What are the diagnostic criteria for prediabetes. How can you prevent prediabetes from progressing to type 2 diabetes. What lifestyle changes are recommended for managing prediabetes. When should children be tested for prediabetes.

Diagnosing Prediabetes: Key Tests and Criteria

Prediabetes is a condition that precedes type 2 diabetes, characterized by elevated blood sugar levels that are not yet high enough to be classified as diabetes. Early detection and intervention are crucial for preventing the progression to full-blown diabetes. The American Diabetes Association (ADA) recommends diabetes screening for most adults beginning at age 45, or earlier for those who are overweight and have additional risk factors.

There are several blood tests used to diagnose prediabetes:

Glycated Hemoglobin (A1C) Test

This test measures your average blood sugar level over the past three months. The results are interpreted as follows:

• Below 5.7%: Normal
• 5.7% to 6.4%: Prediabetes
• 6.5% or higher on two separate tests: Type 2 diabetes

It’s important to note that certain conditions, such as pregnancy or uncommon forms of hemoglobin, can affect the accuracy of the A1C test.

Fasting Blood Sugar Test

This test requires fasting for at least eight hours before a blood sample is taken. The results are interpreted as follows:

• Below 100 mg/dL (5.6 mmol/L): Normal
• 100 to 125 mg/dL (5.6 to 7.0 mmol/L): Prediabetes (impaired fasting glucose)
• 126 mg/dL (7.0 mmol/L) or higher: Type 2 diabetes

Oral Glucose Tolerance Test

This test is primarily used to diagnose diabetes during pregnancy. After fasting and having an initial blood sample taken, you drink a sugary solution, and your blood sugar is measured again after two hours. The results are interpreted as follows:

• Below 140 mg/dL (7.8 mmol/L): Normal
• 140 to 199 mg/dL (7.8 to 11.0 mmol/L): Prediabetes (impaired glucose tolerance)
• 200 mg/dL (11.1 mmol/L) or higher: Type 2 diabetes

If you’re diagnosed with prediabetes, your doctor will typically check your blood sugar levels at least once a year to monitor your condition.

Prediabetes in Children: Risk Factors and Testing

With the rise in childhood obesity, type 2 diabetes is becoming increasingly common in children and adolescents. The ADA recommends prediabetes testing for children who are overweight or obese and have one or more additional risk factors, including:

• Family history of type 2 diabetes
• Certain racial/ethnic backgrounds (African American, Hispanic, Native American, Asian American, and Pacific Islander)
• Low birth weight
• Being born to a mother who had gestational diabetes

The blood sugar ranges used to diagnose prediabetes and diabetes are the same for children and adults. Children with prediabetes should be tested annually for type 2 diabetes, or more frequently if there are changes in weight or symptoms such as increased thirst, urination, fatigue, or blurred vision.

Lifestyle Interventions for Managing Prediabetes

Adopting healthy lifestyle choices can help bring your blood sugar levels back to normal or prevent them from rising to diabetic levels. Here are some key strategies for managing prediabetes:

Eat a Healthy Diet

Focus on consuming foods that are low in fat and calories but high in fiber. Incorporate plenty of fruits, vegetables, and whole grains into your meals. Aim for a varied diet that helps you achieve your health goals without compromising on taste or nutrition.

Increase Physical Activity

Regular exercise is crucial for managing prediabetes. Aim for at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous aerobic activity per week. This can include activities like brisk walking, cycling, swimming, or dancing.

Achieve and Maintain a Healthy Weight

If you’re overweight, losing just 5% to 7% of your body weight can significantly reduce your risk of developing type 2 diabetes. For example, if you weigh 200 pounds (91 kilograms), losing 14 pounds (6.4 kilograms) can make a substantial difference. Focus on making permanent changes to your eating and exercise habits to maintain a healthy weight long-term.

Quit Smoking

Smoking has been linked to an increased risk of developing type 2 diabetes. If you currently smoke, consider quitting to improve your overall health and reduce your diabetes risk.

Take Medications as Prescribed

In some cases, your doctor may recommend medications to help manage prediabetes. Metformin (Glumetza, others) is commonly prescribed for individuals at high risk of diabetes. Additionally, medications to control cholesterol and high blood pressure may be recommended as part of a comprehensive treatment plan.

Managing Prediabetes in Children: Special Considerations

Children diagnosed with prediabetes should follow similar lifestyle recommendations as adults, with some specific considerations:

• Weight management through healthy eating and increased physical activity
• Reducing consumption of refined carbohydrates and unhealthy fats
• Increasing fiber intake
• Controlling portion sizes
• Limiting eating out at restaurants
• Engaging in at least one hour of physical activity daily

It’s important to note that medication is generally not recommended as the first-line treatment for prediabetes in children. Instead, the focus is on lifestyle modifications and regular monitoring.

