Diabetes, Internal Medicine FAQ

Understanding Glycated Hemoglobin: Key Questions for Your Doctor

Questions related to glycated hemoglobin? (Revised, seeking Dr. Lee's opinion, thank you.) Hello Dr. Lee! I initially consulted another physician, but there are several questions I need to ask my primary physician. Unfortunately, I am currently unable to make an appointment....

Dr. Li Zhiyao Reply:
Dear Pikachu, Please forgive my frankness, and I hope I do not offend you! You have two major issues: one is "obsession," and the other is "losing sight of the main issue." Allow me to explain. "Obsession" refers to your fixation on numbers; please ...

Understanding Glycated Hemoglobin: Key Questions and Insights

Questions related to glycated hemoglobin? Hello, Dr. Hsiao! I have a few questions I would like to ask you. Currently, I do not have diabetes, but my hemoglobin A1c has been rising rapidly (it was 5.1% on February 17 of this year and 5.7% on April 11 of this year), and I have gai...

Dr. Xiao Yongxun Reply:
Reply 1: The frequency of testing for glycated hemoglobin should be determined based on clinical changes and the physician's judgment. Reply 2: This should be discussed with your physician, who can determine if there is any impact. Reply 3: Clinical issues are not that s...

Understanding Fasting Blood Sugar Testing: Common Questions Answered

Please ask again about the timing for blood glucose testing and any other related questions? Hello, Dr. Hsiao! I have read your previous response regarding my question about blood sugar testing times and other related issues, but I still have some confusion. I would like to ask a...

Dr. Xiao Yongxun Reply:
Question 1: The diagnostic criteria for diabetes published by the American Diabetes Association in 2010 are as follows: a. Fasting plasma glucose level ≥ 126 mg/dl after at least 8 hours of fasting. b. Plasma glucose level ≥ 200 mg/dl during a 2-hour oral glucose tolerance test. ...

Understanding Fasting and Postprandial Blood Sugar Testing Guidelines

Questions related to blood glucose testing times and others? Hello Dr. Hsiao! I have a few questions I would like to ask... 1. For fasting blood glucose testing, is it necessary to fast for 8 hours? For example, if I am to test fasting blood glucose today, does that mean I must...

Dr. Xiao Yongxun Reply:
In healthy individuals, approximately 5 to 15 minutes after eating, glucose absorbed through digestion stimulates the beta cells of the pancreas to release stored insulin granules directly into the bloodstream. Between 20 minutes and 2 hours after eating, insulin is subsequently ...

Managing High Nighttime Blood Sugar with Normal Morning Levels

High blood sugar before bedtime and normal blood sugar upon waking? Hello Dr. Hsiao, my mother is seventy years old. She takes insulin during the day and controls her diet for three meals, but her blood sugar levels are consistently over 300 before bedtime. In the morning, her le...

Dr. Xiao Yongxun Reply:
1. There are many types of insulin, primarily including ultra-rapid acting, rapid acting, intermediate acting, and long acting. The timing of their peak effect and duration of action varies. Clinically, it is possible to mix rapid acting and intermediate acting insulins for injec...

Understanding Elevated Postprandial Blood Sugar: Insights and Solutions

Glycated hemoglobin is normal, fasting blood glucose is normal, but postprandial blood glucose is elevated? I undergo a comprehensive health check-up every two years, and my previous blood sugar levels have always been normal. During my recent check-up last month, my fasting bloo...

Dr. Zeng Guosen Reply:
Hello, netizen: Blood glucose levels are a crucial indicator for diagnosing diabetes. In healthy individuals, fasting blood glucose levels after an 8-hour fast should be below 100 mg/dL, and blood glucose levels two hours after a meal should be below 140 mg/dL. If fasting blood g...

Managing Diabetes: Key Questions on Blood Sugar and Diet

Revisiting Diabetes Mellitus? Hello Dr. Hsiao, First of all, thank you for your response last time. Yesterday, I visited the cardiology department to review my blood test results. My fasting blood glucose was 96 mg/dL and my HbA1c was 5.5% (three months ago, my fasting blood glu...

