Blood Sugar Levels and Dietary Guidance from Nutritionist Tsai

Thank you, Dietitian Tsai?

Hello, Dietitian Tsai: Today I returned to the cardiology department to review my blood test results.
My fasting blood glucose is 96 mg/dL and my hemoglobin A1c is 5.5% (three months ago, my fasting blood glucose was 130 mg/dL and my hemoglobin A1c was 6.4%).
I asked the doctor if this still qualifies as diabetes, and the doctor said it does not.
Regarding diet, the recommendation is to eat small, frequent meals.
I would like to ask Dietitian Tsai if I still need to strictly control my starch intake.
Over the past three months, I have frequently experienced irregular bowel movements, and I am currently unsure of the cause.
The cardiologist suggested taking probiotics.
I would like to ask Dietitian Tsai if lactic acid bacteria and probiotics are the same thing.
Additionally, I would like to know if they are suitable for someone with stage 2 kidney disease.
Thank you, Dietitian Tsai, for your guidance on my diet over the past two months.

Da Pang, 40~49 year old female. Ask Date: 2014/11/25

Dr. Cai Xiuwen reply Nutrition

Hello.
Currently, the diagnostic criteria for diabetes in the country include: 1.
Fasting blood glucose levels exceeding 126 mg/dL on two occasions, 2.
Random blood glucose levels exceeding 200 mg/dL, 3.
Hemoglobin A1c exceeding 6.5%.
Therefore, since both of your blood test results did not exceed these standards, you are not classified as having diabetes.
However, the significant decrease in your first and second reports suggests that you have made adjustments to your diet and lifestyle.
The causes of diabetes are primarily due to long-term lifestyle habits and dietary issues.
Blood glucose levels can be affected by stress, lack of sleep, obesity, excessive intake of sweets, and fats.
It is recommended that you regularly monitor your blood glucose levels.
If possible, self-monitoring can help you understand what foods may cause your blood sugar to rise.
Combining monitoring with a review of your lifestyle and diet is the most beneficial approach for long-term health.
I suggest you visit a nutrition consultation clinic to discuss dietary and lifestyle issues in detail with a dietitian for tailored advice.

Regarding the causes of constipation, they may include insufficient physical activity, inadequate fiber intake, insufficient hydration, and imbalances in gut bacteria.
In addition to supplementing with probiotics, it is advisable to exercise more and increase your fiber intake through vegetables, fruits, whole grains, and nuts.
Also, aim to drink more than 2000 cc of water daily.
As for stage 2 kidney disease, have you confirmed this further with your doctor? It is important to identify the underlying cause of the kidney issue and make adjustments accordingly, as dietary recommendations will vary based on the specific cause.

This response is provided by Dietitian Tsai Hsiu-Wen from Nantou Hospital, Ministry of Health and Welfare.
Wishing you peace and health.

Reply Date: 2014/11/25

More Info

Hello! It's great to hear that you're actively monitoring your health and seeking guidance on your dietary choices, especially considering your recent blood sugar levels and overall health status. Let's break down your questions and concerns regarding blood sugar management, dietary starch intake, and the role of probiotics in your diet.

Firstly, regarding your blood sugar levels: a fasting blood sugar of 96 mg/dL and a hemoglobin A1c (HbA1c) of 5.5% are indeed within the normal range. The American Diabetes Association (ADA) defines normal fasting blood glucose as less than 100 mg/dL and an HbA1c of less than 5.7%. Since your previous readings indicated higher levels (fasting blood sugar of 130 mg/dL and HbA1c of 6.4%), it seems you have made significant improvements. Your doctor is correct in stating that you are not classified as having diabetes at this point. However, it’s essential to maintain a balanced diet and monitor your carbohydrate intake, especially starches, to prevent any future spikes in blood sugar.

When it comes to starch intake, while you may not need to be as strict as someone with diabetes, it is still advisable to be mindful of the types and amounts of carbohydrates you consume. Complex carbohydrates, such as whole grains, legumes, and vegetables, are preferable as they are digested more slowly and have a lesser impact on blood sugar levels compared to simple carbohydrates found in sugary snacks and refined grains. The concept of "small, frequent meals" can help in stabilizing blood sugar levels, but it’s important to ensure that these meals are balanced and include a good mix of proteins, healthy fats, and fiber alongside your carbohydrates.

Now, regarding your digestive issues and the use of probiotics: Lactobacillus (often referred to as "lactic acid bacteria") and probiotics are terms that are sometimes used interchangeably, but they are not exactly the same. Probiotics are live microorganisms that provide health benefits when consumed in adequate amounts, and Lactobacillus is a specific genus of bacteria that is commonly found in probiotics. Probiotics can help improve gut health and may alleviate issues such as constipation by promoting a healthy balance of gut bacteria.
For someone with stage 2 chronic kidney disease (CKD), it's crucial to consult with your healthcare provider or a registered dietitian before starting any new supplements, including probiotics. Some probiotics may contain ingredients that are not suitable for individuals with kidney issues, and the overall dietary management for CKD often requires careful consideration of protein, potassium, and phosphorus intake.

In summary, while your blood sugar levels are currently within a healthy range, maintaining a balanced diet with controlled starch intake is essential for ongoing health. Probiotics can be beneficial for digestive health, but it's important to choose the right type and consult with a healthcare professional, especially considering your kidney condition. Keep up the good work with your dietary management, and don’t hesitate to reach out for further guidance as needed!

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