The Importance of Regular Monitoring and Follow-up

Regular monitoring of blood sugar levels is crucial for individuals with prediabetes. Your healthcare provider will typically recommend periodic follow-up appointments to assess your progress and adjust your management plan as needed. These appointments may include:

• Blood sugar tests to track your levels over time
• Blood pressure and cholesterol checks
• Weight measurements
• Discussions about your diet and exercise habits
• Adjustments to your treatment plan, if necessary

By staying vigilant and proactive in your prediabetes management, you can significantly reduce your risk of progressing to type 2 diabetes and improve your overall health.

Understanding the Relationship Between Fasting Glucose and Long-term Health

A fasting glucose level of 105 mg/dL falls within the prediabetic range, indicating an increased risk of developing type 2 diabetes. However, it’s essential to understand that blood sugar levels can fluctuate, and a single reading doesn’t provide a complete picture of your health. Here’s what you need to know about the relationship between fasting glucose and long-term health:

The Significance of Fasting Glucose Levels

Fasting glucose levels provide valuable information about how your body processes sugar when you haven’t eaten for several hours. A level of 105 mg/dL suggests that your body may be struggling to maintain normal blood sugar levels, potentially due to developing insulin resistance or decreased insulin production.

Long-term Health Implications

Consistently elevated fasting glucose levels can have several long-term health implications:

• Increased risk of developing type 2 diabetes
• Higher likelihood of cardiovascular disease
• Potential for nerve damage (neuropathy)
• Increased risk of kidney problems
• Greater susceptibility to infections

However, it’s important to remember that prediabetes is reversible with appropriate lifestyle changes and medical intervention if necessary.

Strategies for Lowering Fasting Glucose Levels

If your fasting glucose level is 105 mg/dL or in the prediabetic range, there are several strategies you can employ to help lower it:

1. Dietary Modifications

Focus on consuming foods with a low glycemic index, which are less likely to cause rapid spikes in blood sugar. These include:

• Non-starchy vegetables (e.g., leafy greens, broccoli, cauliflower)
• Whole grains (e.g., quinoa, brown rice, oats)
• Lean proteins (e.g., chicken, fish, tofu)
• Healthy fats (e.g., avocados, nuts, olive oil)

2. Regular Exercise

Physical activity helps improve insulin sensitivity and lowers blood sugar levels. Aim for a combination of aerobic exercises and strength training for optimal results.

3. Stress Management

Chronic stress can elevate blood sugar levels. Incorporate stress-reduction techniques such as meditation, deep breathing exercises, or yoga into your daily routine.

4. Adequate Sleep

Poor sleep quality and insufficient sleep duration can negatively impact blood sugar control. Aim for 7-9 hours of quality sleep each night.

5. Stay Hydrated

Proper hydration helps your kidneys flush out excess glucose through urine. Aim to drink plenty of water throughout the day.

The Role of Continuous Glucose Monitoring in Managing Prediabetes

Continuous Glucose Monitoring (CGM) systems are becoming increasingly popular tools for managing prediabetes and diabetes. These devices provide real-time information about your blood sugar levels throughout the day and night, offering several benefits:

Benefits of CGM for Prediabetes Management

• Identify patterns in blood sugar fluctuations
• Understand how different foods and activities affect your glucose levels
• Detect nocturnal hypoglycemia or hyperglycemia
• Provide motivation for maintaining healthy habits
• Allow for more precise adjustments to your management plan

While CGM systems are not always covered by insurance for individuals with prediabetes, discussing this option with your healthcare provider can help you determine if it’s a suitable tool for your specific situation.

The Importance of a Multidisciplinary Approach to Prediabetes Management

Managing prediabetes effectively often requires a multidisciplinary approach, involving various healthcare professionals who can provide comprehensive care and support. This team may include:

• Primary Care Physician: Oversees your overall health and coordinates your care
• Endocrinologist: Specializes in hormonal disorders, including diabetes and prediabetes
• Registered Dietitian: Provides personalized nutrition advice and meal planning
• Certified Diabetes Educator: Offers education and support for managing blood sugar levels
• Exercise Physiologist: Helps develop safe and effective exercise programs
• Mental Health Professional: Addresses the psychological aspects of managing a chronic condition

By working with a diverse team of healthcare professionals, you can develop a comprehensive management plan that addresses all aspects of your health and well-being.

Exploring Alternative and Complementary Therapies for Prediabetes

While lifestyle modifications and conventional medical treatments are the cornerstone of prediabetes management, some individuals may be interested in exploring alternative and complementary therapies. It’s important to note that these approaches should not replace conventional treatments but may be used in conjunction with them under the guidance of your healthcare provider.

Potential Alternative and Complementary Approaches

• Acupuncture: Some studies suggest that acupuncture may help improve insulin sensitivity
• Herbal supplements: Certain herbs, such as cinnamon and fenugreek, have shown potential in improving blood sugar control
• Mindfulness practices: Techniques like meditation and mindfulness-based stress reduction may help manage stress and improve overall well-being
• Yoga: Regular yoga practice may help improve blood sugar control and reduce stress
• Chromium supplementation: Some research suggests that chromium may help improve insulin sensitivity

Always consult with your healthcare provider before starting any alternative or complementary therapies, as they may interact with medications or have unexpected effects on your blood sugar levels.