Dr. Xiao Yongxun Reply:
Question 1: Should I still strictly control my intake of starches and sugars? Answer: Strictly controlling the intake of starches and sugars can indeed lower blood glucose and glycated hemoglobin levels, thereby improving conditions such as diabetes or glucose intolerance. In f...

Understanding Blood Sugar Fluctuations in Diabetes Management

About diabetes? Hello Director Hsiao, Over two months ago, I had a blood test at the hospital, and my fasting blood glucose was 130 mg/dL, with a hemoglobin A1c of 6.4%. The doctor did not prescribe medication and advised dietary control instead. I purchased a blood glucose mete...

Dr. Xiao Yongxun Reply:
1. Generally, a fasting blood glucose level of 126 mg/dL corresponds to a glycated hemoglobin (HbA1c) level of approximately 6.5%. Therefore, the test results from two months ago should be reliable. 2. In the classification of diabetes, type 2 diabetes accounts for about 92-95%...

Understanding Hunger-Induced Dizziness and Sleepiness: Blood Sugar Issues?

Feeling hungry, dizzy, and experiencing mood swings, followed by sleepiness after eating, could indicate several issues. These symptoms may suggest fluctuations in blood sugar levels, possibly related to conditions such as hypoglycemia or insulin resistance. It could also be rela...

Dr. Xiao Yongxun Reply:
1. According to the conclusions and recommendations of the American Diabetes Association in 2010, a fasting plasma glucose level between 100 and 125 mg/dl is classified as impaired fasting glucose, indicating an increased risk of diabetes. Therefore, if your blood glucose level i...

Understanding HbA1c Results: Do You Have Diabetes?

Revisiting the second question - Dr. Hsiang-Yung Hsiao? Hello, Doctor! I recently had my hemoglobin A1c tested, and the result was 6.5% (I did not test fasting and postprandial blood glucose). I would like to ask if I have officially been diagnosed with diabetes. My previous hemo...

Dr. Xiao Yongxun Reply:
It is advisable to discuss your concerns with your physician; an HbA1c of 6.5% is already close to diabetes. Therefore, it is essential to pay attention to dietary control and avoid excessive intake; regular exercise is also important.

Understanding HbA1c Results: Do I Have Diabetes?

What are the issues related to diabetes? Hello, Doctor! I recently had my hemoglobin A1c tested, and the report showed 6.5% (I did not test fasting and postprandial blood glucose). I would like to ask if I have officially been diagnosed with diabetes. Previously, my hemoglobin A1...

Dr. Xiao Yongxun Reply:
1. Generally, the onset of type 2 diabetes is gradual and is associated with factors such as genetics, weight, lack of exercise, overeating, alcohol abuse, and medication. Your weight of 113 kilograms is indeed a risk factor for developing the disease; moreover, the longer one is...

Do I Need Medical Attention for a Minor Scratch After Nail Contact?

Could you please tell me if this could lead to a tetanus infection? I previously had a 1 cm long and 1 mm deep (very shallow) scratch on my shoulder, but I don't know what caused it. While working, I accidentally came into contact with a dirty nail, and it seems like it may ...

Dr. Xiao Yongxun Reply:
1. According to your description, the wound is not large; however, if it is a contaminated wound, it is still advisable for you to seek follow-up treatment at a surgical outpatient clinic as soon as possible. 2. Some wounds can develop secondary infections; there is also a possib...

Managing Blood Sugar During Lower GI Barium Enema Preparation

Lower gastrointestinal (GI) contrast enema examination? Hello Doctor, my mother has diabetes. Due to rectal bleeding, the doctor has recommended a lower gastrointestinal tract barium enema examination. However, for this procedure, she needs to take medication the night before to ...

Dr. Xiao Yongxun Reply:
1. Lower gastrointestinal tract imaging has been performed in clinical practice for many years, and every hospital should have a standard operating procedure in place; this also includes considerations for diabetic patients. You and your mother should inquire again with your hosp...

