Is a Fasting Blood Sugar of 131 a Sign of Diabetes?

A blood sugar level of 131 mg/dL does not necessarily indicate diabetes. According to the American Diabetes Association, a fasting blood sugar level of 126 mg/dL or higher is considered diagnostic for diabetes?

Hello Dr.
Lin,
My mother is 83 years old and was diagnosed with Parkinson's disease four years ago.
Since her diagnosis, she has been regularly visiting the clinic and taking her medication.
Currently, she has some ability to walk, but it is very slow.
She returned to the hospital for a routine check-up in early October, and today the report came back showing a fasting blood glucose level of 131 mg/dL and a hemoglobin A1c of 8.6%.
I am concerned whether this could be related to her long-term medication use.
Recently, she has been feeling cold and is reluctant to exercise.
Given the hospital report, I am worried that she may have diabetes, especially since her previous test results were normal.
If she is indeed diagnosed with diabetes, I would like to know what special considerations and dietary precautions she should take in addition to continuing her Parkinson's medication.
Thank you for taking the time to respond.
Cathy

Cathy, 50~59 year old female. Ask Date: 2018/10/29

Dr. Lin Wufu reply Internal Medicine

Hello! According to the current diagnostic criteria, since glycated hemoglobin (HbA1c) reflects the average blood glucose levels over the past three months, a value greater than 6.5% on one occasion is sufficient for a diabetes diagnosis.
Of course, considering your mother's situation, in addition to the primary diabetes (which is uncommon to develop in someone over eighty), it is important to be cautious of other causes of secondary hyperglycemia (such as infections, medications, etc.).
It is advisable to consult the physician who prescribed the Parkinson's medication (likely a neurologist) for further evaluation.
In addition to conducting further tests, general hospitals typically provide educational materials or activities related to diet and lifestyle for diabetes management!

Reply Date: 2018/10/29

More Info

Hello Cathy,
Thank you for reaching out with your concerns regarding your mother's health. Based on the information you've provided, a fasting blood sugar level of 131 mg/dL and a hemoglobin A1c (HbA1c) of 8.6% are indeed indicative of diabetes. According to the American Diabetes Association (ADA), a fasting blood sugar level of 126 mg/dL or higher on two separate tests is a criterion for diagnosing diabetes. Additionally, an HbA1c of 6.5% or higher also confirms a diagnosis of diabetes. Given that your mother's levels exceed these thresholds, it is reasonable to conclude that she has diabetes.

The fact that your mother has Parkinson's disease and is on medication may complicate her diabetes management. Some medications can affect blood sugar levels, either raising or lowering them, so it's essential to discuss her current medications with her healthcare provider to understand their potential impact on her blood sugar control.

As for managing diabetes, there are several lifestyle modifications and dietary considerations that can help maintain stable blood sugar levels:
1. Dietary Changes:
- Balanced Meals: Encourage a diet rich in whole grains, lean proteins, healthy fats, and plenty of fruits and vegetables. This can help manage blood sugar levels.

- Carbohydrate Counting: Understanding how carbohydrates affect blood sugar is crucial. It may be beneficial to work with a dietitian who can help create a meal plan tailored to her needs.

- Portion Control: Eating smaller, more frequent meals can help prevent spikes in blood sugar.

2. Physical Activity:
- Although your mother may have limited mobility due to Parkinson's, it's important to encourage some form of physical activity. Gentle exercises, such as walking or stretching, can help improve insulin sensitivity and overall health. Consult her healthcare provider for suitable exercise options.

3. Monitoring Blood Sugar Levels:
- Regular monitoring of blood sugar levels is essential for managing diabetes. This will help you understand how different foods and activities affect her blood sugar and allow for timely adjustments in her care.

4. Medication Management:
- If diabetes is confirmed, her doctor may prescribe medications to help control her blood sugar levels. It's crucial to follow the prescribed treatment plan and attend regular follow-ups to monitor her condition.

5. Education and Support:
- Educating yourself and your mother about diabetes management is vital. There are many resources available, including diabetes education programs, support groups, and online resources.

6. Regular Check-ups:
- Ensure that she continues to have regular check-ups with her healthcare provider to monitor her diabetes and Parkinson's disease. This will help in adjusting her treatment plan as needed.

7. Managing Other Health Conditions:
- Since your mother is also dealing with Parkinson's disease, it's important to manage her overall health. This includes monitoring for any complications that may arise from either condition.

In summary, your mother's fasting blood sugar of 131 mg/dL and HbA1c of 8.6% suggest that she has diabetes. It is crucial to work closely with her healthcare team to develop a comprehensive management plan that addresses both her diabetes and Parkinson's disease. With the right strategies in place, she can lead a healthy and fulfilling life.

If you have any further questions or concerns, please feel free to ask. Thank you for taking the time to care for your mother's health.

Best regards,
Doctor Q&A Teams

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