The Future of Prediabetes Management: Emerging Technologies and Treatments

As research in the field of diabetes and prediabetes continues to advance, new technologies and treatments are emerging that may revolutionize how we manage these conditions. Some promising areas of development include:

1. Artificial Intelligence and Machine Learning

AI-powered algorithms are being developed to analyze data from CGM devices and other health metrics to provide more personalized recommendations for diet, exercise, and medication adjustments.

2. Smart Insulin Delivery Systems

While primarily designed for type 1 diabetes, these systems may also benefit individuals with prediabetes or early-stage type 2 diabetes by providing more precise insulin delivery.

3. Gut Microbiome Interventions

Research is exploring the potential of modifying the gut microbiome to improve insulin sensitivity and glucose metabolism.

4. Gene Therapy

Scientists are investigating the possibility of using gene therapy to enhance insulin production or improve insulin sensitivity at the cellular level.

5. Novel Pharmacological Agents

New classes of medications are being developed that target different aspects of glucose metabolism and insulin action, potentially offering more effective treatments for prediabetes and type 2 diabetes.

As these technologies and treatments continue to evolve, they may offer new hope for more effective management of prediabetes and prevention of its progression to type 2 diabetes. However, it’s important to remember that lifestyle modifications remain the foundation of prediabetes management, and emerging technologies should be viewed as complementary tools rather than replacements for healthy habits.

Prediabetes – Diagnosis and treatment

Diagnosis

The American Diabetes Association (ADA) recommends that diabetes screening for most adults begin at age 45. The ADA advises diabetes screening before age 45 if you’re overweight and have additional risk factors for prediabetes or type 2 diabetes.

There are several blood tests for prediabetes.

Glycated hemoglobin (A1C) test

This test shows your average blood sugar level for the past three months. The test measures the percentage of blood sugar attached to the oxygen-carrying protein in red blood cells called hemoglobin. The higher your blood sugar levels, the more hemoglobin you’ll have with sugar attached.

In general:

• An A1C level below 5.7% is considered normal
• An A1C level between 5. 7% and 6.4% is considered prediabetes
• An A1C level of 6.5% or higher on two separate tests indicates type 2 diabetes

Certain conditions can make the A1C test inaccurate — such as if you’re pregnant or have an uncommon form of hemoglobin.

Fasting blood sugar test

A blood sample is taken after you fast for at least eight hours or overnight.

In general:

• A fasting blood sugar level below 100 milligrams per deciliter (mg/dL) — 5.6 millimoles per liter (mmol/L) — is considered normal.
• A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 7.0 mmol/L) is considered prediabetes. This result is sometimes called impaired fasting glucose.
• A fasting blood sugar level of 126 mg/dL (7. 0 mmol/L) or higher indicates type 2 diabetes.

Oral glucose tolerance test

This test is usually used to diagnose diabetes only during pregnancy. A blood sample is taken after you fast for at least eight hours or overnight. Then you’ll drink a sugary solution, and your blood sugar level will be measured again after two hours.

In general:

• A blood sugar level less than 140 mg/dL (7.8 mmol/L) is considered normal.
• A blood sugar level from 140 to 199 mg/dL (7.8 to 11.0 mmol/L) is considered prediabetes. This is sometimes referred to as impaired glucose tolerance.
• A blood sugar level of 200 mg/dL (11.1 mmol/L) or higher indicates type 2 diabetes.

If you have prediabetes, your doctor will typically check your blood sugar levels at least once a year.

Children and prediabetes testing

Type 2 diabetes is becoming more common in children and adolescents, likely due to the rise in childhood obesity. The ADA recommends prediabetes testing for children who are overweight or obese and who have one or more other risk factors for type 2 diabetes.

These other risk factors include:

• Family history of type 2 diabetes.
• Race. Children who are African American, Hispanic, Native American, Asian American and Pacific Islander are at higher risk.
• Low birth weight.
• Being born to a mother who had gestational diabetes.

The ranges of blood sugar level considered normal, prediabetic and diabetic are the same for children and adults.

Children who have prediabetes should be tested annually for type 2 diabetes — or more often if the child experiences a change in weight or develops signs or symptoms of diabetes, such as increased thirst, increased urination, fatigue or blurred vision.

Treatment

Healthy lifestyle choices can help you bring your blood sugar level back to normal, or at least keep it from rising toward the levels seen in type 2 diabetes.

To prevent prediabetes from progressing to type 2 diabetes, try to:

• Eat healthy foods. Choose foods low in fat and calories and high in fiber. Focus on fruits, vegetables and whole grains. Eat a variety of foods to help you achieve your goals without compromising taste or nutrition.
• Be more active. Aim for at least 150 minutes of moderate or 75 minutes of vigorous aerobic activity a week.
• Lose excess weight. If you’re overweight, losing just 5% to 7% of your body weight — about 14 pounds (6.4 kilograms) if you weigh 200 pounds (91 kilograms) — can reduce the risk of type 2 diabetes. To keep your weight in a healthy range, focus on permanent changes to your eating and exercise habits.
• Stop smoking. Smoking may up your risk of developing type 2 diabetes.
• Take medications as needed. If you’re at high risk of diabetes, your doctor might recommend metformin (Glumetza, others). Medications to control cholesterol and high blood pressure might also be prescribed.

