Blood Sugar Concerns: Am I at Risk for Prediabetes?

Regarding blood sugar?

Hello, doctor.
I have some concerns about my health.
Over the past six months, I have seen doctors more than twenty times, and although nothing has been diagnosed, I am always worried about my health.
I find it difficult to distinguish whether my concerns are just anxiety or if there is a real issue with my body.
Recently, I have been worried about my blood sugar levels and fear that I may be in the prediabetes stage.
I keep thinking about my fasting blood sugar level of 99 from four months ago, and I'm anxious that I might already be in the prediabetes range since the number is so close.
Here is some information for your reference: (1) Three years ago, my fasting blood sugar was 85.
(2) There is no history of diabetes in my immediate family.
(3) During my sophomore year in college, I occasionally bought drinks (sugar-free or lightly sweetened) about every 3 to 4 days.
(4) I walk for at least 30 minutes every day (since middle school).
(5) On the day I received my report (four days after blood and urine tests), the paper results were not yet available, so I don't know if my hemoglobin A1c was tested.
However, I specifically mentioned my concerns about diabetes to my doctor, who said he would also check my liver and kidney function.
He only mentioned that my values were normal, including the fasting blood sugar of 99.
When he saw that I was still anxious, he asked if I had eaten, and I replied that I had consumed 290 ml of unsweetened oat milk an hour prior.
He said that was fine and suggested a postprandial test (which came back at 104).
He reassured me that this was normal, but upon reflection, I realized that it was only about 40 minutes after eating, not the hour I initially stated.
I have been regretting that I misspoke.
Just the day before, I reviewed my kidney report (as I was worried about my kidneys last week), and I shared my situation with my doctor.
He said that everything was actually fine, and that a level of 104 indicates that my fasting blood sugar is not high.
He explained that the value would be higher closer to the time of consumption.
He advised that if I am concerned, I should have my blood sugar checked annually as part of my routine check-ups.
I am unsure if I am in the prediabetes stage or if this is just my panic.
Thank you, doctor, for reading all of this.

xuesheng, 20~29 year old female. Ask Date: 2020/08/21

Dr. Wu Shuyu reply Urology

Please schedule a follow-up examination in the outpatient clinic.

Reply Date: 2020/08/21

More Info

Based on the information you've provided, it seems you have valid concerns about your blood sugar levels and the potential risk of prediabetes. Let's break down your situation and clarify some key points regarding blood sugar management and diabetes risk assessment.

1. Understanding Blood Sugar Levels: Your recent fasting blood sugar level of 99 mg/dL is indeed within the normal range, but it is close to the upper limit. According to the American Diabetes Association (ADA), a fasting blood sugar level between 100 and 125 mg/dL is classified as "impaired fasting glucose," which is a precursor to prediabetes. However, your previous fasting level of 85 mg/dL indicates that you have not consistently been in this range.

2. Family History and Lifestyle Factors: You mentioned that there is no family history of diabetes, which is a positive factor. Lifestyle choices play a significant role in diabetes risk. Regular physical activity, such as your daily 30-minute walks, is beneficial for maintaining healthy blood sugar levels. Additionally, your occasional consumption of low-sugar beverages suggests that you are mindful of your dietary choices.

3. The Role of HbA1c: You noted that you are unsure if your HbA1c (glycated hemoglobin) was tested during your last visit. The HbA1c test provides an average of your blood sugar levels over the past two to three months. An HbA1c level of 5.7% to 6.4% indicates prediabetes, while a level of 6.5% or higher suggests diabetes. If you have not had this test, it would be wise to request it during your next check-up, as it can provide a clearer picture of your blood sugar control over time.

4. Postprandial Blood Sugar Levels: After consuming your unsweetened oat milk, your postprandial (after meal) blood sugar level was 104 mg/dL. This is also within the normal range, as the ADA suggests that a postprandial blood sugar level should be less than 140 mg/dL two hours after eating. However, it is important to note that the timing of your blood draw after eating can affect the results, so it’s best to follow your doctor's instructions regarding fasting and post-meal testing.

5. Anxiety and Health Concerns: It is common to feel anxious about health issues, especially when you are experiencing symptoms or have concerns about conditions like diabetes. It is important to differentiate between genuine health concerns and anxiety. Keeping a regular check on your blood sugar levels and maintaining a healthy lifestyle can help alleviate some of this anxiety.
6. Regular Monitoring: Given your concerns, it would be beneficial to continue regular health check-ups, including annual blood tests to monitor your blood sugar levels and HbA1c. This proactive approach can help you stay informed about your health status and make necessary lifestyle adjustments.

In conclusion, while your current blood sugar levels are within the normal range, it is wise to remain vigilant and monitor your health. Requesting an HbA1c test during your next visit can provide further insight into your risk for prediabetes. Continue your healthy habits, and don't hesitate to discuss your concerns with your healthcare provider for personalized advice and reassurance.

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