Should You Check Post-Meal Blood Sugar If Fasting Levels Are Normal?

If the fasting blood glucose levels are normal, is it necessary to also measure postprandial blood glucose?

Dr.
Chen: Hello! I would like to ask you a few questions.

1.
During my company's health check-up, my fasting blood glucose was 83 mg/dL, but I heard that fasting blood glucose alone is not sufficient.
Should I go to the hospital and see a specialist in metabolism to check my postprandial blood glucose? PS: My father, grandmother, and great-grandmother all have diabetes.
2.
My mother has hypertension and has been taking medication for hyperlipidemia, but recently her doctor discontinued the lipid-lowering medication after she had been on it for about a year.
The doctor at the Veterans General Hospital mentioned that long-term use could be harmful to the liver.
My mother has consistently taken antihypertensive medication, and her blood pressure has been maintained around the 120s.
However, a few days ago, her blood pressure spiked to the 150s, and she is puzzled.
Could the increase in her blood pressure be related to stopping the lipid-lowering medication?
I would greatly appreciate your response to my concerns.
Thank you! Sincerely, Hua Hua.

Hua Hua, 30~39 year old female. Ask Date: 2008/05/17

Dr. Chen Qingbin reply Internal Medicine

1.
Fasting blood glucose is 83, no diabetes, regular check-ups are sufficient.
2.
Cholesterol-lowering medication should only be taken if necessary; it's best to consult your attending physician directly.

Reply Date: 2008/05/17

More Info

Dear Hua Hua,
Thank you for your questions regarding blood sugar monitoring and your family's health history. It's great that you are being proactive about your health, especially considering your family history of diabetes. Let's address your concerns one by one.

1. Should You Check Post-Meal Blood Sugar If Fasting Levels Are Normal?
Your fasting blood sugar level of 83 mg/dL is indeed within the normal range (typically considered to be between 70-99 mg/dL). However, given your family history of diabetes, it is prudent to monitor your post-meal blood sugar levels as well. Fasting blood sugar alone does not provide a complete picture of your glucose metabolism.
Post-meal blood sugar levels can reveal how well your body is managing glucose after eating. For most people, blood sugar levels should rise after a meal but should return to normal (below 140 mg/dL) within two hours. If your post-meal levels are consistently high, it could indicate insulin resistance or prediabetes, even if your fasting levels are normal.
Given your family history, it would be wise to consult with a healthcare provider, possibly an endocrinologist or a metabolic specialist, to discuss the need for post-meal blood sugar testing. They may recommend a glucose tolerance test or continuous glucose monitoring to assess your blood sugar levels more comprehensively.

2. Blood Pressure Concerns Regarding Your Mother
Regarding your mother’s situation, it’s important to note that blood pressure can fluctuate due to various factors, including medication changes, stress, diet, and overall health. The recent increase in her blood pressure to 150s could be influenced by several factors:
- Medication Changes: Stopping her cholesterol medication may have an indirect effect on her overall cardiovascular health, but it is less likely to cause an immediate spike in blood pressure. However, if her cholesterol levels were contributing to her overall health, discontinuing the medication could have longer-term effects.

- Diet and Lifestyle: Changes in diet, physical activity, or stress levels can significantly impact blood pressure. If she has been less active or has made dietary changes, this could contribute to elevated readings.

- Measurement Variability: Blood pressure can vary throughout the day and can be influenced by factors such as time of day, hydration status, and even the method of measurement. It’s advisable to take multiple readings at different times to get a more accurate assessment.

Recommendations
1. For You: Given your family history, it would be beneficial to monitor your post-meal blood sugar levels. Discuss this with your healthcare provider to determine the best course of action.

2. For Your Mother: Encourage her to monitor her blood pressure regularly, especially after stopping her medication. If her blood pressure remains elevated, she should consult her healthcare provider to discuss her readings and any necessary adjustments to her treatment plan.

3. Lifestyle Modifications: Both you and your mother could benefit from lifestyle modifications. A balanced diet, regular physical activity, and stress management can help maintain healthy blood sugar and blood pressure levels.

In conclusion, being proactive about monitoring both blood sugar and blood pressure is essential, especially with your family history. Regular check-ups and open communication with healthcare providers will help manage and mitigate any potential health issues.

Best wishes for your health and well-being!
Sincerely,
Doctor Q&A Teams

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