Children and prediabetes treatment

Children with prediabetes should undertake the lifestyle changes recommended for adults with type 2 diabetes, including:

• Losing weight
• Eating fewer refined carbohydrates and fats, and more fiber
• Reducing portion sizes
• Eating out less often
• Spending at least one hour every day in physical activity

Medication generally isn’t recommended for children with prediabetes unless lifestyle changes aren’t improving blood sugar levels. If medication is needed, metformin (Glumetza, others) is usually the recommended drug.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Alternative medicine

Many alternative therapies have been touted as possible ways to treat or prevent type 2 diabetes. But, there’s no definitive evidence that any alternative treatments are effective. Therapies that have been said to be helpful in type 2 diabetes and are also likely to be safe, include:

• Cassia cinnamon
• Flaxseed
• Ginseng
• Magnesium
• Oats
• Soy
• Xanthan gum

Talk to your doctor if you’re considering dietary supplements or other alternative therapies to treat or prevent prediabetes. Some supplements or alternative therapies might be harmful if combined with certain prescription medications. Your doctor can help you weigh the pros and cons of specific alternative therapies.

Preparing for your appointment

You’re likely to start by seeing your primary care doctor. He or she may refer you to a doctor who specializes in diabetes treatment (endocrinologist), a dietitian or a certified diabetes educator.

Here’s some information to help you get ready for your appointment.

What you can do

Before your appointment, take these steps:

• Ask about any pre-appointment restrictions. You’ll probably need to fast for at least eight hours before your appointment so that your doctor can measure your fasting blood sugar level.
• List symptoms you’ve been having and for how long.
• List all medications, vitamins and supplements you take, including the doses.
• List key personal and medical information, including other conditions, recent life changes and stressors.
• Prepare questions to ask your doctor.

For prediabetes, some basic questions to ask your doctor include:

• How can I prevent prediabetes from turning into type 2 diabetes?
• Do I need to take medication? If so, what side effects can I expect?
• I have other health conditions. How can I best manage them together?
• How much do I need to exercise each week?
• Should I avoid any foods? Can I still eat sugar?
• Do I need to see a dietitian?
• Can you recommend any local programs for preventing diabetes?

What to expect from your doctor

Your doctor is likely to ask you a number of questions, such as:

• Has your weight changed recently?
• Do you exercise regularly? If so, for how long and how often?
• Do you have a family history of diabetes?

Sept. 22, 2020

Prediabetes 101

Misconceptions abound about prediabetes. Elizabeth Halprin, MD, an endocrinologist at Joslin Diabetes Center in Boston, explains some basics about this condition.

How is prediabetes different from diabetes?

Prediabetes is a condition that happens when your blood sugar levels are above normal but not high enough to be considered type 2 diabetes. A fasting blood sugar between 110 and 125 would be considered in the “prediabetes” range. Less than 110 is normal and greater than 126 is diabetes. These abnormal blood sugar levels usually happen when a person’s tissues don’t respond well to a hormone [insulin] signal to take up sugar from the blood. Also, the body doesn’t make enough insulin to help overcome the weak tissue response to insulin.

Does prediabetes always progress to type 2 diabetes?

No, not always. People who eat a health-conscious diet, exercise regularly, and keep a healthy weight can lower their blood sugar levels and even bring them back to normal. In fact, learning you have prediabetes gives you a chance to make the lifestyle changes you need to avoid getting type 2 diabetes.

What puts me at risk of having prediabetes?

The biggest risk factor for prediabetes in the general adult population is being overweight or obese, particularly when the extra weight is due to excess fat in your abdomen. Also, the older you get, the higher your risk goes. Black, Hispanic, and Asian people are at higher risk than other races, as well as women who have had gestational diabetes, and people with a family history of diabetes.

How can a doctor tell if I have prediabetes? Are there symptoms?

There’s no way to know you have prediabetes without a doctor diagnosing with a blood test. Typically, people with prediabetes don’t have any symptoms. Symptoms of high blood sugar levels — like frequent urination, increased thirst, blurry vision, and fatigue — usually become noticeable once a person develops diabetes. Some people with prediabetes may have signs of insulin resistance — darkened skin in the armpit or on the back and sides of the neck or small skin growths or skin tags in these same areas.

What can I do to help prevent prediabetes?

Eat more vegetables, fewer simple carbs [such as those in sugary foods like candy and many processed foods], and increase your activity. Try to get 10,000 steps per day, at least. Exercise gets your body to use its own insulin more efficiently so that the blood sugars come down. It also helps you lose or maintain your weight, which will decrease the risk of prediabetes and diabetes.

Avoid junk food, and sweets, and especially sweet drinks like soda and juice. Get plenty of sleep. Poor sleep hygiene and not getting enough sleep makes it harder to lose weight, and therefore increases the risk of prediabetes.

