Am I at Risk for Prediabetes? Blood Sugar Levels and Health

Afraid of developing diabetes?

Hello Doctor, let me describe my situation: Three years ago during a physical examination, my fasting blood glucose was 85 mg/dL, with no signs of diabetes, and everything else was normal.
I had a military physical examination in the summer, which did not include a blood glucose test (I had my blood drawn 2-3 hours after a meal).
Four months ago, I experienced a recurrence of kidney issues and, worried about diabetes, I went to see a doctor.
The next day, he ordered a fasting blood test (including liver and kidney function tests), and I had gained two kilograms compared to six months ago.
Four days later, when reviewing the report, the printed results were not yet available, so I didn't know if he had tested for HbA1c (but I specifically mentioned my concern about diabetes, so I assumed he would have tested it).
He told me that all values were normal: fasting glucose was 99 mg/dL, liver and kidney functions were normal, and there was no glucose in my urine (the second urine after waking up).
He noticed my anxiety and asked if I had eaten; I replied that I had a 350 ml unsweetened oat milk about an hour ago.
He said that one hour is acceptable and suggested I do a postprandial test (though I realized it had only been about 40 minutes, which made me a bit worried about the 20-minute discrepancy).
The result was 104 mg/dL, and the doctor said it was normal.

To add context: (1) There is no family history of diabetes (at least none that has been discovered so far).
(2) I am 21 years old, with a BMI of 20, and I eat out often (as a university student).
Sometimes I go to bed late, around 2-3 AM, but generally, I sleep around 11 PM to midnight.
(3) I tend to feel thirstier after large meals (which I have noticed for a long time).
(4) I walk at least 30 minutes every day.
Today, I went to see the doctor (because I was worried about kidney disease last week and got checked).
I asked him if my situation indicated prediabetes, and he did not think so.
He suggested that if I was very concerned, I could have an annual check-up.
I mentioned the 20-minute discrepancy to him, and he thought it was not a significant issue, stating that a blood glucose level at 40 minutes might actually be higher than at 60 minutes, and that 104 mg/dL indicated my fasting blood glucose was not high before drinking.
On my way home, I kept getting stuck in my thoughts: "Is a fasting level of 99 mg/dL dangerous? Am I close to prediabetes?" I don't know if I should feel relieved.
The thought of possibly being close to prediabetes makes me very anxious.
I also recalled that during my sophomore year, I sometimes had bread as a late-night snack around 10 PM and occasionally drank beverages (with a little sugar), and I feel like I have been indulgent, which seems to increase my risk of diabetes.
Am I in the prediabetes stage?

Dàxuéshēng, 20~29 year old female. Ask Date: 2020/08/20

Dr. He Dongjin reply Cardiology

Hello, I see that there is no issue; you are still far from prediabetes.
My own data is even higher than yours, so there's no need to worry.
Just maintain regular exercise and a stable routine, and you will be fine.
I pray for you, and Changhua Hospital cares about you.

Reply Date: 2020/08/20

More Info

Based on the information you've provided, it appears that you are currently not at significant risk for prediabetes, but there are some factors worth considering for your overall health and future monitoring.

Understanding Your Blood Sugar Levels
1. Fasting Blood Sugar: Your fasting blood sugar level of 99 mg/dL is within the normal range, but it is on the higher end. According to the American Diabetes Association (ADA), a fasting blood sugar level of 100-125 mg/dL is classified as "prediabetes." Therefore, while you are not classified as prediabetic yet, you are close to that threshold.

2. Postprandial Blood Sugar: Your post-meal blood sugar level of 104 mg/dL is also within the normal range. The ADA defines a normal postprandial blood sugar level (measured two hours after eating) as less than 140 mg/dL. Therefore, your reading suggests that your body is managing blood sugar levels effectively after meals.

3. Glycated Hemoglobin (HbA1c): Although you did not mention your HbA1c level, it is a crucial marker for assessing long-term blood sugar control. An HbA1c level of 5.7% to 6.4% indicates prediabetes, while a level of 6.5% or higher indicates diabetes. If you have not had this test recently, it may be beneficial to request it during your next check-up.

Lifestyle Factors
1. Diet and Eating Habits: You mentioned that you sometimes indulge in late-night snacks and sugary drinks. While these habits can contribute to weight gain and increased blood sugar levels, moderation is key. Maintaining a balanced diet rich in whole grains, fruits, vegetables, lean proteins, and healthy fats can help manage blood sugar levels.

2. Physical Activity: You are already engaging in regular physical activity, which is excellent. The ADA recommends at least 150 minutes of moderate-intensity aerobic activity per week. Regular exercise helps improve insulin sensitivity and can lower blood sugar levels.

3. Sleep Patterns: You mentioned occasionally staying up late. Poor sleep can affect insulin sensitivity and blood sugar levels. Aim for 7-9 hours of quality sleep per night to support overall health.

Family History and Other Considerations
You noted that there is no family history of diabetes, which is a positive factor. Genetics can play a role in diabetes risk, but lifestyle choices are often more influential.

Recommendations
1. Regular Monitoring: Since you have some concerns about your blood sugar levels, it would be wise to continue monitoring them regularly. Consider having your HbA1c checked annually, along with fasting and postprandial blood sugar tests.

2. Consult a Healthcare Provider: If you continue to feel anxious about your risk for diabetes, consider discussing your concerns with a healthcare provider. They can provide personalized advice and may suggest further testing if necessary.

3. Healthy Lifestyle Choices: Focus on maintaining a balanced diet, regular physical activity, and good sleep hygiene. These lifestyle changes can significantly reduce your risk of developing prediabetes or diabetes in the future.

In conclusion, while you are not currently classified as prediabetic, it is essential to remain vigilant about your health. By adopting healthy habits and monitoring your blood sugar levels, you can significantly reduce your risk of developing diabetes.

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