Prediabetes: Causes, Management, and Lifestyle Changes - Internal Medicine

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Understanding prediabetes is crucial for managing your health effectively, especially given your recent lab results and lifestyle changes. Prediabetes is a condition where blood sugar levels are higher than normal but not yet high enough to be classified as diabetes. Your fasting blood sugar of 96 mg/dL and HbA1c of 5.7% indicate that you are indeed in the prediabetic range.

1. Causes of Elevated Blood Sugar
Your question about whether your carbohydrate intake, particularly from pasta, or stress could be contributing to your elevated blood sugar levels is valid. High carbohydrate consumption can lead to spikes in blood sugar, especially if those carbohydrates are refined or processed. However, your overall diet seems to have improved significantly since you have reduced your intake of fried foods, spicy foods, and sugary drinks.
Stress can also play a significant role in blood sugar regulation. When you experience stress, your body releases hormones like cortisol and adrenaline, which can increase blood sugar levels. Given that you've mentioned experiencing anxiety and various health issues, it is possible that stress could be impacting your blood sugar levels.

2. Weight Loss and Blood Sugar
Regarding your weight loss, it is important to note that unintentional weight loss can sometimes be a sign of underlying health issues, including diabetes. However, in your case, it seems more likely that your weight loss is related to your dietary changes and possibly stress. Since you have a history of poor nutrient absorption, it may also be contributing to your weight loss.

3. Medication and Management
Your healthcare provider's recommendation to manage your prediabetes through lifestyle changes rather than medication is common, especially for individuals who are not overweight. Many people with prediabetes can effectively reverse their condition through diet, exercise, and weight management. It’s understandable to be concerned about the long-term use of medication, and lifestyle changes can often be a more sustainable approach.


4. Referral to a Specialist
Whether or not you should see an endocrinologist or a metabolic specialist depends on your ongoing symptoms and how well you manage your prediabetes. If you continue to experience significant health issues or if your blood sugar levels do not improve with lifestyle changes, a referral may be beneficial. However, regular follow-ups with your primary care physician every six months can also be sufficient for monitoring your condition.


5. Weight Management
Your concern about being underweight and whether you need to lose more weight is important. In general, weight loss is recommended for those who are overweight or obese to help manage blood sugar levels. However, since you are already underweight, the focus should be on maintaining a healthy weight rather than losing more. It may be beneficial to consult with a nutritionist who can help you create a balanced meal plan that supports weight gain while managing your blood sugar levels.


6. Timing of Exercise
As for your question about exercising before or after meals, both can be beneficial. Exercising before meals can help lower blood sugar levels, while post-meal exercise can aid in glucose uptake by the muscles, helping to stabilize blood sugar levels. Your routine of drinking oat milk before exercising and then consuming a boiled egg or steamed vegetables afterward seems appropriate.

Conclusion
In summary, managing prediabetes involves a multifaceted approach that includes dietary modifications, regular physical activity, stress management, and regular monitoring of blood sugar levels. Your proactive steps towards improving your health are commendable, and it’s essential to continue these efforts. If you have ongoing concerns or if your symptoms persist, don’t hesitate to reach out to your healthcare provider for further evaluation and guidance.