Eye Exams for Diabetic Patients: Understanding the Process and Communication

Eye examinations for diabetic patients? Hello, Doctor. I would like to ask about eye examinations. My father has type 2 diabetes and regularly visits Chang Gung Memorial Hospital (CGMH) every three months for check-ups and picks up his medication monthly. During his last visit, t...

Dr. Xiao Yongxun Reply:
1. To facilitate the early diagnosis and treatment of diabetic retinopathy, it is medically recommended to undergo a comprehensive eye examination at least once a year. The examinations at Changhua Christian Hospital should be considered reasonable and necessary. 2. As for how t...

Understanding Unexplained Weight Loss: A Case Study in Mental Health and Lifestyle

Weight loss Hello Doctor: Since April of this year, I have been working full-time collecting scrap metal. I am a person with a mental disability, and finding a job is not easy; therefore, I resorted to recycling. Initially, it was just a hobby, and I would only collect occasional...

Dr. Xiao Yongxun Reply:
1. Generally, the most common causes of weight loss include diabetes, hyperthyroidism, chronic illnesses, cancer, and others; it also encompasses physical exertion, depression, anorexia, and so on. Since you have already been evaluated by a physician who ruled out the possibility...

Understanding Microscopic Hematuria, Glucose, and Protein in Urine

Microscopic hematuria, glucose, and protein in the urine? Dr. Lee: Hello! I had a pre-employment physical examination on May 20, and on May 29, the report indicated that I had microscopic hematuria at 3+. I went for another urinalysis on May 31, and today, June 6, I received the ...

Dr. Li Zhiyao Reply:
Hello Yu-Yan: If your tests were not conducted during your menstrual period, based on the report results, there is indeed a need to suspect the possibility of kidney disease (urinary tract disorders) and diabetes. However, further examinations are necessary; the diagnosis of diab...

Understanding Excessive Urination: Causes and Concerns Explained

Regarding issues related to urine output? I often feel that I have a large urine output, with a daily intake of at least 1500 to 2500 cc and a drinking volume of about 2000 cc. I went to a urologist for a urinalysis, and aside from a urine specific gravity of 1.003, everything el...

Dr. Wu Jiyu Reply:
1. According to your description of "at least 1500 to 2500 cc per day" and "not urinating much if drinking little or no water," both are normal phenomena. 2. The human body has a self-regulating mechanism; more fluid intake leads to more urination, while less...

Managing Constipation in Diabetic Patients: Tips and Alternatives

Diabetes and Constipation The doctor would like to ask you, my dad has been experiencing constipation for many days and cannot find a way to relieve it. He has issues with high blood pressure and elevated blood sugar. My dad says that the constipation problem started after taking...

Dr. Li Zhiyao Reply:
Hello: 1. If your father's constipation issue is indeed caused by the blood sugar-lowering medication, please have him inform the prescribing physician so that the doctor is aware. The physician may change the medication or prescribe a stool softener. 2. Hypertension can be ...

Does Gallbladder Removal Increase Type 2 Diabetes Risk?

Several questions regarding diabetes? Hello Doctor: I would like to ask about the high-risk groups for diabetes. I am a gallstone patient and have had my gallbladder removed. Does the absence of a gallbladder increase the risk of developing type 2 diabetes? In my family history, ...

Dr. Xiao Yongxun Reply:
1. Having a family history of type 2 diabetes indeed increases the likelihood of developing the condition. This apparent familial clustering of incidence may be attributed to genetic factors, as well as shared dietary and lifestyle habits shaped by cohabitation. The progression o...

Can You Test Your Own Lead Levels? Understanding Symptoms and Home Testing

Dr. Hsiao, is it possible to test for lead levels on my own? Frequent urination at night with bubbles can be concerning.

Dr. Xiao Yongxun Reply:
The assessment of nocturia requires a comprehensive medical history and physical examination, and may even necessitate laboratory tests, urodynamic studies, or imaging examinations. The differential diagnosis must consider many factors, including overactive bladder, heart failure...

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