Managing Blood Sugar Levels: Concerns and Solutions for Anxiety-Driven Results

Q: Managing Blood Sugar Levels: Concerns and Solutions for Anxiety-Driven Results

Dear Mr. Cc： 1. According to the diagnostic criteria for diabetes set by the American Diabetes Association： a. A fasting plasma glucose level of ≥126 mg/dl after fasting for more than 8 hours, b. A 2-hour plasma glucose level of ≥200 mg/dl during

How to improve blood sugar levels?

Last Friday, I suddenly experienced itching all over my body, and I was worried it might be diabetes.
I felt very low and anxious for three consecutive days—Friday, Saturday, and Sunday—resulting in insufficient sleep.
On Monday, I went to the hospital's metabolic department to have my blood drawn while fasting.
My hemoglobin A1c was 5.1, but my fasting blood glucose was 104.
The doctor told me not to worry and didn't say much else.
However, after researching at home, I'm concerned whether I might have diabetes since my fasting blood glucose is 104.
I was in a state of anxiety and poor sleep for three days before getting tested early Monday morning.
Could this anxiety and lack of sleep have caused my fasting blood glucose to exceed the normal range? Also, what should I do to bring my fasting blood glucose back to normal? There is no family history of diabetes, and my current height is 174 cm and weight is 70 kg.
My urine test showed no abnormalities.
Thank you.

cc, 30~39 year old female. Ask Date: 2018/04/18

Dr. Xiao Yongxun reply Internal Medicine

Dear Mr.
Cc:
1.
According to the diagnostic criteria for diabetes set by the American Diabetes Association:
a.
A fasting plasma glucose level of ≥126 mg/dl after fasting for more than 8 hours,
b.
A 2-hour plasma glucose level of ≥200 mg/dl during an oral glucose tolerance test,
c.
An HbA1c of ≥6.5% (this must be confirmed by a method that is certified by the NGSP and meets the DCCT standards, and there should be no disproportionate hyperglycemia),
All of the above (a, b, c) must be confirmed on two separate occasions.

d.
If there are clinical symptoms of diabetes (such as polydipsia, polyuria, polyphagia, weight loss, etc.), a random plasma glucose level of ≥200 mg/dl is sufficient (this can be confirmed on one occasion only).
2.
Therefore, you currently do not have diabetes.
3.
Your fasting plasma glucose level is 104 mg/dl, and your body mass index (BMI) is 23.1 kg/m²; both are within acceptable ranges.
Although your fasting glucose level is slightly above the currently recommended normal value of 100 mg/dl, possible reasons include overeating the previous night, lack of exercise, excessive intake of high-sugar and high-calorie foods, taking certain medications or supplements, or experiencing significant stress.
The endocrinologist you consulted is very good and has efficiently ruled out diabetes.
Many media or online sources can be referenced, but do not scare yourself; moreover, your BMI is normal, and there is currently no issue with obesity.
4.
It is still recommended that modern individuals engage in more physical activity and consume less refined foods; in particular, avoid overeating, limit the intake of high glycemic index foods, and ensure adequate sleep.
This can help improve blood glucose levels.
Even mild diabetes can be reverted to normal.
This means that the development of diabetes is not an all-or-nothing phenomenon or something that occurs suddenly; rather, it is progressive.
Therefore, it is essential to consistently maintain a healthy lifestyle, dietary habits, and regular exercise.
5.
If you have further questions, it is advisable to discuss them with your family physician.

Reply Date: 2018/04/18

More Info

Managing blood sugar levels can be a complex issue, especially when anxiety and stress are involved. Your recent experience of feeling itchy, anxious, and having poor sleep for several days before your blood test may have contributed to your elevated fasting blood sugar level of 104 mg/dL. While this reading is slightly above the normal range (which is typically considered to be below 100 mg/dL), it does not necessarily indicate diabetes.

Firstly, it's important to understand how stress and anxiety can affect blood sugar levels. When you experience anxiety, your body releases stress hormones like cortisol and adrenaline. These hormones can lead to increased glucose production in the liver and decreased insulin sensitivity, which can elevate blood sugar levels. In your case, the combination of anxiety, lack of sleep, and possibly dietary choices could have contributed to your elevated fasting blood sugar.

Your HbA1c level of 5.1% is reassuring, as it indicates that your average blood sugar levels over the past two to three months have been within a normal range. An HbA1c below 5.7% is generally considered normal, while levels between 5.7% and 6.4% indicate prediabetes, and 6.5% or higher suggests diabetes. Therefore, your HbA1c suggests that you are not at risk for diabetes at this time.

To address your concerns about managing your blood sugar levels, here are some practical steps you can take:
1. Monitor Your Blood Sugar: Regularly checking your blood sugar levels can help you understand how your body responds to different foods, stress, and activities. Consider keeping a log of your readings, noting the time of day and any relevant factors (like meals or stress levels).

2. Manage Stress and Anxiety: Since anxiety can significantly impact your blood sugar levels, finding effective ways to manage stress is crucial. Techniques such as mindfulness meditation, deep breathing exercises, yoga, or even talking to a mental health professional can be beneficial.

3. Improve Sleep Quality: Aim for 7-9 hours of quality sleep each night. Poor sleep can exacerbate stress and negatively affect blood sugar levels. Establishing a calming bedtime routine, reducing screen time before bed, and creating a comfortable sleep environment can help improve your sleep quality.

4. Healthy Eating Habits: Focus on a balanced diet rich in whole foods, including vegetables, fruits, whole grains, lean proteins, and healthy fats. Avoid excessive consumption of sugary foods and beverages, as they can lead to spikes in blood sugar levels. Eating smaller, more frequent meals can also help maintain stable blood sugar levels.

5. Regular Physical Activity: Engaging in regular exercise can improve insulin sensitivity and help regulate blood sugar levels. Aim for at least 150 minutes of moderate aerobic activity each week, along with strength training exercises at least twice a week.

6. Stay Hydrated: Drinking enough water is essential for overall health and can help your body manage blood sugar levels more effectively.

7. Consult with Healthcare Professionals: If you continue to have concerns about your blood sugar levels or anxiety, consider discussing them with your healthcare provider. They can provide personalized advice and may recommend further testing or referrals to specialists if necessary.

In summary, while your fasting blood sugar of 104 mg/dL is slightly elevated, your HbA1c of 5.1% indicates that you are not currently at risk for diabetes. By managing stress, improving sleep, maintaining a healthy diet, and engaging in regular physical activity, you can help keep your blood sugar levels within a healthy range. If you have ongoing concerns, don't hesitate to reach out to your healthcare provider for further guidance.

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