Prediabetes Symptoms: Insights from Military Health Exams

Q: Prediabetes Symptoms: Insights from Military Health Exams

Dear Mr. Anonymous： 1. The Oral Glucose Tolerance Test (OGTT) results after a 12-hour fasting show fasting blood glucose： 102 mg/dl, 1 hour： 152 mg/dl, 2 hours： 122 mg/dl, and HbA1c： 5.3%. This result does not meet the criteria for a diabetes diagnosis. It can

Pre-diabetic symptoms in military service medical examinations?

Hello Doctor: I have a few questions for you.
I am 23 years old, with a BMI of 18.6 and weighing 48 kg.
Before my health check, I ate half a lunch box, and the report showed urine glucose converted to 200 mg/dl, indicating abnormal diabetes; a few days later, I underwent a re-examination (Oral Glucose Tolerance Test, OGTT) after fasting for 12 hours, with the following results: Fasting blood glucose: 102 mg/dl, 1 hour: 152 mg/dl, 2 hours: 122 mg/dl, HbA1c: 5.3%, which indicates prediabetes symptoms.

1.
Doctor, which data points are abnormal, and is it very serious? I have found many versions of information, and I am quite anxious about this matter; could you please clarify?
2.
I need to wait four months for a specialized examination; I currently have no direction.
What should I do next, Doctor?
3.
I usually do not consume sweet drinks or desserts, and I am slim.
Is it possible that I am not exercising enough, experiencing life stress, or is there another reason? Please help clarify, thank you.

Niming, 20~29 year old female. Ask Date: 2016/03/15

Dr. Xiao Yongxun reply Internal Medicine

Dear Mr.
Anonymous:
1.
The Oral Glucose Tolerance Test (OGTT) results after a 12-hour fasting show fasting blood glucose: 102 mg/dl, 1 hour: 152 mg/dl, 2 hours: 122 mg/dl, and HbA1c: 5.3%.
This result does not meet the criteria for a diabetes diagnosis.
It can be classified as impaired fasting glucose (IFG) at most.
While this is not severe and there is no need for concern, it is important to pay attention to blood glucose control issues; this is advisable.
2.
According to the diabetes diagnostic criteria published by the Ministry of National Defense's Military Medical Bureau: fasting blood glucose must be 126 mg/dl or higher, the 2-hour post-OGTT blood glucose must be 200 mg/dl or higher, and symptoms such as polyuria, thirst, weight loss, or random blood glucose of 200 mg/dl or higher, or HbA1c of 6.5% or higher must be present.
(For asymptomatic individuals, repeat testing is required.) Your situation is not too severe; with dietary control, avoiding overeating, ensuring adequate sleep, and regular exercise—at least a one-hour walk after meals—you should be fine.
If your military unit requests a re-examination, please comply.
3.
The prevention or management of diabetes primarily relies on dietary control and regular exercise; medication is only necessary when required.
Dietary control includes eating until 80% full, avoiding eating too quickly or too much, and steering clear of high-sugar, high-fat, and high-calorie foods or drinks, as well as instant coffee mixes, cakes, and fried foods.
Dinner should not be too heavy, and moderate activity should follow meals before going to bed.
Regular exercise is equally important; aim for at least three times a week, around one hour each time; otherwise, at the very least, take a walk after meals and avoid sitting down to work immediately.
Additionally, ensure adequate sleep and reduce life stress, as these factors will also aid in blood glucose control.

Reply Date: 2016/03/15

More Info

Understanding prediabetes symptoms is crucial, especially for young individuals like yourself who may not fit the typical profile of someone at risk for diabetes. Based on your provided data, let's break down your situation and address your concerns.

1. Understanding Your Test Results:
- Your initial urine glucose level of 200 mg/dl indicates glycosuria, which can be a sign of elevated blood glucose levels. This is concerning as it suggests that your kidneys are excreting excess glucose, which typically occurs when blood sugar levels exceed the renal threshold.

- The follow-up glucose tolerance test (OGTT) results show a fasting blood sugar of 102 mg/dl, which is slightly above the normal range (normal is less than 100 mg/dl). The 1-hour post-load glucose of 152 mg/dl and 2-hour level of 122 mg/dl indicate that your body is having difficulty processing glucose effectively, which is characteristic of prediabetes.
- Your HbA1c level of 5.3% is within the normal range (less than 5.7% is considered normal), but it is essential to monitor this closely as it can indicate your average blood sugar levels over the past 2-3 months.

In summary, while your HbA1c is normal, the other results suggest that you are on the cusp of developing diabetes, which should not be taken lightly. Prediabetes is a significant health concern as it increases the risk of developing type 2 diabetes and cardiovascular diseases.

2. Next Steps:
- Since you are advised to wait four months for a follow-up, it is essential to focus on lifestyle modifications in the meantime. This includes adopting a balanced diet rich in whole grains, lean proteins, healthy fats, and plenty of fruits and vegetables while minimizing processed foods and sugars.

- Regular physical activity is crucial. Aim for at least 150 minutes of moderate aerobic exercise each week, such as brisk walking, cycling, or swimming. Exercise helps improve insulin sensitivity and can lower blood sugar levels.

- Monitoring your blood sugar levels at home, if possible, can provide valuable insights into how your body responds to different foods and activities.

3. Lifestyle Factors:
- Your BMI of 18.6 indicates that you are on the lower end of the weight spectrum, which is generally positive. However, being underweight can sometimes lead to nutritional deficiencies that may affect your overall health, including your metabolic health.

- Lack of physical activity can contribute to insulin resistance, even in individuals who are not overweight. If you have a sedentary lifestyle, incorporating regular exercise can significantly improve your metabolic health.

- Stress management is also vital. Chronic stress can lead to hormonal changes that may affect blood sugar levels. Consider practices such as mindfulness, yoga, or other relaxation techniques to help manage stress.

In conclusion, while your situation may seem daunting, it is manageable with the right lifestyle changes and regular monitoring. Engaging with a healthcare provider or a registered dietitian can provide personalized guidance tailored to your needs. Remember, early intervention can prevent the progression to type 2 diabetes, so taking proactive steps now is essential for your long-term health.

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