Diabetes Risk: Managing Family History and Lifestyle Choices

Diabetes issues

Both parents have diabetes, and both sisters have also been diagnosed with diabetes.
Therefore, there is a regular habit of exercising and maintaining a light diet.
Recently, due to frequent feelings of hunger, a visit was made to the hospital's metabolic department.
Blood tests showed a fasting blood glucose level of 114 mg/dL and a hemoglobin A1c of 5.8%.
The doctor advised annual follow-up examinations.
I would like to ask the physician: 1.
Given the regular attention to exercise and diet, can these test results be interpreted as indicative of being a diabetic but well-controlled? 2.
With almost daily activities such as walking, hiking, or cycling, and a diet primarily consisting of light meals and brown rice, what additional efforts can be made? 3.
Since I drink 500cc of plain water every morning upon waking, and did the same on the day of the blood test, could this affect the test results and cause discrepancies? Thank you!

murasima, 60~69 year old female. Ask Date: 2020/08/19

Dr. Li Jian reply Internal Medicine

1.
A hemoglobin A1c level of 5.8% can be diagnosed as prediabetes.

2.
Taiwanese people often consume too much fruit, leading to elevated blood sugar levels; it is important to be cautious about excessive fruit intake.

3.
Blood tests should be done after an absolute fasting period of eight hours, and drinking 500 milliliters of water is not recommended.

Reply Date: 2020/08/19

More Info

Understanding your risk for diabetes, especially with a family history, is crucial for maintaining your health. Given that both of your parents and two sisters have been diagnosed with diabetes, you are indeed at a higher risk of developing the condition yourself. The statistics indicate that if both parents have diabetes, the risk for their children can be as high as 40-50%. However, it's important to note that genetics is just one piece of the puzzle. Lifestyle factors such as diet, exercise, and weight management play a significant role in determining whether or not you will develop diabetes.

1. Interpreting Your Blood Sugar Levels: Your fasting blood sugar level of 114 mg/dL and HbA1c of 5.8% suggest that you are on the borderline of prediabetes. While these numbers are not yet in the diabetic range, they indicate that your blood sugar levels are higher than normal. The American Diabetes Association defines normal fasting blood sugar as less than 100 mg/dL, and prediabetes is diagnosed when fasting blood sugar is between 100-125 mg/dL. An HbA1c of 5.7% to 6.4% is considered prediabetes. Therefore, while you are not classified as diabetic, your results indicate that you are at risk and should continue to monitor your health closely.

2. Lifestyle Modifications: It’s commendable that you are already engaging in regular physical activity and maintaining a healthy diet. However, there is always room for improvement. Here are some suggestions:
- Increase Exercise Intensity: If you are currently walking or cycling, consider incorporating more vigorous activities or strength training into your routine. Aim for at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous activity each week, along with muscle-strengthening activities on two or more days a week.

- Dietary Adjustments: While you are already consuming a diet rich in whole grains like brown rice, consider further reducing your intake of refined carbohydrates and sugars. Focus on incorporating more non-starchy vegetables, lean proteins, and healthy fats. Monitoring portion sizes can also help manage your caloric intake.

- Regular Monitoring: Since you have a family history of diabetes, regular monitoring of your blood sugar levels is essential. Follow your healthcare provider's recommendations for follow-up tests and screenings.

3. Impact of Water Intake on Blood Tests: Drinking water before a blood test generally does not affect the results of fasting blood sugar tests. Staying hydrated is important, and drinking water can help facilitate the blood draw. However, it is advisable to avoid any food or drink other than water for at least 8 hours before a fasting blood test to ensure the most accurate results. If you are concerned about your water intake affecting your test results, you can always consult with your healthcare provider for specific guidance.

In summary, while your current lifestyle choices are commendable and have likely helped you maintain your blood sugar levels within a manageable range, it is crucial to remain vigilant given your family history. Continue to engage in regular physical activity, monitor your diet closely, and keep up with your medical check-ups. Early intervention and lifestyle modifications can significantly reduce your risk of developing diabetes in the future. Remember, managing stress and ensuring adequate sleep are also important components of a healthy lifestyle that can contribute to better metabolic health.

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