Prediabetes Diagnosis After Post-Meal Blood Sugar Test

Q: Prediabetes Diagnosis After Post-Meal Blood Sugar Test

Glycated hemoglobin (HbA1c)： A level of 5.8% is sufficient to diagnose prediabetes. <br>HbA1c can be tested after meals, and a follow-up test can be conducted in three months.

Regarding the postprandial blood glucose test results in the United States indicating prediabetes?

Hello Dr.
Lee,
I am approximately 169 cm tall and weighed 67.5 kg at the time of my examination on July 28.
I have a history of ankylosing spondylitis (diagnosed in 2008) and am a carrier of hepatitis B (with ALT at 16 units and AST at 14 units during this examination, both within normal range; I also had an ultrasound three years ago).
Regarding my family history, both my paternal grandfather and father have diabetes.
I do not smoke or drink alcohol.

After returning to the United States from Taiwan at the end of July, I experienced symptoms such as palpitations, frequent urination, difficulty urinating, and genital heat and pain.
Consequently, I visited a local internist for an initial diagnosis and underwent blood and urine tests.
I later consulted a urologist, who performed a resting electrocardiogram and a 48-hour Holter monitor; my heart was determined to have no significant issues, only an incomplete right bundle branch block (RBBB), which the doctor indicated has little clinical significance.

In terms of urology, a CT scan showed no abnormalities, but urine tests and a prostate examination indicated a non-bacterial infection, for which I was prescribed a month of antibiotics.
I have completed the course and currently have no symptoms.

Regarding my blood tests, I was not informed to fast prior to the tests on July 28, so I had breakfast between 8 and 9 AM, and my blood was drawn around 11:40 AM (2-3 hours post-meal).
The results indicated elevated levels of glycated hemoglobin and total cholesterol, as well as low-density lipoprotein (LDL) cholesterol.
The doctor informed me that I am in the prediabetic stage and advised me to monitor my cholesterol levels, increase hydration, exercise more, and be cautious with my diet and sugar intake.
I have actively adjusted my diet and increased my physical activity, and my weight has decreased to 64.5 kg from 67.5 kg.
The doctor has advised me to return for follow-up tests in December.

Given my family history of diabetes, I am aware of the need to closely monitor these abnormal values.
However, I would like to inquire whether the blood glucose test results taken 2-3 hours after a meal confirm that I am in the prediabetic stage.
Thank you, doctor!
Relevant data details:
Blood glucose test results:
- Hemoglobin A1C HPLC Bld QN (Glycated Hemoglobin): 5.8% (high) (reference range: 4.0% - 5.6% mg/dL)
- Estimated Average Glucose mg/dL: 120 mg/dL (high) (reference range: <= 114 mg/dL)
- Estimated Average Glucose mmol/L: 6.65 mmol/L (high) (reference range: <= 6.30 mmol/L)
- Glucose (urine): Normal mg/dL
- Ketones (urine): Negative mg/dL
Cholesterol test results:
- Cholesterol SerPl QN: 214 mg/dL (high) (reference range: <= 200 mg/dL)
- Triglyceride SerPl QN: 78 mg/dL (reference range: 0 - 150 mg/dL)
- HDL SerPl QN: 44 mg/dL (reference range: >= 40 mg/dL)
- LDL Calculated QN: 154 mg/dL (high) (reference range: 0 - 100 mg/dL)

Jeff, 30~39 year old female. Ask Date: 2021/10/04

Dr. Li Jian reply Internal Medicine

Glycated hemoglobin (HbA1c): A level of 5.8% is sufficient to diagnose prediabetes.
HbA1c can be tested after meals, and a follow-up test can be conducted in three months.

Reply Date: 2021/10/04

More Info

Based on the information provided, it appears that you have undergone a series of blood tests that indicate you are in the prediabetes range, particularly highlighted by your Hemoglobin A1C (HbA1c) level of 5.8%. According to the American Diabetes Association (ADA), an HbA1c level of 5.7% to 6.4% is classified as prediabetes, while a level of 6.5% or higher indicates diabetes. Your results suggest that you are indeed at risk for developing diabetes, especially considering your family history of the disease.

Your estimated average glucose level of 120 mg/dL also supports this diagnosis, as it is above the normal range. The normal fasting blood glucose level is less than 100 mg/dL, and levels between 100 mg/dL and 125 mg/dL indicate impaired fasting glucose, which is another form of prediabetes. Since your blood glucose was measured 2-3 hours after a meal, it is important to note that postprandial (after meal) glucose levels can vary significantly based on the meal consumed. However, a post-meal glucose level of 140 mg/dL or higher is considered indicative of diabetes.

In your case, the combination of your HbA1c level and the estimated average glucose suggests that you are indeed in the prediabetes range. This is a critical stage where lifestyle changes can significantly impact your health outcomes. The fact that you have already begun to adjust your diet and increase your physical activity is commendable and can help reverse the trend towards diabetes.

Regarding your cholesterol levels, your total cholesterol of 214 mg/dL and LDL (low-density lipoprotein) of 154 mg/dL are both elevated. High LDL cholesterol is a risk factor for cardiovascular disease, and it is important to manage these levels alongside your blood sugar. Lifestyle modifications, including a heart-healthy diet, regular exercise, and possibly medication, may be necessary to address these issues.

Given your family history of diabetes, it is crucial to maintain regular check-ups with your healthcare provider. They can monitor your blood sugar levels, cholesterol, and overall health, and provide guidance tailored to your specific situation. It is also advisable to discuss any symptoms you experience, such as heart palpitations or urinary issues, as these could be related to your overall metabolic health.

In summary, your test results indicate that you are in the prediabetes range, and it is essential to continue your efforts in lifestyle modification. Regular follow-ups with your healthcare provider will be key in managing your health and preventing the progression to type 2 diabetes. Keep up the good work with your diet and exercise, and stay proactive about your health!

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