Blood Sugar Fluctuations and Diabetes Management

Inquiry about blood sugar issues?

Hello Dr.
Lin, I would like to ask you a few questions:
1.
In non-diabetic patients, is it possible for acute gastroenteritis causing inflammation and persistent vomiting to lead to a temporary increase in blood glucose levels?
2.
For patients with prediabetes (elevated blood glucose and HbA1c levels but not exceeding the threshold), can medications like metformin be used to prevent the progression to actual diabetes? Or is it true that once these medications are started, they cannot be discontinued? Of course, I understand that exercise and dietary control are the best methods, but I am just curious about the efficacy of medications in this regard.

3.
If someone is unfortunately diagnosed with diabetes but their levels are not excessively high (for example, fasting blood glucose of 130 and HbA1c of 6.6), and the diagnosis was made within the past year, is it still possible to normalize their levels and potentially reverse early-stage diabetes through dietary adjustments, exercise, or even with the help of medications? Thank you!

A Cheng, 30~39 year old female. Ask Date: 2018/09/11

Dr. Lin Jianliang reply Internal Medicine

1.
The body may experience abnormal blood sugar levels when feeling unwell or under significant stress.
2.
The current trend seems to suggest that the use of metformin for diabetes prevention is not recommended.
3.
In the early stages of diabetes, when the condition is not severe, diet and exercise can largely help control blood sugar levels.
However, it is important to ensure regular monitoring, and if any discomfort arises, one should seek medical attention immediately.
Thank you.

Reply Date: 2018/09/11

More Info

Dear Patient,
Thank you for your insightful questions regarding blood sugar fluctuations and diabetes management. Let’s address each of your concerns systematically.

1. Acute Gastroenteritis and Blood Sugar Levels: It is indeed possible for non-diabetic individuals to experience temporary elevations in blood sugar levels during episodes of acute gastroenteritis. This condition often leads to inflammation and stress responses in the body, which can trigger the release of stress hormones such as cortisol and adrenaline. These hormones can increase insulin resistance and promote gluconeogenesis (the production of glucose from non-carbohydrate sources) in the liver, leading to elevated blood sugar levels. Additionally, vomiting and diarrhea can lead to dehydration, which may further affect blood sugar regulation. Therefore, it is crucial for individuals experiencing such symptoms to monitor their hydration status and blood sugar levels closely.

2. Medications for Prediabetes: Regarding the use of medications such as Metformin (福適佳) for individuals with prediabetes, it is important to note that these medications can indeed help in managing blood sugar levels and potentially delaying or preventing the progression to type 2 diabetes. Metformin works primarily by improving insulin sensitivity and reducing hepatic glucose production. While lifestyle modifications, including diet and exercise, are the cornerstone of diabetes prevention, pharmacological interventions can be beneficial, especially in individuals with a higher risk of developing diabetes. However, it is essential to understand that the decision to start medication should be made in consultation with a healthcare provider, as they can assess the individual’s overall health, risk factors, and potential benefits of medication. If initiated, the medication may not necessarily need to be a lifelong commitment, but any changes should be closely monitored by a healthcare professional.

3. Reversing Early Diabetes: If diagnosed with early-stage diabetes (for example, fasting blood sugar of 130 mg/dL and HbA1c of 6.6%), there is indeed a possibility to reverse this condition through lifestyle modifications. Research has shown that significant weight loss, regular physical activity, and a balanced diet can lead to improvements in blood sugar levels and even remission of diabetes in some cases. The American Diabetes Association emphasizes that individuals with early-stage diabetes should work closely with their healthcare team to develop a personalized management plan that includes dietary changes, increased physical activity, and possibly medication if necessary. The goal is to achieve and maintain blood sugar levels within the normal range, thereby reducing the risk of complications associated with diabetes.

In conclusion, managing blood sugar levels effectively requires a multifaceted approach that includes lifestyle changes, regular monitoring, and, when appropriate, medication. It is essential to maintain open communication with your healthcare provider to tailor a management plan that best suits your individual needs and circumstances. If you have further questions or concerns, please do not hesitate to reach out.

Best regards,
Doctor Q&A Teams

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