Find more articles, browse back issues, and read the current issue of WebMD Magazine.

The Surprising Truth About Prediabetes

Prediabetes Flies Under the Radar

You can have prediabetes for years but have no clear symptoms, so it often goes undetected until serious health problems show up. That’s why it’s important to talk to your doctor about getting your blood sugar tested if you have any of the risk factors for prediabetes, which include:

• Being overweight
• Being 45 years or older
• Having a parent, brother, or sister with type 2 diabetes
• Being physically active less than 3 times a week
• Ever having gestational diabetes (diabetes during pregnancy) or giving birth to a baby who weighed more than 9 pounds

Race and ethnicity are also a factor: African Americans, Hispanic/Latino Americans, American Indians, Pacific Islanders, and some Asian Americans are at higher risk.

Ready to find out your risk? Take the 1-minute prediabetes risk test and be sure to share the results with your doctor.

Diabetes Is Harder to Live with Than Prediabetes

Though people with prediabetes are already at a higher risk of heart disease and stroke, they don’t yet have to manage the serious health problems that come with diabetes.

Diabetes affects every major organ in the body. People with diabetes often develop major complications, such as kidney failure, blindness, and nerve damage (nerve damage can lead to amputation of a toe, foot, or leg). Some studies suggest that diabetes doubles the risk of depression, and that risk increases as more diabetes-related health problems develop. All can sharply reduce quality of life.

Prediabetes = Preventdiabetes

Think of prediabetes as a fork in the road: Ignore it, and your risk for type 2 diabetes goes up. Lose a modest amount of weight and get regular physical activity, and your risk goes down. Modest weight loss means 5% to 7% of body weight, just 10 to 14 pounds for a 200-pound person. Regular physical activity means getting at least 150 minutes a week of brisk walking or similar activity. That’s just 30 minutes a day, five days a week.

The CDC-led National Diabetes Prevention Program (National DPP) has been proven to help people make the lifestyle changes needed to prevent or delay type 2 diabetes. Through the program, participants:

• Work with a trained coach to make lasting lifestyle changes.
• Discover how to eat healthy and add more physical activity into their day.
• Find out how to manage stress, stay motivated, and solve problems that can slow progress.

If you’re told you have prediabetes, ask your doctor or nurse if there is a National DPP lifestyle change program offered in your community. The best time to prevent type 2 diabetes is now.

Gestational Diabetes Fasting Blood Sugar 105-110

If you’re diagnosed with gestational diabetes (GD), it’s very important to keep your blood glucose (sugar) level within the target range. You may need to check it several times a day – typically before meal (fasting) and after meal. Fasting blood sugar 105 and 110 mg /dL are commonly considered abnormal. These high levels are still too dangerous for pregnancy. The good news, GD is controllable and you can still have a healthy pregnancy.

Brief summary about gestational diabetes

As the name suggests, it occurs during pregnancy – and it’s only found in pregnancy. You cannot get rid of it during pregnancy, but again it’s treatable! And it usually goes away on its own after giving birth.

Causes and risk factors

Like diabetes mellitus, in GD the body also loses its natural ability to use glucose (sugar) for energy as effectively as usual. What is the exact cause? The answer is not fully known yet. But there are some explanations.

The increased pregnancy hormones, especially in late pregnancy, are often to blame. The placenta is essential part of pregnancy. It is responsible to stimulate and produce essential hormones for baby development and growth during pregnancy.

But some of these hormones can interrupt with the mother’s insulin that may cause a condition called insulin resistance (when insulin doesn’t work as effectively as usual). The demand for insulin can significantly increase during pregnancy, could be 2-3 times greater than normal. In some pregnancies, the body fails to make enough insulin, and GD may develop.

What is insulin?

Insulin is essential hormone that plays a key role in your glucose metabolism. It is produced by pancreas. With insulin, glucose in the blood can be effectively absorbed by cells of the body for energy. And if there something goes awry with insulin, the body will lose its natural ability to regulate the balance of glucose in the blood.

When pregnancy is over, so is gestational diabetes. Soon after delivery, the pregnancy hormones and placenta go away. Then insulin will return to normal.

Doctors don’t know why some pregnancies develop GD. But in general, the risk of developing the condition is high in women with the following risk factors:

1. Being obese before pregnant.
2. Having pre-diabetes before pregnant, a condition in which you have high blood sugar but not high enough to be categorized into diabetes. See also the table of normal and abnormal blood sugar levels!
3. GD is also likely to run in families. If you have a family history of GD or diabetes mellitus, your risk is higher to develop the same condition.
4. A personal history of GD. If you have had GD in your previous pregnancy, you’re likely to have it again in your next pregnancy.
5. GD is relatively more common in Native American, African-American, Hispanic, and Asian.

What happen if gestational diabetes is poorly controlled?

Again, GD doesn’t go away during pregnancy. But this doesn’t mean that you can ignore it. It’s always important to make sure that your GD is well controlled.

