Blood Sugar Levels: Signs of Potential Diabetes

Unsure if diabetes has already developed?

Hello, Doctor.
Recently, I measured my fasting blood glucose at home using a glucometer, and it was 91 mg/dL (after fasting for about 10-12 hours).
After eating curry rice (starting the timer from the first bite), my blood glucose one hour after the meal was 183 mg/dL, and two hours after the meal, it was 199 mg/dL.
I'm puzzled as to why the two-hour postprandial measurement was higher than the one-hour measurement.
I currently have no symptoms of weight loss, excessive thirst, or frequent urination.
My height is 160 cm and my weight is 92 kg.
I'm very concerned that I may have diabetes.
I would appreciate your clarification.
Thank you.

Niu Bao, 30~39 year old female. Ask Date: 2015/09/06

Dr. Xiao Yongxun reply Internal Medicine

1.
If your weight is 92 kg and your height is 160 cm, your Body Mass Index (BMI) is 35.9 kg/m².
According to the classification by Taiwan's Ministry of Health and Welfare, since it exceeds 27 kg/m² and is over 35 kg/m², it falls into the category of severe obesity.
Additionally, your fasting blood glucose level is 91 mg/dL, which is within the normal range as it is less than 100 mg/dL.
However, your blood glucose level one hour after a meal is 188 mg/dL, and two hours after a meal, it is 199 mg/dL, which is greater than 140 mg/dL and even close to 200 mg/dL, indicating a risk of diabetes.

2.
Clinically, the two-hour postprandial blood glucose level is chosen as the basis for discussion primarily because most individuals tend to have their highest blood glucose levels two hours after eating, making it convenient for medical comparison and tracking.
3.
Since there are no symptoms such as polyuria, polydipsia, polyphagia, or weight loss, along with the laboratory data you provided, it is currently unlikely that you have diabetes.
However, severe obesity and elevated blood glucose levels two hours after meals indicate significant glucose intolerance.
If dietary, exercise, and lifestyle adjustments are not actively made, the likelihood of developing diabetes in the future is very high.
4.
It is recommended that you maintain a balanced diet, eat slowly, and aim to be 80% full; avoid high-calorie and high-fat foods, and also refrain from late-night snacking.
After meals, do not go directly to sleep or remain inactive; it is best to take a walk to alleviate post-meal bloating.
Additionally, establish a regular exercise routine, aiming for three times a week for 30 to 60 minutes each session.
Avoid prolonged sitting or inactivity; for short distances, it is best to walk.
5.
If you have further questions, it is advisable to discuss and explore them further with your family physician.

Reply Date: 2015/09/06

More Info

Based on your recent blood sugar measurements and your concerns regarding potential diabetes, it’s important to analyze your results in the context of established medical guidelines and to understand what they may indicate about your health.

1. Understanding Your Blood Sugar Levels: Your fasting blood sugar level of 91 mg/dL is within the normal range, as normal fasting blood glucose levels are typically below 100 mg/dL. However, your postprandial (after meal) blood sugar levels are concerning. A reading of 183 mg/dL one hour after eating and 199 mg/dL two hours after eating indicates that your body may not be processing glucose effectively. According to the American Diabetes Association, a blood sugar level of 200 mg/dL or higher two hours after eating is considered indicative of diabetes.

2. Why Is Your Two-Hour Reading Higher?: It is unusual for blood sugar levels to rise after one hour and then increase further by the two-hour mark. This could be due to several factors, including the type of food consumed, the glycemic index of the meal, and individual metabolic responses. Foods high in carbohydrates, especially refined carbohydrates, can cause significant spikes in blood sugar. Additionally, if your body is struggling to produce enough insulin or if your cells are resistant to insulin, this could lead to elevated blood sugar levels.

3. Symptoms and Risk Factors: You mentioned that you do not have symptoms such as weight loss, increased thirst, or frequent urination, which are common signs of diabetes. However, the absence of these symptoms does not rule out the possibility of diabetes, especially if you have risk factors such as obesity (your BMI indicates you are in the overweight category) and a family history of diabetes.
4. Next Steps: Given your blood sugar readings, it would be prudent to consult with a healthcare provider for further evaluation. They may recommend additional tests, such as an Oral Glucose Tolerance Test (OGTT) or HbA1c test, to assess your blood sugar control over time. The HbA1c test provides an average blood sugar level over the past two to three months and can help determine if you are in the prediabetes or diabetes range.

5. Lifestyle Modifications: Regardless of the test results, adopting a healthier lifestyle can significantly impact your blood sugar levels. This includes:
- Diet: Focus on a balanced diet rich in whole grains, lean proteins, healthy fats, and plenty of fruits and vegetables. Limit processed foods and those high in sugar.

- Physical Activity: Regular exercise can help improve insulin sensitivity and lower blood sugar levels. Aim for at least 150 minutes of moderate aerobic activity each week.

- Weight Management: If you are overweight, even a modest weight loss of 5-10% can improve blood sugar control and reduce the risk of developing diabetes.

6. Monitoring: Continue to monitor your blood sugar levels regularly. Keeping a log of your readings, along with what you eat and your physical activity, can help you and your healthcare provider identify patterns and make informed decisions about your health.

In summary, while your fasting blood sugar is normal, the postprandial readings are concerning and warrant further investigation. It’s essential to work closely with your healthcare provider to determine the best course of action and to implement lifestyle changes that can help manage your blood sugar levels effectively.

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