥ 200 mg/dL during a 2-hour oral glucose tole

Blood sugar issues?

Hello, doctor.
After my health check-up, I found that my blood sugar levels were elevated, so I completely stopped eating sweets.
However, I often feel very hungry after meals.
Although it doesn't significantly affect my daily routine, I would like to ask whether I should see a doctor or if this is just a transitional phenomenon from not eating sweets.
If I need to go to a large hospital, should I visit the Family Medicine department?

A-Hong, 30~39 year old female. Ask Date: 2017/12/11

Dr. Xiao Yongxun reply Internal Medicine

Dear Mr.
Ahong:
1.
According to the diagnostic criteria for diabetes set by the American Diabetes Association: a.
Fasting plasma glucose level ≥ 126 mg/dL after fasting for more than 8 hours, b.
Plasma glucose level ≥ 200 mg/dL during a 2-hour oral glucose tolerance test, c.
HbA1c (glycated hemoglobin) ≥ 6.5% (this must be confirmed by 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 by two tests.
d.
Clinical symptoms of diabetes (such as polydipsia, polyuria, polyphagia, weight loss, etc.) with any plasma glucose level ≥ 200 mg/dL (this condition only needs to be met once).
Therefore, the information you provided indicates that you do not have diabetes, but rather wish to control and prevent its onset early.
2.
In medicine, there is often discussion about considering the glycemic index (GI) and glycemic load (GL).
The glycemic index (GI) refers to how quickly a food causes blood glucose levels to rise after consumption.
In principle, high GI foods can be consumed, but not in excess; low GI foods can be eaten more freely, but one must be cautious as consuming too many low GI foods can also lead to high caloric intake.
Glycemic load (GL) is calculated as GI × grams of carbohydrates in the food consumed / 100.
This means that low GI foods can still cause blood sugar to rise significantly if eaten in large quantities; conversely, high GI foods may not raise blood sugar levels for long if only a small amount is consumed.
The sweets you mentioned are likely high glycemic index foods, which can cause a rapid spike in blood sugar, leading to a quick sense of happiness or satisfaction; however, if consumed in large amounts, they can lead to elevated fasting blood sugar before the next meal.
Due to the lack of detailed information about your diet, I suspect that sweets comprise a significant portion of your intake, which is why stopping them leads to a reduction in total daily caloric intake, making you feel hungrier.
This phenomenon may require an appropriate increase in low glycemic index foods, which could help improve the situation.
I still recommend that you discuss your dietary content with your family physician or nutritionist for some adjustments, as this may be a better approach.
3.
If you plan to visit a large hospital, it is advisable to seek assistance from a physician specializing in metabolism or family medicine.

Reply Date: 2017/12/11

More Info

Managing high blood sugar is a crucial aspect of maintaining overall health, especially for individuals who may be at risk for diabetes. Based on your situation, where you have experienced elevated blood sugar levels after a health check, it is important to approach this matter with a comprehensive understanding of dietary habits, potential medical evaluations, and lifestyle changes.

Firstly, it is essential to recognize that elevated blood sugar levels can be indicative of prediabetes or diabetes. According to the American Diabetes Association, fasting blood sugar levels of 100-125 mg/dL are classified as prediabetes, while levels of 126 mg/dL or higher indicate diabetes. Since your blood sugar is elevated, it is advisable to consult with a healthcare provider to assess your risk further. A visit to a family medicine physician or an endocrinologist would be appropriate, as they can provide a thorough evaluation, including tests such as the HbA1c test, which gives an average blood sugar level over the past two to three months.

Regarding your dietary changes, completely eliminating sweet foods may not be necessary or sustainable. While it is true that high-glycemic index (GI) foods, such as sugary snacks and beverages, can cause rapid spikes in blood sugar, it is important to maintain a balanced diet that includes carbohydrates. Instead of cutting out all sweet foods, consider focusing on portion control and choosing lower-GI options. Foods with a low GI are digested more slowly, leading to a gradual increase in blood sugar levels, which can help you manage hunger better.

Incorporating whole grains, legumes, fruits, and vegetables into your diet can provide essential nutrients while helping to stabilize blood sugar levels. Additionally, pairing carbohydrates with protein or healthy fats can slow down the absorption of sugar into the bloodstream, helping to prevent spikes in blood sugar and keeping you feeling fuller for longer.

Feeling hungry after meals can be a common experience, especially if your previous diet was high in sugars and refined carbohydrates. This hunger may be a sign that your body is adjusting to a new dietary pattern. To combat this, consider increasing your intake of fiber-rich foods, which can promote satiety and help regulate blood sugar levels. Foods such as beans, lentils, whole grains, fruits, and vegetables are excellent sources of fiber.

It is also important to engage in regular physical activity, as exercise can significantly improve insulin sensitivity and help lower blood sugar levels. Aim for at least 150 minutes of moderate-intensity aerobic activity each week, along with strength training exercises on two or more days per week.

In summary, while it is wise to be cautious about high blood sugar levels, completely avoiding sweet foods may not be necessary. Instead, focus on a balanced diet that includes a variety of nutrients, monitor your portion sizes, and consult with a healthcare professional for personalized advice. If you continue to experience elevated blood sugar levels or have concerns about your health, seeking medical attention is crucial for early intervention and management.

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