Managing Prediabetes: Balancing Carbs, Weight Loss, and Blood Sugar Levels

Prediabetes

Hello Doctor,
I apologize for the interruption, but I would like to ask a question.
I was diagnosed last August with a fasting blood sugar of 115 mg/dL, HbA1c of 5.8%, and a weight of 79 kg.
By April of this year, my fasting blood sugar was 108 mg/dL, HbA1c was 5.7%, and my weight had decreased to 74 kg.
During this time, I have been continuously adjusting my diet, but I have not been able to bring my blood sugar down to normal levels.
I maintain a daily exercise routine, so I still need to consume carbohydrates; currently, I am taking in about 280 grams of carbohydrates per day, with a total caloric intake of around 2500 calories (my basal metabolic rate is 1850 calories).

I am concerned that my continuous weight loss might be due to diabetes affecting my nutrient absorption.
However, my recent health check reports, aside from blood sugar, show all other values within normal ranges (total cholesterol 152 mg/dL, triglycerides 88 mg/dL, and normal liver and kidney function tests).

I would like to ask if I will continue to lose weight following this pattern, or if I can increase my carbohydrate intake, knowing that it might raise my blood sugar levels.
Thank you.

Ke Li Si, 40~49 year old female. Ask Date: 2024/04/27

Dr. Ye Qianyu reply Family Medicine

Hello! Based on the information you provided, you are currently not in the prediabetic stage.
Through dietary and exercise control, both your blood glucose and glycated hemoglobin levels have improved, leading to weight loss, and it is not due to hyperglycemia causing cachexia.
I recommend adjusting your carbohydrate intake based on the intensity of your physical activity; you may increase it moderately.
As long as you continue to manage your diet and exercise, and regularly monitor your blood glucose levels, you should be able to delay or even avoid the need for medication.
However, please be cautious not to excessively restrict your diet in order to achieve normal test results, as this may lead to nutritional imbalances.

Reply Date: 2024/04/27

More Info

Managing prediabetes effectively involves a careful balance of carbohydrate intake, weight management, and blood sugar control. Based on your situation, it seems you have made significant progress in managing your blood sugar levels and weight, but you still have concerns about your nutritional intake and overall health.

Firstly, it’s important to understand that prediabetes is a condition where blood sugar levels are higher than normal but not yet high enough to be classified as diabetes. Your reported fasting blood sugar levels of 115 mg/dL and 108 mg/dL, along with an HbA1c of 5.8% and 5.7%, indicate that you are in the prediabetic range. While these numbers show improvement, they also suggest that continued vigilance is necessary to prevent progression to type 2 diabetes.

Your current carbohydrate intake of approximately 280 grams per day, along with a caloric intake of 2500 calories, seems to be aligned with your exercise routine. Regular physical activity is crucial for managing blood sugar levels and improving insulin sensitivity. Since you are exercising daily, it is essential to ensure that your carbohydrate intake supports your energy needs without causing spikes in blood sugar.

Regarding your concern about weight loss, it is not uncommon for individuals with prediabetes to experience weight fluctuations, especially when making dietary adjustments. The fact that your other health markers, such as total cholesterol and triglycerides, are within normal ranges is a positive sign. However, significant and unintentional weight loss can sometimes indicate underlying issues, including malabsorption or other metabolic concerns. Since your blood tests are normal aside from the blood sugar levels, it is unlikely that you are experiencing malabsorption due to diabetes at this stage.

To address your question about whether you will continue to lose weight on your current regimen, it is possible if your caloric intake remains below your energy expenditure. However, if you are concerned about losing too much weight, you might consider gradually increasing your carbohydrate intake while monitoring your blood sugar levels closely. A balanced approach would involve incorporating healthy carbohydrates, such as whole grains, fruits, and vegetables, which can provide essential nutrients and energy without causing significant spikes in blood sugar.

It’s also important to focus on the quality of carbohydrates rather than just the quantity. Opt for complex carbohydrates that are high in fiber, as they can help regulate blood sugar levels and keep you feeling full longer. Additionally, incorporating healthy fats and proteins into your meals can help stabilize blood sugar levels and provide sustained energy.

In summary, you should not hesitate to adjust your carbohydrate intake as needed, but do so mindfully. Monitor your blood sugar levels regularly to see how changes in your diet affect them. If you find that increasing carbohydrates leads to higher blood sugar levels, you may need to reassess your overall dietary strategy. Consulting with a registered dietitian or a healthcare provider specializing in diabetes management can provide personalized guidance tailored to your specific needs and lifestyle.

Lastly, remember that managing prediabetes is a long-term commitment. Continue to focus on balanced nutrition, regular physical activity, and routine monitoring of your blood sugar levels. With these strategies, you can effectively manage your prediabetes and work towards achieving and maintaining a healthy weight.

Similar Q&A

Managing Weight and Blood Sugar: A Guide for Diabetic Patients

Hello, doctor. I have been managing gestational diabetes for 13 years with medication, but my blood sugar levels have not been ideal. My recent blood test showed a fasting glucose level of 172 mg/dL and a hemoglobin A1c of 8.5%. I am 163 cm tall and weigh 62 kg, which is consider...

Dr. Liu Hongxiang reply Family Medicine
Dear Ms. Dong, I hope this message finds you well. After reading your letter several times, I can sense your efforts in managing your blood sugar levels; please continue to maintain this. If you want to achieve weight loss effectively, it is essential to focus primarily on dieta...

Managing Prediabetes: Effective Dietary Strategies for Better Health

Hello, Dr. Fan. I am 186 cm tall and weigh about 74 kg. I have Mediterranean anemia and Wilson's disease. On July 19, my blood glucose and glycated hemoglobin results were 105 mg/dL and 6%, respectively, which indicates prediabetes. I would like to ask if it is feasible to h...

Dr. Fan Chunmei reply Nutrition
The normal range for glycated hemoglobin (HbA1c) in the general population is approximately 4-6%, and your HbA1c is within the standard range. A fasting blood glucose level of 100-126 mg/dL indicates prediabetes. It is important to focus on a balanced diet consisting of the six m...

Understanding Prediabetes: Causes, Management, and Lifestyle Changes

Hello, doctor. My height is 173 cm and my weight is 42.2 kg. In March, my weight was 45.2 kg. Due to weight loss, I underwent blood glucose and thyroid tests. The results showed fasting blood glucose of 96 mg/dL, hemoglobin A1c of 5.7%, eAG of 117 mg/dL, free T4 of 1.05 ng/dL, an...

Dr. Lin Jianliang reply Internal Medicine
Hello: The normal range for fasting blood glucose levels is typically 70 to 100 mg/dL, and the normal range for hemoglobin A1c is 4 to 6%. I'm not sure what your laboratory's standard range is. For prediabetes, dietary changes and exercise can be effective in managing t...

Managing Prediabetes: Key Tips for Blood Sugar Control

Dear Dr. Hsiao, I had a fasting blood glucose level of 127 mg/dL at the health examination center. After two weeks of paying special attention to my diet and recording it daily, along with maintaining a routine of walking 10,000 steps three times a week, my blood glucose level w...

Dr. Xiao Yongxun reply Internal Medicine
Hello: Here are the responses to your questions: 1. According to the diagnostic criteria for diabetes published by the American Diabetes Association in 2010, the following criteria are used: (1) Fasting plasma glucose level >= 126 mg/dL after at least 8 hours; (2) 2-hour plas...