Poorly-controlled high blood sugar will pay the price in some consequences. The following are some complications that may occur if your GD is poorly controlled:

1. The risk of a serious pregnancy complication called preeclampsia, typically characterized by excessive protein in the urine and high blood pressure. It can hurt both the mother and baby – even sometime it could cause death. It is commonly found during the second half of pregnancy, though sometime it may also develop earlier.
2. The risk of giving birth earlier than normal due to the baby has grown too big or if you have preeclampsia or due to other reasons. And you may need to take a cesarean section (c-section) to deliver baby earlier.
3. And premature birth also carries some consequences. The baby is not only at high risk of getting overweight (larger than normal) at birth, but also may experience hypoglycemia (low blood glucose) right after birth, respiratory distress syndrome (a breathing problem), and a greater chance of dying soon after or before birth.

GD also increases the risk of type-2 diabetes. All of these risks may make you worry about your pregnancy. But these risks are so preventable. Even many pregnant women with GD, especially if the condition is well controlled, have normal pregnancies and deliver healthy babies.

Gestational diabetes fasting blood sugar targets

Your doctor usually asks you to check blood glucose at certain times of day, particularly such as after fasting or before your first meal of the day. As the name implies, fasting means refraining from eating or drinking (except plain water).

Fasting blood sugar is used for a number of reasons. It can be used to see how well your blood sugar is controlled. It may also help analyze the effectiveness of diabetic treatment you’re taking.

Again, fasting blood sugar 105 and 110 are still considered high in GD. The blood sugar level targets may vary from woman to woman – ask your healthcare provider for more advice. In general, the following are recommended blood sugar targets for pregnant women with GD:

Fasting blood glucose levels and initiation of insulin therapy in gestational diabetes

Objective:

To determine whether an initial fasting blood glucose determination will predict which pregnant women will need insulin in addition to dietary measures to maintain fasting glucose levels during gestation.

Methods:

All women referred for management of gestational diabetes received dietary counseling and instructions for self-monitoring of blood glucose levels during fasting and at 2 hours after each meal. Insulin therapy was initiated if the fasting blood glucose value exceeded 5.8 mmol/L (105 mg/dL) on more than one occasion, the 2-hour postprandial glucose exceeded 8.3 mmol/L (150 mg/dL), or the 2-hour postprandial glucose exceeded 6.7 mmol/L (120 mg/dL) three times in a week. The use of diet alone or diet plus insulin therapy was determined by review of medical records.

Results:

Fifty-two pregnant women with fasting blood glucose levels of less than 5.8 mmol/L (105 mg/dL) and with two or more elevated blood glucose values on a 3-hour glucose tolerance test underwent follow-up at least through the 36th week of gestation. In 21 patients, insulin therapy was initiated in addition to diet. Two of five women with an initial fasting glucose level of less than 4.4 mmol/L (80 mg/dL) required insulin, and 8 of 24 women with fasting levels of 5.3 to 5.8 mmol/L (96 to 105 mg/dL) eventually needed insulin.

Conclusion:

The height of the fasting blood glucose level in women with gestational diabetes does not separate those who will maintain blood glucose levels in the targeted therapeutic range on diet alone from those who will need insulin. Therefore, all women with gestational diabetes need to participate in self-monitoring of blood glucose levels.

Blood sugar 105 mg/dl fasting – good or bad?

We help you interpret your blood sugar values. You have tested your blood sugar fasting and the result was 105 mg/dl. The corresponding A1C is 5.3%. Let’s have a look at the blood sugar gauge:

Your result is:

Slightly too high blood sugar (beginning hyperglycemia)

To improve your blood sugar fasting you need to
lower your blood glucose level by 5mg/dl.

Your fasting blood sugar level should always be below 100mg/dl but not fall below 80mg/dl.

Blood sugar testing measures how much glucose is in the bloodstream. No matter what is eaten, from a small snack to a large meal, blood glucose values rise in response to any carbohydrates that are digested.Check your fasting blood sugar

In a healthy person, the pancreas reacts to the higher blood glucose by releasing insulin, a hormone that converts blood sugar into usable energy.

In addition to carbohydrates, other body processes also raise blood sugar levels.When a person fasts, which is defined medically as not eating or drinking anything aside from water for at least eight hours, the release of glucagon is triggered in the body. Glucagon instructs the liver to metabolize reserve supplies of glycogen, which are then circulated into the bloodstream as sugars. Accordingly, the amount of plasma glucose goes up. This is how the body creates energy even while fasting.

In sum, when diabetes is not present the body responds to all blood sugars by manufacturing insulin in proportion with the glucose level. When it comes to fasting blood sugars, insulin lowers and stabilizes the levels so that they remain in a normal, healthy range. Yet when any form of diabetes is present, either pre-diabetes, Type 1 diabetes or Type 2 diabetes, the whole physiological process doesn’t work correctly, and blood sugars are often considerably higher than normal. The fasting blood sugar test (FBS) is commonly used to detect the existence of diabetes.

In order to prepare for a fasting blood sugar test, one must refrain from eating or drinking from eight to twelve hours before the test, depending upon the doctor’s instructions. It is conducted in the same manner as any laboratory blood test. The health professional will wrap an elastic band around the upper arm in order to restrict blood flow, which enlarges the veins and facilitates the insertion of a needle. After disinfecting the site with alcohol, a needle is placed into the vein and blood is drawn into a vial, which will be then be sent for laboratory testing.

