Impaired Glucose Tolerance: Symptoms and Management - Internal Medicine

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Impaired glucose tolerance


Doctor, I seem to have impaired glucose tolerance.
My fasting blood sugar is around 80, which is normal, but my postprandial blood sugar sometimes reaches 130, 140, 150, and even up to 166 after two hours.
Could this be a sign of impaired glucose tolerance? My BMI is 21.3, but over the past year and a half, I have been eating late-night snacks almost every day, going to bed right after eating, and I haven't been exercising much.
If this is the case, can adjusting my lifestyle, diet, and exercise help bring my postprandial blood sugar back to normal levels?

Mr. Zeng, 10~19 year old female. Ask Date: 2012/12/18

Dr. Cai Zonglin reply Internal Medicine


The standard procedure is the Oral Glucose Tolerance Test (OGTT), where a solution containing 75 grams of glucose is consumed.
If the blood glucose level is between 140 and 199 mg/dL two hours after drinking, it is classified as impaired glucose tolerance (IGT).
Regardless of whether it is diabetes or prediabetes, adjustments in lifestyle and diet, along with exercising three times a week for at least 30 minutes each session, can help with blood glucose control.
If there is a family history of diabetes, it is recommended to regularly monitor blood glucose levels and consider consulting a metabolic specialist.

Reply Date: 2012/12/18

More Info


Impaired glucose tolerance (IGT) is a condition characterized by higher than normal blood sugar levels after eating, but not high enough to be classified as diabetes. It is often considered a precursor to type 2 diabetes and is associated with insulin resistance. Based on your description, where your fasting blood glucose is around 80 mg/dL (which is normal), but your postprandial (after meal) blood sugar levels can reach up to 166 mg/dL, it is indeed possible that you are experiencing impaired glucose tolerance.


Symptoms of Impaired Glucose Tolerance
Many individuals with IGT may not exhibit noticeable symptoms, but some common signs can include:
1. Increased Thirst: This can occur as your body attempts to dilute excess sugar in the bloodstream.

2. Frequent Urination: High blood sugar levels can lead to increased urination as your kidneys work to filter out the excess glucose.

3. Fatigue: You may feel more tired than usual, as your body struggles to utilize glucose effectively for energy.

4. Blurred Vision: Fluctuating blood sugar levels can affect your vision temporarily.


Management and Lifestyle Changes
The good news is that lifestyle modifications can significantly improve your glucose tolerance and potentially return your postprandial blood sugar levels to normal. Here are some strategies:
1. Dietary Adjustments:
- Balanced Meals: Focus on a diet rich in whole grains, lean proteins, healthy fats, and plenty of fruits and vegetables. This can help stabilize blood sugar levels.

- Limit Refined Carbohydrates: Reduce intake of sugary foods and drinks, white bread, and other refined carbohydrates that can cause spikes in blood sugar.

- Portion Control: Eating smaller, more frequent meals can help manage blood sugar levels better than larger meals.

2. Regular Physical Activity:
- Exercise: Aim for at least 150 minutes of moderate-intensity aerobic activity each week, such as brisk walking, swimming, or cycling. Exercise helps improve insulin sensitivity and can lower blood sugar levels.

- Strength Training: Incorporating resistance training into your routine can also be beneficial, as it helps build muscle mass, which can improve glucose metabolism.

3. Weight Management:
- Maintaining a healthy weight is crucial. Even a modest weight loss of 5-10% of your body weight can significantly improve insulin sensitivity and glucose tolerance.

4. Sleep Hygiene:
- Ensure you are getting adequate sleep, as poor sleep can negatively affect insulin sensitivity and blood sugar levels. Aim for 7-9 hours of quality sleep per night.

5. Stress Management:
- Chronic stress can lead to elevated blood sugar levels. Techniques such as mindfulness, yoga, or meditation can help manage stress effectively.


Monitoring and Follow-Up
It is essential to monitor your blood sugar levels regularly to understand how your body responds to different foods and activities. Keeping a food diary can also help identify patterns and triggers for higher blood sugar levels.

If lifestyle changes do not lead to improvements or if your blood sugar levels continue to rise, it may be necessary to consult with a healthcare provider for further evaluation and potential medical intervention. They may recommend additional testing, such as an oral glucose tolerance test (OGTT), to confirm the diagnosis of IGT or to rule out diabetes.


Conclusion
In summary, while your current postprandial blood sugar levels suggest impaired glucose tolerance, there is a significant opportunity for improvement through lifestyle changes. By focusing on a balanced diet, regular exercise, and overall healthy habits, you can work towards restoring your blood sugar levels to a normal range. Regular monitoring and consultation with healthcare professionals will also be key in managing your condition effectively.

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