Managing High Fasting Blood Sugar with Normal HbA1c: A Guide - Family Medicine

Dr. Xiao Yongxun reply Family Medicine

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Dear Mr.
Peter:
1.
Generally speaking, a normal fasting plasma glucose level is less than 100 mg/dL.
If the level is between 100 mg/dL and 126 mg/dL, it can be considered as prediabetes or impaired fasting glucose.
Of course, if the fasting glucose is greater than or equal to 126 mg/dL, diabetes should be suspected.
2.
Your fasting glucose levels were 112, 104, and 100 mg/dL; however, your hemoglobin A1c levels are normal, which may indicate mild impaired fasting glucose.
This is often due to overeating recently or lack of exercise.
In fact, if there are family members with diabetes, individuals who are obese, those with a history of gestational diabetes, women who have given birth to infants weighing over 4 kg, individuals with hyperlipidemia, hypertension, unexplained weight loss, or wounds that do not heal easily, they all have an increased risk of diabetes.
If none of these apply to you, there is no need to panic.
Increasing physical activity, reducing the intake of refined foods, especially avoiding overeating and high glycemic index foods, getting enough sleep, and moderate weight loss can improve blood glucose levels.
Mild diabetes can improve to impaired glucose tolerance; impaired glucose tolerance can improve to normal.
This means that the development of diabetes is not an all-or-nothing phenomenon or something that happens suddenly; it is progressive.
Therefore, it is essential to consistently change lifestyle, dietary habits, and maintain regular exercise.
3.
You mentioned that you often feel hungry at midnight and sometimes drink unsweetened soy milk.
In fact, unsweetened soy milk also contains calories, and if consumed without burning off the calories, it may still affect your morning fasting glucose levels.
4.
Bitter melon peptides are considered a health supplement and are generally safe as long as they are not consumed in excess.
However, there is a lack of rigorous research reports on their effectiveness in controlling blood glucose levels, so high expectations should be avoided.
5.
Regarding practical measures for diabetes prevention, I personally recommend that you chew your food well during meals, avoid overeating (aim for 80% fullness), and limit high-calorie, high-fat, and high-sugar foods or beverages.
Reduce the intake of high-cholesterol and trans fats (often found in creamers, butter, ghee, instant coffee, milk tea, etc.) and high fructose corn syrup (commonly found in commercial beverages, desserts, sodas, pastries, etc.).
These types of foods may be harder for the body to metabolize, may contain calories without providing a sense of fullness, and can easily lead to elevated blood glucose levels.
On the other hand, develop a regular exercise routine, such as playing sports, jogging, swimming, or cycling.
In fact, taking a good walk for 30-60 minutes after each meal can be very effective.
In terms of daily living, avoid excessive stress and ensure sufficient sleep; this will reduce the secretion of related hyperglycemic hormones and increase the secretion of leptin, which helps with weight control.
Additionally, based on personal observation, it is advisable to avoid excessive cold drinks or ice water and to keep air conditioning at a moderate temperature, as this can lead to increased hunger and overeating.
6.
If you have further questions, please discuss them with your family physician for a decision, or visit the outpatient department of a regional hospital's metabolism clinic for medical care.

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Reply Date: 2021/07/27