Blood Sugar Levels and Acanthosis Nigricans: Key Insights - Family Medicine

Dr. Xiao Yongxun reply Family Medicine

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Dear Mr.
Zhou:
1) Could this indicate prediabetes? Generally, a normal fasting plasma glucose level is less than 100 mg/dL.
If it falls between 100 mg/dL and 126 mg/dL, it can be considered as prediabetes or impaired fasting glucose.
Of course, if the postprandial glucose level is greater than or equal to 126 mg/dL, diabetes should be suspected.
According to the American Diabetes Association's diagnostic criteria for diabetes: a.
Fasting plasma glucose level ≥126 mg/dL after fasting for 8 hours or more, b.
2-hour plasma glucose level ≥200 mg/dL during an oral glucose tolerance test, c.
HbA1c (glycated hemoglobin) ≥6.5% (must be confirmed with a method that is NGSP and DCCT certified), and any of the above a, b, or c must be confirmed on two separate occasions.
d.
Clinical symptoms of diabetes (such as polyuria, polydipsia, polyphagia, and unexplained weight loss) with any random plasma glucose level ≥200 mg/dL (this can be confirmed with just one test).
If the postprandial plasma glucose level is between 140 mg/dL and 199 mg/dL, it may indicate impaired glucose tolerance, currently referred to as "increased risk for diabetes," which is what was termed prediabetes in 2010.
To make this diagnosis, it is better to conduct a standard oral glucose tolerance test.
2) Is acanthosis nigricans a manifestation of prediabetes? Acanthosis nigricans is indeed associated with a higher likelihood of diabetes; however, it cannot be concluded that this individual will definitely develop diabetes in the future.
3) Will my anxiety and nervousness affect my blood sugar readings? Anxiety or nervousness can stimulate the sympathetic nervous system, potentially leading to elevated blood glucose levels; however, it is difficult to quantify this in medical research.
In practice, significant elevations are rarely observed.
4) When measuring blood sugar, does the fasting period start after finishing dinner and last until the next day’s measurement? Should it be controlled to around 8-10 hours for accuracy? (I have approximately a 14-hour gap; could fasting too long cause elevated blood sugar?) Theoretically, a fasting period of 8-10 hours is ideal, as this is when blood sugar is least influenced by food intake during basal metabolism.
Unless there are special circumstances, a fasting period of 14 hours should not cause elevated blood sugar.
5) Today, when I measured my blood sugar, the glucose meter indicated that the battery was low and needed replacement, but it still allowed me to measure my blood sugar.
Could this situation affect the accuracy of the readings? Theoretically, the backup power should last for a while; in future instances, it is advisable to replace the battery first.
6) Do anxiety, tension, and stress lead to elevated blood sugar levels? This is similar to question three.
7) Does drinking water during the 8-hour fasting period or before measurement affect the results? Unless a large amount of water is consumed, a small amount should not significantly affect the total body water content.
Additionally, regarding diabetes prevention measures, I personally recommend: chewing food thoroughly during meals, avoiding overeating (aim for about 80% fullness), and limiting high-calorie, high-fat, and high-sugar foods or beverages.
Reduce 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, and pastries).
These types of foods may be harder for the body to metabolize or may provide calories without a feeling of fullness, leading to increased blood sugar levels.
On the other hand, it is important to 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 have excellent effects.
In terms of lifestyle, it is essential to avoid excessive stress and ensure adequate sleep; this will help reduce the secretion of related hyperglycemic hormones and increase leptin secretion, aiding in weight control.

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Reply Date: 2022/04/30