Intermittent fasting diet

A normal result for fasting blood glucose ranges from 70 – 100 mg/dL. According to criteria set by the American Diabetes Association, a higher than normal fasting blood sugar between 100 to 125 mg/dL (5.6 to 6.9 mmol/L) may indicate prediabetes. This shows an increased risk of developing Type 2 diabetes.

When the measurement is above 126 mg/dL (7 mmol/L), a diagnosis of diabetes is likely. A lower than normal result may point to hypoglycemia that is caused by a specific type of tumor in the pancreas, and further diagnostic testing is needed.

Besides eating or drinking during the eight hours before the fasting blood sugar test, other factors may influence the outcome. Illness, drinking alcohol or excessive caffeine the day before, smoking and emotional stress can all impact blood sugar levels. Fasting blood sugar tests should therefore be performed twice, on two separate days, in order to confirm that results are consistent.

Non-Fasting Glucose: What Are Normal Blood Sugar Levels?

People with diabetes should test their non-fasting glucose levels regularly.

Image Credit: PeopleImages/E+/GettyImages

Non-fasting glucose levels can be a key measurement of any person’s health, and regular blood sugar testing is an especially critical part of any diabetes care plan.

Here’s what you should know about non-fasting blood work, including normal blood glucose levels.

Glucose 101

Blood sugar, or glucose, is one of the body’s primary sources of fuel, which it mainly gets by metabolizing the carbohydrates in food. The hormone insulin helps move glucose out of the blood and into the cells.

But people with diabetes either don’t make enough insulin or can’t use the insulin their bodies do make effectively, according to the American Diabetes Association (ADA). This results in high blood sugar, or hyperglycemia. People with diabetes can also experience low blood sugar (hypoglycemia), especially if they are taking blood sugar-lowering medications like insulin.

A blood sugar level is simply a measurement of how much glucose is in the bloodstream at the moment you check. If you have diabetes, your doctor will help you determine how frequently you need to check your sugar level. According to the Mayo Clinic, people with diabetes may need to monitor their blood sugar anywhere from two to 10 times per day.

What Is Normal Non-Fasting Glucose?

Normal non-fasting blood sugar levels should be less than 180 milligrams per deciliter (mg/dL) for those with diabetes, according to the ADA. For those without diabetes, it’s less than 140 mg/dL, according to Virginia Mason Diabetes Care.

Blood Sugar Before and After Meals

There are many different times of day when you can check your blood sugar, but the most important times are typically before and after a meal. Checking your blood sugar before a meal can help you decide which foods to eat and how much insulin to take. According to the ADA’s Standards of Medical Care in Diabetes — 2019, a healthy blood sugar level before a meal should fall somewhere between 80 and 130 mg/dL.

Checking your blood sugar after you eat tells you how your body is processing your meal and whether or not you currently have enough insulin in your system. But don’t check your blood sugar immediately after you finish your food. “If a patient wants to see their body’s response to a meal, they need to wait two hours before checking blood glucose,” says Samar Hafida, MD, an endocrinologist at Boston’s Joslin Diabetes Center. “That’s how long it takes for the body to fully digest carbs.”

To see the effect of a meal on your blood glucose, measure your blood sugar two hours after starting your meal; that’s when your blood sugar will peak. According to the ADA, the goal is that this peak, non-fasting glucose level will be less than 180 mg/dL.

Read more: How Long Does It Take for Blood Sugar Levels to Peak After Eating?

Your blood sugar levels will measure differently before and after meals.

Image Credit: Marco_Piunti/iStock/GettyImages

Blood Sugar Levels at Night

It’s also important to check your blood sugar before bedtime. According to the Joslin Diabetes Center, your before-bed blood sugar should be between 90 and 150 mg/dL. If your level is lower than this, you may need to have a small snack to prevent your blood sugar from falling too low overnight.

If you notice that your morning blood sugar levels are high, it may be due to something called the Somogyi effect, according to the Cleveland Clinic. This phenomenon occurs when blood sugar levels drop too low overnight, prompting the liver to release stored glucose to “rescue” you. If your doctor suspects that you are experiencing the Somogyi effect, he or she may ask you to check your blood sugar between 2 and 3 a.m. for several nights in a row. If your overnight sugars are indeed too low, your doctor will help you come up with a plan to manage the situation.

Read more: How to Quickly Reverse a Sugar Crash

When Should You Check Your Non-Fasting Glucose Levels?

Talk with your doctor about how often you need to check your blood sugar. Testing will depend on the type of diabetes medicine you take, as well as your overall glucose level (aka A1C level). If you’re new to insulin, you’ll likely have to check your blood sugar several times a day. Other people with diabetes may only need to check their levels a few times a week.

You might occasionally need to check your blood sugar at times unrelated to a meal or bedtime. For example, if your doctor has recently made a change to your diabetes medication, he or she may ask you to monitor your blood glucose more frequently throughout the day in order to gauge how well your new medications are working.

