Q. I was recently screened for diabetes, and my fasting plasma glucose level was 91 mg/dl and my A1C was 5.6%. The A1C level got me worried, so I bought a blood glucose meter, and my monitoring results have only added to my concerns. Given my lab results, when should I be tested again for diabetes?
A. Congratulations on taking a proactive approach to addressing your risk for diabetes. The results you report are not yet in the prediabetic range, which is a fasting plasma glucose level between 100 mg/dl and 125 mg/dl and an A1C level between 5.7% and 6.4%, but monitoring your blood glucose levels may help you avoid entering that stage. It is important, however, to understand when to self-monitor and what the results really indicate. Blood glucose monitoring is usually done before meals, after meals, and at bedtime. If you are checking your blood before breakfast (or after you’ve been fasting for at least eight hours), a desirable result is under 100 mg/dl. When you’re checking your blood after you have eaten, you should wait approximately two hours and look for a result under 140 mg/dl.
Generally the recommendation for people with prediabetes is to be checked for Type 2 diabetes every one to two years. However, in this case, if you are consistently using your blood glucose meter and seeing higher numbers than the thresholds listed above, you should follow up with your doctor. Additional lab testing, such as an oral glucose tolerance test (OGTT), may help your doctor evaluate how your body is processing glucose. When you see your doctor, bring a log of your self-monitoring results, including the times you checked your blood glucose and, if possible, information on your physical activity and what you’ve been eating.
One of the many benefits of being proactive with your health care is that you can often prevent any health problems you have from getting worse. It is possible for some people with elevated blood glucose or even diagnosed prediabetes to return their blood glucose levels to the normal range with early treatment. According to the American Diabetes Association, people with a high risk of developing Type 2 diabetes can lower it by 58% by losing 7% of their body weight and exercising 30 minutes a day most days of the week. If you have extra weight to lose, making just a few healthier food choices (such as cutting out sugary drinks and extra snacks) can help you lose the 10 to 15 pounds that may make a huge difference in your risk for diabetes.