Managing Glucose Intolerance: Dietary Adjustments and Lifestyle Changes

Q: Managing Glucose Intolerance: Dietary Adjustments and Lifestyle Changes

1. <br>Clinical diagnostic criteria for diabetes： Hemoglobin A1c (HbA1c) ≥ 6.5%, fasting plasma glucose ≥ 126 mg/dL, 2-hour plasma glucose ≥ 200 mg/dL during an oral glucose tolerance test, or symptoms of hyperglycemia (including polyuria, polydipsia, and weight loss) with a rand

Glucose Tolerance Abnormality and Dietary Adjustments

Hello, doctor.
I am the person who asked about the elevated fasting blood glucose level (#189944).
Recently, my OGTT results came back with fasting: 911, 1-hour: 1822, 2-hour: 1263, and 3-hour: 61, indicating impaired glucose tolerance.
The physician mentioned not to worry too much because the high concentration of glucose solution used in the test is not reflective of my usual diet.
I have currently adjusted my diet as follows: for breakfast at 9:30, I eat 1 boiled egg and water; for lunch at 12:00, I have a light bento box (which consists mainly of vegetables and side dishes, specifically a less greasy type like Chishang bento), replacing white rice with about 100-150g of baked sweet potato; the main dish is 100g of pre-cooked chicken breast.
For dinner at 18:00, I cook at home, reducing the rice portion by 1/3 to 1/2 and substituting black brown rice for white rice, increasing the amount of vegetables.
After lunch and dinner, I go for a brisk walk for about 30 minutes.
On weekends, I increase my fitness activities to include 30 minutes of aerobic exercise and 30-40 minutes of weight training.
Is there any issue with this adjustment? Additionally, while sweet potatoes have a low GI value, they still contain a considerable amount of sugar.
Consuming a maximum of 150g daily should not be too much, right?

Niming, 20~29 year old female. Ask Date: 2022/12/20

Dr. Li Jian reply Internal Medicine

1.
Clinical diagnostic criteria for diabetes: Hemoglobin A1c (HbA1c) ≥ 6.5%, fasting plasma glucose ≥ 126 mg/dL, 2-hour plasma glucose ≥ 200 mg/dL during an oral glucose tolerance test, or symptoms of hyperglycemia (including polyuria, polydipsia, and weight loss) with a random plasma glucose ≥ 200 mg/dL.
The case does not fall within the diabetes range.

2.
Regarding abnormal glucose tolerance: Based on your blood glucose values: Fasting: 91 (normal), 1 hour: 182 (normal), 2 hours: 126 (normal), 3 hours: 61 (hypoglycemia; avoid hypoglycemia, with values below 70 considered hypoglycemic).
Just maintain a balanced diet.
3.
Dietary recommendations: For breakfast at 9:30, consume 1 boiled egg + water => recommended 1 boiled egg or a cup of soy milk + 2 servings of carbohydrates, such as 2 slices of whole grain toast or 100g of sweet potato.
For lunch at 12:00, have a light bento meal, replacing white rice with 100-150g of baked sweet potato, and purchase 100g of ready-to-eat chicken breast => lunch is fine.
For dinner at 18:00, prepare meals at home, reducing rice portion by 1/3 to 1/2, and substituting white rice with black brown rice, while increasing vegetable intake => dinner lacks protein (chicken, pork, fish, or soy products).
It is recommended to have a fixed portion of carbohydrates for each meal, ideally 3-4 servings (2/3 to 1 bowl of rice or 150-200g of sweet potato).
Please refer to online food exchange lists.
4.
To lower the glycemic index (GI) of meals, increase dietary fiber in the same meal, such as brown rice, mixed grain rice, or whole grain products.
5.
If engaging in strength training, ensure adequate protein intake, with each meal including a portion of protein equivalent to the size of your palm, such as beans, fish, eggs, or meat.
6.
If there are further dietary concerns, it is recommended to consult a nutrition clinic during your follow-up visit for dietary advice.

Reply Date: 2022/12/20

More Info

Managing glucose intolerance is a critical aspect of preventing the progression to type 2 diabetes and improving overall health. Your recent glucose tolerance test (OGTT) results indicate that you have abnormal glucose tolerance, which is a warning sign that your body is struggling to manage blood sugar levels effectively. The dietary adjustments and lifestyle changes you are implementing are commendable and can significantly impact your health.

Dietary Adjustments
1. Breakfast Choices: Starting your day with a boiled egg is an excellent choice as it provides high-quality protein and healthy fats without causing a spike in blood sugar. Eggs are low in carbohydrates, which is beneficial for managing glucose levels.

2. Lunch and Dinner: Opting for a light meal with plenty of vegetables is a smart move. Vegetables are low in calories and high in fiber, which can help regulate blood sugar levels. Replacing white rice with black or brown rice is also a good strategy, as whole grains have a lower glycemic index (GI) and provide more nutrients and fiber.

3. Sweet Potatoes: While sweet potatoes have a lower GI compared to white potatoes, they still contain carbohydrates that can affect blood sugar levels. Consuming them in moderation (100-150g) is reasonable, especially if you are balancing your intake with other low-GI foods.

4. Snacking: If you find yourself hungry between meals, consider healthy snacks such as nuts, seeds, or low-GI fruits like berries. These options can help maintain your energy levels without causing significant spikes in blood sugar.

Lifestyle Changes
1. Physical Activity: Incorporating regular exercise is crucial for managing glucose intolerance. Your plan to walk after meals and engage in aerobic and strength training exercises on weekends is excellent. Exercise helps improve insulin sensitivity, allowing your body to use glucose more effectively.

2. Meal Timing: Eating at regular intervals and avoiding long gaps between meals can help maintain stable blood sugar levels. Your current schedule seems well-structured, with meals spaced out appropriately.

3. Hydration: Staying well-hydrated is essential. Water is the best choice, but herbal teas can also be beneficial. Avoid sugary drinks, as they can lead to rapid increases in blood sugar.

Monitoring Progress
1. Blood Sugar Levels: Keep track of your blood sugar levels regularly. This will help you understand how different foods and activities affect your glucose levels and allow you to make informed adjustments.

2. Consultation with Healthcare Professionals: Regular check-ups with your healthcare provider or a registered dietitian can provide personalized guidance and support. They can help you refine your dietary choices and exercise regimen based on your progress and any changes in your health status.

Conclusion
Your proactive approach to managing glucose intolerance through dietary adjustments and lifestyle changes is commendable. The combination of a balanced diet, regular physical activity, and consistent monitoring will significantly enhance your ability to manage your blood sugar levels effectively. Remember, the goal is not only to lower blood sugar but also to promote overall health and well-being. If you have any concerns or experience any unusual symptoms, do not hesitate to reach out to your healthcare provider for further evaluation and guidance.

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