You may also experience elevated blood sugars when you’re sick, as this can be part of the body’s natural response to fighting an infection, according to the National Institutes of Health. If you have a cold, therefore, you might need to check your blood sugar levels more frequently. Blood glucose can also be elevated during pregnancy or times of stress.

If you experience the symptoms of hypoglycemia, check your blood sugar ASAP. This is the only way to actually confirm that it’s low, according to the ADA.

It’s not a good idea to check your blood sugar without a clear reason, however. “The meaningful data points provided by blood sugar readings are usually tied to a meal,” Dr. Hafida explains. Checking blood sugar randomly — especially directly after a meal — can be misleading, and might cause you to adjust your medicine or carb intake incorrectly.

School of Diabetes – Self-Monitoring of Blood Glucose

The main goal of treatment is to achieve normal or near-normal glycated hemoglobin levels (reflects the “average” blood glucose levels over 2-3 months) to prevent complications of diabetes.

The individual goal of treatment (glycated hemoglobin and fasting glucose level) you choose together with your doctor, it will depend on several conditions: the duration of the disease and the presence of complications, age and concomitant diseases, etc.d.

In most cases, the optimal target is a glycated hemoglobin level <7%. In order to achieve this goal, it is necessary that the blood glucose level during self-monitoring does not exceed the corresponding values ​​(see table below).

Individual treatment goals for fasting / pre-meal plasma glucose and 2 hours post-meal depending on the selected target glycated hemoglobin (HbA1c) level.

For self-monitoring of blood glucose, use:

Test strips for portable devices – glucometers.The use of the meter does not require special training, it is only necessary, as before using any household appliance or equipment, to carefully read the instructions. Glucometers differ among themselves primarily by the method of the test (electro- and photochemical), as well as the speed of determination (from 5 to 45 seconds), the presence or absence of a special code, the memory size of the results and other functions. The technique is very simple: you need to turn on the device, enter the code of the test strips (if necessary), insert the test strip and apply on it a small drop of blood obtained from the finger (the test strip with a capillary device will suck blood from the drop by itself).

See more Technique for taking a drop of blood.

Modern glucometers allow you to quickly get an accurate result (permissible error of 10-20%) anywhere (you can carry them with you), and also have a number of useful additional functions, the number of which is constantly increasing (memory, sound signal for visually impaired patients, the possibility download results to a computer, etc.)

At the same time, it is necessary to take into account your possibilities: choose a device that you can afford to “maintain”, since the main expenses are not the cost of the device, but the cost of consumables – test strips.Sometimes the costs of purchasing test strips can be partially covered by relatives, for example, as a gift for a holiday, you can ask for a gift of test strips.

Remember that you need to calibrate your meters on a regular basis (check their accuracy with a known concentration of glucose solution supplied with the meter, or in laboratories / firms that offer such services), and change the batteries in time.

Remember not to use

test strips

• Exposed to high or low temperatures

Expired

• Stored in an open box

How often should self-monitoring of blood glucose be performed?

General rules for self-testing are approximately as follows.

In everyday life, for patients on insulin, self-monitoring of blood glucose levels should be performed daily at least 4 times a day – before meals and before bedtime, sometimes 2 hours after meals, and several times a month at 2-4 am.

The frequency of self-monitoring of blood glucose levels depends on the type of antihyperglycemic therapy:

Additional measurements will be required in the following situations:

• sports
• travel
• symptoms of hypoglycemia
• before driving.

Regular blood glucose measurements allow the trained patient to independently adjust their insulin doses and / or adjust their diet and physical activity to achieve target blood glucose values ​​to prevent future complications. However, sometimes self-monitoring blood glucose data are insufficient to understand the causes of poor glycemic control. Installing a continuous blood glucose monitoring system (CGMS) can help in this situation.

Correlation between blood pressure variability and blood glucose level in arterial hypertension and type 2 diabetes mellitus

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280. Elbaev A.D., Kurdanov Kh.A., Elbaeva A.D. Blood pressure monitoring in patients with type 2 diabetes // Successes of modern natural science. – 2006. No. 12. – S. 79-80.

281. Kurdanov Kh.A, Elbaeva A.D., Batyrbekova L.M., Kurdanova M.Kh., Elbaev A.D. A new method of daily monitoring of blood pressure and glycemic levels // Fundamental Sciences to Medicine: Proceedings of the RAS conference. -M .: Slovo, 2006.- S. 100-102.

282. Elbaev A.D., Kurdanov Kh.A., Elbaeva A.D. Diagnostic aspects of the relationship between hemodynamic parameters and blood glucose levels // Clinical physiology of blood circulation. 2006. – No. 3. – S. 15-20.

283. Elbaeva A.D. Variability of blood pressure and blood glucose levels in diabetes mellitus // Perspective-2007: Reports of the International Congress of Students, Postgraduates and Young Scientists. T. 4. -Nalchik: Cab.-Balk. un-t, 2007.S. 151-152.

284.Elbaeva A.