HbA1c Levels: Can You Reverse Prediabetes?

The glycated hemoglobin (HbA1c) level is 6.2?

The hospital measured my hemoglobin A1c at 6.2.
After three months of dietary control, my hemoglobin A1c was measured at 5.9.
No one in my family has diabetes, but I have gained a lot of weight due to taking medication for bipolar disorder.
I am 179 cm tall and weigh 95 kg.
Doctor, has my pancreatic function been impaired? I am currently afraid to eat anything every day.
Is it possible for my condition to be reversible, allowing me to eat freely like a healthy person? I am very scared, and I also have hypertension, hyperlipidemia, and hyperglycemia.

Weiwei, 30~39 year old female. Ask Date: 2018/10/02

Dr. Chen Shunfu reply Internal Medicine

Congratulations! Your hemoglobin A1c has decreased from 6.2% to 5.9% after three months of dietary control.
Based on your height of 179 cm and weight of 95 kg, your BMI is calculated to be 29.6, which indicates obesity.
The medication Depakine (valproate) that you are taking can indeed lead to increased appetite and weight gain.
Although your hemoglobin A1c has dropped from 6.2% to 5.9%, you are still in the prediabetes stage.
If your hemoglobin A1c rises to 6.5% or higher, it can be diagnosed as diabetes, at which point pancreatic insulin secretion will be compromised by more than half.
It is recommended that you adopt proper dietary control and lifestyle adjustments, and develop a good exercise habit (such as exercising 3 to 5 times a week for 40 minutes each session).
I believe this will greatly help in managing your conditions related to hypertension, hyperglycemia, and hyperlipidemia.

Reply Date: 2018/10/02

More Info

Understanding HbA1c levels is crucial for managing your health, especially when it comes to prediabetes and diabetes. Your recent HbA1c levels of 6.2% and then 5.9% indicate that you are on the cusp of normal blood sugar levels, but you are not yet in the diabetic range. An HbA1c of 5.7% to 6.4% is classified as prediabetes, while levels of 6.5% or higher indicate diabetes.
The fact that you have managed to lower your HbA1c from 6.2% to 5.9% over three months is a positive sign and suggests that you are taking steps in the right direction. This reduction indicates that your blood sugar levels have improved, likely due to dietary changes and possibly increased physical activity. It is essential to continue monitoring your HbA1c levels regularly, as they provide an average of your blood sugar levels over the past two to three months.

Regarding your concerns about pancreatic function, it is important to understand that the pancreas produces insulin, which helps regulate blood sugar levels. If you are experiencing high blood sugar levels, it may indicate that your pancreas is not producing enough insulin or that your body is becoming resistant to insulin. However, since your HbA1c levels are trending downwards, it suggests that your pancreas is still functioning adequately, at least for now.
Your weight of 95 kg at a height of 179 cm gives you a Body Mass Index (BMI) of approximately 29.7, which classifies you as overweight. Being overweight is a significant risk factor for developing insulin resistance and type 2 diabetes. However, weight loss can significantly improve insulin sensitivity and help reverse prediabetes. Even a modest weight loss of 5-10% of your body weight can lead to substantial health benefits, including improved blood sugar control.

You mentioned that you have "三高" (three highs), which typically refers to high blood pressure, high cholesterol, and high blood sugar. Managing these conditions is crucial for your overall health and can help reduce the risk of complications associated with diabetes and cardiovascular diseases. It is essential to work closely with your healthcare provider to develop a comprehensive plan that includes dietary changes, physical activity, and possibly medication if necessary.

As for your fear of eating, it is vital to maintain a balanced diet rather than restricting yourself excessively. While it is understandable to be cautious about food intake, especially with a history of mood disorders like bipolar disorder, it is essential to nourish your body adequately. Focus on whole foods, such as fruits, vegetables, whole grains, lean proteins, and healthy fats. Avoid processed foods high in sugar and unhealthy fats, as these can spike your blood sugar levels.

In conclusion, your condition is potentially reversible with lifestyle changes. You can work towards achieving a healthier weight, improving your diet, and increasing physical activity. Regular follow-ups with your healthcare provider will help monitor your progress and make necessary adjustments to your management plan. Remember, it is possible to lead a healthy life and enjoy food without fear, as long as you make informed choices and maintain a balanced approach.

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