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Routine Blood Work Showed Slightly Elevated Fasting Glucose With Ideal A1C

I went in for my routine physical a couple of weeks ago and my doctor ran a number of tests. She told me my fasting blood work showed a "slightly elevated" glucose level of 103 mg/dL but that my A1c was "ideal" and under the 5.6 threshold. She does not appear to be concerned, but should I be?

She said even though I was fasting if I had lots of sugar the day prior (I did have ice cream the evening before roughly 12.5 hours before test and to be honest I eat ice cream or cookies every other night) that it could have been a temporary residual spike of some kind. She said because my A1c is in ideal range and my margin for glucose was so slight she just wants me to keep work on getting healthier.

Background, I am 5'11" and 203 pounds, just turned 30 years old. 2 years ago I weight 238 pounds and I've been working really hard to get my weight down. One thing I am thinking is because I only eat 1,700 calories a day, but a large majority of it is fruits, juices, and like I said dessert, maybe my intake ratios of sugar are just too high?
2 Responses
15695260 tn?1549596713
Hello and welcome to MedHelp's forums.  Thanks for the question.  Has your doctor recommended any further evaluation?  Most likely they will test you again in the near future.  Continue to work with them and ask as many questions as you have as your doctor is best to guide you.  

Normal fasting blood sugar levels is 72 to 100 for the average person.  Yours are slightly elevated at 103.  This would mean that you should begin watching this to make sure they don't continue to rise and to see if you can impact it to lower the number.  Ways to do so naturally are through diet including cutting back on sugar and carbs as well as increasing your exercise. Weight control can help with diabetes control.  Do you know your BMI?  Also shoot for that target BMI.  https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm

Let us know how you are doing.
2 Comments
Thanks for your insight on my questions. My doctor advised me to get an at home monitor and see how different foods affect my blood sugar.

I've spent a week doing daily monitoring. Having cut out fruit juice from my morning smoothie (replaced with almond milk), cut out honey from my morning tea (replaced with stevia), and cut out my nightly dessert of ice cream or cookies, I have not seen my blood sugar spike above 126 mg/dL at 1 hour postprandial. I've still been eating carbs, just trying to choose brown rice instead of white rice and things like that.

My morning fasting levels have been 91 mg/dL, 95 mg/dL, 96 mg/dL, and 91 mg/dL the last four mornings. I know that at home monitors are not exact, but I feel ok about them.

My pre-meal (breakfast lunch and dinner) readings seem to consistently fall between 75 mg/dL and 85 mg/dL.

My 1 hour postprandial readings seem to consistently fall between 115 mg/dL and 125 mg/dL.

My 2 hour postprandial readings seem to consitently fall between 85 mg/dL and 95 mg/dL but I've seen it hit as high as 105 mg/dL  eating a veggie burger with a bun (60+ grams of carbs and 15+ grams of sugar) but when I took a 2.5 hour postprandial reading it was at 96 mg/dL.

I am 5'11" and currently weight 199 lbs. I weight 221 lbs in February of this year, so I've lost about 22 lbs in the last 3 months. I weight 238 lbs back in August of 2017, so I am down almost 40 lbs in total. With those numbers being considered, my BMI has dropped from 30.8 to 27.8 in the last 3 months. My doctor said she would like to see me under 190 lbs and closer to 185 lbs. That would take my BMI to 25.8 which is still technically overweight. However, I have a very large frame (broad shoulders) and she doesn't think it's necessary to push myself under 180 lbs which is when my BMI would reach the 24's.

It sounds like you have been doing an excellent job of managing this.  I commend you for taking your health seriously and with the efforts you have made, you very well could hold off and control onset of diabetes.  You must keep at it though which is the  hard part!
231441 tn?1333896366
Given your weight and your diet habits, would suggest very strongly that you consider yourself at high risk of diabetes developing in the future.

What was your hba1c?  Truly normal is 5 or less, so if you were above 5 that is also of concern (even if it doesn't concern your doctor).
Insulin levels can be abnormal (and causing health issues) well in advance of your blood sugars rising.

Fruits, sweets, juices and desserts are all very high sugar and are certainly stressing your body and your pancreas and hindering your ability to lose weight.   There is no such thing as an essential carb or sugar, but you definitely need high quality proteins and healthy fats to nuture your body.

Suggest that you replace your fruits and deserts with low carb items and increase your proteins (for satiety and good nutrition).  Desserts can be some low carb fruits such as berries, unsweetened yoghurt, some nuts.    Cut the juices and replace with water or plain teas.

You may even want to look into paleo or low carb eating.  

Please let us know how you go.   Please ask more questions.

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231441 tn?1333896366
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