Abnormal Fasting Blood Sugar: Causes and Solutions

Abnormal fasting blood glucose?

Hello Dr.
Yang,
Last year during my physical examination, I was diagnosed with impaired glucose tolerance.
After making some adjustments, I have been using a glucometer to monitor my blood sugar levels, which have been consistently around 95 mg/dL fasting, 140 mg/dL at 30 minutes, 160 mg/dL at 60 minutes, 150 mg/dL at 90 minutes, and 110 mg/dL at 120 minutes, with a variation of about 5-10 mg/dL.
My hemoglobin level was tested at 15.2 in March this year.
Due to my work abroad, I found it difficult to obtain testing strips for the glucometer, so I stopped testing at the end of April until I return to Taiwan.
Now, my blood sugar results show fasting levels between 100-110 mg/dL and postprandial levels between 110-120 mg/dL.
I am very concerned that I may be developing diabetes.
Additionally, I have been experiencing unstable sleep and feel very fatigued upon waking.
I also feel discomfort in the area of my right kidney.
Could this be the reason for my abnormal blood sugar levels? My job is quite specialized and does not allow for any symptoms of diabetes; otherwise, I would permanently lose this position.
I would appreciate your guidance on how to proceed with treatment.
Thank you.
Best regards,
A-Chao

A Chao, 30~39 year old female. Ask Date: 2009/07/19

Dr. Yang Hongzhi reply Internal Medicine

The reasons you mentioned lack a clear correlation with blood sugar levels.
Currently, the proven methods to reduce the progression from impaired glucose tolerance to diabetes are lifestyle changes.
Dietary modifications and exercise (similar to weight control) can reduce the incidence of diabetes by approximately half.

Reply Date: 2009/07/19

More Info

Understanding abnormal fasting blood sugar levels is crucial, especially for individuals who have previously shown signs of glucose intolerance. Based on your description, it appears that your fasting blood sugar levels have recently ranged between 100 and 110 mg/dL, with postprandial (after meal) levels around 110 to 120 mg/dL. These values suggest that you may be entering a prediabetic state, which is characterized by blood sugar levels that are higher than normal but not yet high enough to be classified as diabetes.

To clarify, normal fasting blood sugar levels are typically below 100 mg/dL. Levels between 100 and 125 mg/dL indicate prediabetes, while levels of 126 mg/dL or higher on two separate tests suggest diabetes. Given your current readings, it is essential to take proactive steps to manage your blood sugar levels and prevent the progression to type 2 diabetes.

Several factors can contribute to elevated blood sugar levels, including diet, physical activity, stress, and sleep quality. You mentioned experiencing poor sleep and fatigue upon waking, which can significantly impact your body's ability to regulate blood sugar. Sleep deprivation can lead to insulin resistance, making it more challenging for your body to manage glucose levels effectively. Therefore, addressing your sleep issues is a critical component of managing your blood sugar.

In terms of dietary adjustments, consider adopting a balanced diet that emphasizes whole foods, including plenty of vegetables, whole grains, lean proteins, and healthy fats. Reducing your intake of refined carbohydrates and sugars can help stabilize your blood sugar levels. Regular physical activity is also vital; aim for at least 150 minutes of moderate-intensity exercise each week, as this can improve insulin sensitivity and help regulate blood sugar.

You mentioned discomfort in your right kidney area, which could be unrelated to your blood sugar levels but should not be ignored. Kidney issues can sometimes affect metabolic processes, including glucose metabolism. It would be wise to consult a healthcare provider to evaluate this discomfort further, as it may require specific attention.

Given your concerns about your job and the potential implications of developing diabetes, it is crucial to monitor your blood sugar levels closely. Since you have previously used a blood glucose meter, consider resuming regular testing as soon as you can obtain the necessary supplies. Keeping a log of your readings can help you and your healthcare provider identify patterns and make informed decisions about your management plan.

In summary, your current blood sugar levels indicate a potential risk for developing diabetes, but with lifestyle modifications and regular monitoring, you can take steps to improve your situation. Focus on enhancing your diet, increasing physical activity, addressing sleep issues, and consulting with a healthcare professional regarding your kidney discomfort. Regular follow-ups and blood tests will be essential in tracking your progress and making necessary adjustments to your management plan.

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