Blood Sugar Levels: Managing Pre-Diabetes and Dietary Choices

Blood sugar issues

Hello, doctor.
I often drink bubble tea, sometimes up to two cups of lightly sweetened beverages in a day.
A urine test showed some sugar in my urine, so my nephrologist ordered a blood test.
My fasting blood glucose was 102, and my hemoglobin A1c was around 5.5 (I can't remember the exact number, but I asked the doctor if it was within the normal range, and he said it was!).
The doctor mentioned that it was okay and that there might not be any significant issues, possibly indicating prediabetes or being close to it.
He advised me to control my diet, suggesting that the sugar in my urine could be due to consuming sugary drinks before the test.
Currently, he recommended a similar approach to physical therapy (diet control and increased exercise).
The doctor also mentioned that my metabolism might be abnormal, so I should be cautious.

After that test, I completely avoided sugary drinks for two weeks and only drank plain water.
My diet was normal without strict restrictions.
However, tonight, while dining out with friends, I ordered a lightly sweetened drink.
I checked online and found that even lightly sweetened drinks can contain nearly the equivalent of 10 sugar cubes.
I realized I forgot to control my sugar intake, so I didn't finish the drink and discarded it.
I stopped drinking around 10 PM, and about two hours later, at 12:30 AM, I measured my blood sugar at home, which was 132.

Doctor, I have a few questions:
1.
Since I drank the beverage, should this blood sugar measurement be classified as a postprandial blood glucose test, given that I consumed sugar?
2.
If the answer to the first question is yes, I exceeded the two-hour mark slightly.
Is the reading of 132 still accurate? Is it considered too high?
3.
I had a fasting blood glucose of 102 about two years ago, and I have frequently consumed sugary drinks since then.
Does this mean my condition hasn't worsened? I don't intend to take this lightly; I plan to start controlling my intake now.
4.
If I begin to avoid sugary drinks (the doctor suggested that if I can't control it, I can start with unsweetened options and gradually adjust), and since I can't control my diet too much because I love food, along with increased exercise, do I have a chance of returning to normal glucose levels?
I apologize for the many questions, and thank you for your help!

005, 20~29 year old female. Ask Date: 2019/01/10

Dr. Chen Shunfu reply Internal Medicine

Thank you for your question! Long-term consumption of sugary beverages can increase the risk of diabetes, so it is advisable to reduce intake.
The sugar content in each serving of sugary drinks is not fixed, which is why the current international standard for assessment is the oral glucose tolerance test.
After consuming 75 grams of anhydrous glucose powder, blood glucose levels are measured two hours later.
A normal result is less than 140 mg/dL, while a level greater than 200 mg/dL may indicate diabetes.
Chiayi Hospital cares about your health!

Reply Date: 2019/01/10

More Info

Managing blood sugar levels is crucial, especially for individuals at risk of pre-diabetes or diabetes. Based on your recent experiences and test results, let's break down your situation and provide some guidance on how to manage your blood sugar effectively.

1. Understanding Blood Sugar Measurements: When you consumed a sugary drink and then measured your blood sugar two hours later, that reading of 132 mg/dL can indeed be classified as a postprandial (after eating) blood sugar level. Typically, for a healthy individual, blood sugar levels should be below 140 mg/dL two hours after eating. Your reading is slightly elevated, which could indicate that your body is struggling to manage glucose effectively, especially considering your previous fasting blood sugar of 102 mg/dL, which is already at the upper limit of normal.

2. Accuracy of Blood Sugar Readings: The timing of your blood sugar measurement is important. Since you measured your blood sugar approximately two hours after consuming the drink, the reading of 132 mg/dL is relevant. While it is slightly above the normal range, it is not excessively high. However, it does suggest that your body may not be processing sugar as efficiently as it should, which is a concern for someone with a history of elevated blood sugar levels.

3. Long-term Trends: Given that your fasting blood sugar was 102 mg/dL two years ago and you have continued to consume sugary drinks, it is a positive sign that your levels have not worsened significantly. However, this does not mean you should be complacent. The goal is to prevent any progression towards diabetes, and maintaining or improving your current levels is essential.

4. Dietary Changes and Exercise: It is commendable that you have recognized the need to cut back on sugary drinks. Transitioning to unsweetened beverages is a great first step. Additionally, incorporating more whole foods, such as vegetables, whole grains, and lean proteins, can help stabilize your blood sugar levels. While you mentioned that controlling your diet is challenging due to your love for food, consider focusing on portion control and making healthier substitutions rather than completely restricting your favorite foods.
Regular physical activity is also vital. Aim for at least 150 minutes of moderate aerobic exercise each week, such as brisk walking, cycling, or swimming. Exercise helps improve insulin sensitivity, which can aid in better blood sugar control.

5. Monitoring and Follow-Up: Regular monitoring of your blood sugar levels is crucial. You might want to keep a log of your blood sugar readings, dietary intake, and physical activity. This can help you identify patterns and make necessary adjustments. Additionally, follow up with your healthcare provider regularly to monitor your blood sugar levels and discuss any concerns.

6. Potential for Improvement: With consistent efforts in dietary management and increased physical activity, there is a good chance that you can improve your blood sugar levels and potentially return to a normal range. Many individuals in pre-diabetic states have successfully reversed their condition through lifestyle changes.

In summary, while your current blood sugar levels indicate a need for caution, you have the opportunity to make positive changes. By reducing your intake of sugary beverages, focusing on a balanced diet, and increasing your physical activity, you can work towards better blood sugar management and overall health. Remember, small, sustainable changes can lead to significant improvements over time. If you have any further questions or need personalized advice, don't hesitate to reach out to your healthcare provider.

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