Blood Sugar Levels: Are You at Risk for Diabetes?

Glycated hemoglobin (HbA1c) and fasting blood glucose levels are used to diagnose diabetes?

Hello Doctor, I would like to ask you a few questions: I had a diabetes test done a year ago on August 2020, where my fasting blood glucose was 83 mg/dL and my hemoglobin A1c was 5.61%.
I have no history of diabetes, and there is no family history of diabetes either.
I would like to know how often diabetes testing should be done? 2.
In March 2021, I went to the emergency room due to acute gastroenteritis in the middle of the night.
At that time, I was not completely fasting and experienced symptoms such as diarrhea, vomiting, and abdominal bloating.
The hospital tested my fasting blood glucose, which was 102 mg/dL.
Does this indicate prediabetes? 3.
With a hemoglobin A1c of 5.6%, which is close to the prediabetes threshold of 5.7%, should I be particularly concerned?

Xiao Zhen, 20~29 year old female. Ask Date: 2021/08/04

Dr. Huang Hongshuo reply Family Medicine

The reference upper limit for fasting blood glucose is 99 mg/dL, while the upper limit for blood glucose two hours after a meal is 139 mg/dL.
Hemoglobin A1c, often referred to as average blood glucose, has an upper limit of 5.6%.
The range for elevated fasting blood glucose is 100-125 mg/dL, and the range for elevated blood glucose two hours after a meal is 140-199 mg/dL.
The elevated range for hemoglobin A1c is 5.7-6.4%.
Currently, the diagnosis of diabetes is typically made when hemoglobin A1c reaches 6.5% or higher.
Additionally, if blood glucose levels reach 200 mg/dL or higher on two occasions and there are common symptoms of diabetes such as dry mouth, increased hunger, frequent urination, dehydration, decreased energy, and fatigue, a diagnosis can also be made.
A confirmed fasting blood glucose level of 126 mg/dL or higher can also lead to a diagnosis, but it is usually assessed alongside the other two values.
Your current status indicates that you do not have diabetes.
However, during acute illnesses such as colds, gastroenteritis, or pain, or during times of stress, sudden consumption of high-sugar, high-starch, and high-calorie foods can cause fluctuations in blood glucose levels.
It is advisable to minimize these situations and develop regular habits for sleep, exercise, and eating, as well as to drink plenty of water to avoid or delay the onset of diabetes.
If there is no family history of diabetes, that is certainly a positive factor, as diabetes has a significant familial association related to genetics and constitution.
However, within families, there may not be a common practice of regular health check-ups or awareness of each other's health status, so it is not guaranteed that there are no relatives with diabetes.
Even if there are family members with diabetes, following the aforementioned recommendations can help prevent or delay the onset of the disease.
Balanced nutrition is very important, and it is advisable to monitor your blood pressure and heart rate regularly.
An annual health check-up is recommended, including basic tests such as liver and kidney function, lipid levels, uric acid, and pre- and post-meal blood glucose levels.
Hemoglobin A1c is not commonly included in basic health check-ups, so it is advisable to have that tested as well.
If you are feeling unwell, in addition to searching for information online, please find a family medicine physician with whom you can establish a long-term consultation relationship.
If you need further information, please feel free to ask.
Thank you.

Reply Date: 2021/08/04

More Info

To assess your risk for diabetes based on your blood sugar levels and medical history, let's address your questions one by one.

1. Frequency of Diabetes Testing: The American Diabetes Association recommends that adults aged 45 and older should be screened for diabetes every three years. However, if you have risk factors such as obesity, a sedentary lifestyle, or a family history of diabetes, you may need to be tested more frequently. Given that you have no family history of diabetes and your previous tests have shown normal results, annual testing may not be necessary unless you develop risk factors or symptoms. In your case, since your last test was a year ago and showed normal results, you might consider repeating the test in another year unless you have any new symptoms or concerns.

2. Blood Sugar Levels and Pre-Diabetes: Your blood sugar level of 102 mg/dL, measured during an acute illness, is slightly elevated but does not necessarily indicate pre-diabetes. The criteria for diagnosing pre-diabetes include fasting blood sugar levels between 100 and 125 mg/dL or an HbA1c between 5.7% and 6.4%. Since your reading was taken during an episode of acute gastroenteritis, it may not accurately reflect your usual blood sugar levels. Stress, illness, and other factors can temporarily elevate blood sugar levels. Therefore, it would be prudent to monitor your blood sugar levels under normal circumstances to get a clearer picture of your metabolic health.

3. Concerns About HbA1c Levels: Your HbA1c of 5.6% is within the normal range, as values below 5.7% are considered normal. While it is close to the threshold for pre-diabetes, it is not a cause for alarm. It is essential to understand that HbA1c levels can fluctuate based on various factors, including diet, exercise, and overall health. Regular monitoring and maintaining a healthy lifestyle can help keep your HbA1c levels in check. If you notice any significant changes or if your HbA1c approaches 5.7% or higher in future tests, it would be wise to consult with your healthcare provider for further evaluation.

Additional Considerations: Given your previous normal blood sugar levels and the absence of diabetes in your family, you are currently at a low risk for developing diabetes. However, it is essential to maintain a healthy lifestyle, including a balanced diet, regular physical activity, and routine health check-ups. If you experience any symptoms such as increased thirst, frequent urination, or unexplained weight loss, you should seek medical advice promptly.

In summary, continue to monitor your health, maintain a healthy lifestyle, and consider retesting your blood sugar levels in a year or sooner if you have any concerns. If you have any further questions or symptoms, do not hesitate to reach out to your healthcare provider for personalized advice.

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