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Have variation in glucose level. Various tests done. Taking medicines. Can FBG change so quick?

Dear Sir,
I am 31 male from India ,my BMI was 30.2 ,two months back due to offshore site requirement i have to go through complete tests,In that tests everything was OK but my fasting glocuse level shown 217 mg/dl after 9 hours of fasting (before 9 hour I had few chocolates and cigrate as i was not aware what fasting test meant for).So i was advised to do test of HB1AC and PP which i did after 1 month, the result was HB1AC 9.1% and PP 149 mg/dl with reduced bmi 29.
As I was pretty sure I am fit and also i dont have family history.So I visited to physician after 6 days of this test in that he found my random BG is 107 mg/dl but HbA1C still 9 %.So he asked me to perform OGTT and Fasting test after 3 days,report was fasting 124 mg/dl .OGTT after one hour 213mg/dl after 2 hour 100 mg/dl and after 3 hour 79 mg/dl.He confirmed with OGTT that he cannot say i am diabetic ,for fasting he has given me metformin 500 before 12 days but i didnt start medication because i have reduced my bmi to 28.4 by exercising and dieting.My query Since 1 week i am monitoring my FBG its always in the range of 83 to 102 mg/dl immediately after getting out from bed after 8 to 12 hrs of fasting but most of the time I noticed after getting of the bed my FBG is low but if I brush my teeeth and take hot shower my FBG increases to 15 to 20 mg/dl - is it normal or abnormal,Should i start metformin as advised by my physician before 2 weeks ,Please reply
Asked On : Wed, 24 Apr 2013
Answers:  3 Views:  48
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Diabetologist 's  Response
Hello, You may in a dilemma whether you have Diabetes or not. But you should acknowledge a point that there is something called as Pre Diabetes where there is an impairment in fasting glucose. This is the early stage of Diabetes.

In your case this may be due to overweight which as caused insulin resistance in your body. This explains your impaired blood glucose inspite of your negative family history for Diabetes.

Physical activity and metformin will help you in the long run to postpone full blown Diabetes

Answered: Thu, 25 Apr 2013
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General & Family Physician Dr. Pavan Kumar Gupta's  Response
Your history is very crystal clear and clearly suggests that you were definitely diabetic on your first testing of sugar which was 217 ( fasting ).
Subsequently with dieting and exercises you brought your PP level to 149 in one month but HBA1c was 9.1
HBA1c was high because it shows the average level of blood sugar of past three months.
Now with dieting and regular exercises and lowering of your BMI has resulted in normalisation of blood sugar levels.There is no need for any anti diabetic medicine at the moment and till the time you can manage it with diet and exercises.
As far as slight increase in fasting sugar level level,after bath,is concerned ,it is normal.
When a person gets up in the morning,a slight surge in blood glucose is normal and it happens due to more dumping of blood sugar in blood from the liver.
You must keep dieting and do regular exercises and keep monitoring your blood sugar at regular intervals.
It is very important for you to keep your blood sugar levels normal to avoid micro as well as Macrovascular complications in future.
Answered: Wed, 24 Apr 2013
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Internal Medicine Specialist Dr. Akhilesh Dubey's  Response
Welcome to HCM,
After Going through your history your blood sugar level was in diabetic range and you are over weight this causes insulin resistance and Glucose intolerance.
Your HbA1c is 9% which is result of chronic hyperglycemia hence it is in your benefit to take care of diet that is low in calories 25 Kcal/kg body weight of proteins,low fats and complex carbohydrates and avoid simple sugars.
Physical exercise to reduce your weight and periodic checkup of FBS and PPBS.
You must follow advice of your physician take Metformin as it is helpful in increasing insulin sensitivity and also reduces weight, in such patients chances of low blood sugar are very less with Metformin so take it with consultation of your Physician.
Please repeat FBS and PPBS after 2 weeks and visit your Physician.
Please do not treat yourself self as your Physician knows best.
Take care
Good Luck.
Answered: Thu, 25 Apr 2013
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