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DrSugar Answers: Prediabetes and Blood Sugar Struggles

DrSugar is in the house and he's answering your health questions.

Dear DrSugar,
I was diagnosed last year with prediabetes. I'm 32, caucasian, and have a BMI of 22. I do a variety of exercise, including 30 to 60 minutes of running, climbing stairs, and weightlifting at least five days a week. I've had healthy eating habits (high fiber, low fat, low added sugar, whole grains, low glycemic index foods, etc.) for years. My only risk factor seems to be genetic.

My fasting blood glucose levels, however, are steadily creeping higher and are now in the middle of the "prediabetes" range at 112 mg/dL. My last HbA1c level was at six percent. I'm at a loss for what else I can do to help keep my blood sugar from rising further. My doctor just tells me to watch my carbs. Any advice? Thanks!
Blood Sugar Sweetie

To see DrSugar's advice and to learn more about prediabetes,


Thanks for this question. Prediabetes is a very common problem estimated to affect around 57 million Americans. The condition is defined as a fasting blood sugar between 100 and 125, and according to your test you're clearly in the middle of that range. Diabetes is defined as any fasting blood sugar above 125. The HbA1c test, a measure your average blood sugar over about six weeks, is considered normal at under six percent — so you are just above normal. Prediabetes is an important health condition to recognize and take seriously because it suggests you are at risk for progression to diabetes and all of its complications. Common risk factors for developing prediabetes include being overweight, physical inactivity, age over 45, family history, and non-caucasian ethnicity. As you said, it sounds like your only risk factor is family history, which is unfortunately not modifiable. This is similar to having a family history of high cholesterol. Sometimes doing all the right things in terms of healthy living is not enough to overcome our genetic makeup.

It sounds like you are doing all the right things in terms of preventing the progression of prediabetes to diabetes. These interventions, as you’ve mentioned, include taking part in some form of aerobic activity almost every day and avoiding foods with a high glycemic index. Your BMI is also ideal, so I would not recommend trying to lose weight to help lower your blood sugar. If your BMI was over 25 this might be a different story. Sometimes doing all the right things is not enough. Some doctors treat prediabetes with low doses of diabetes medications such metformin, but this remains controversial. I think watching your carb intake is a good basic principle, but the glycemic index is better in terms judging a foods affect on blood sugar.

If your struggle with prediabetes continues, it might be useful to seek the help of an endocrinologist, a diabetes specialist. For more basic information, try the American Diabetes Association.

Have a question for DrSugar? Send it by private messaging me here, and I will forward it to the good doctor.

DrSugar's posts are for informational purposes only and should not be considered medical advice, diagnosis, or treatment recommendations. Click here for more details.

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LemonOut LemonOut 8 years
Type 2 diabetes is actually much more genetic than type 1, which is ironic because so much of the publicity about is the lifestyle factors that cause it. The family history is, unfortunately, a very big risk factor.
esweet esweet 8 years
I'm Type 1 diabetic (with absolutely no family history of either Type 1 or Type 2 diabetes) and so I can relate to your struggles. It sounds like you are doing everything right. I'd love to have my A1c down to 6.0! One tip is to fill up with LOTS of fiber-rich foods (fruits, veggies, beans, nuts) because they keep you full and don't have a sharp impact on blood glucose levels. I have no problems controlling my sugars when I eat these foods. Unfortunately, it's impossible to eat right 100% of the time, but these types of foods do help!
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