Q. My PP blood sugar level remains in the range of 150 to 176. How to reduce it?

Answered by
Dr. Prabhakar Laxman Jathar
and medically reviewed by iCliniq medical review team.
Published on Nov 25, 2017 and last reviewed on: Oct 09, 2018

Hi doctor,

I am a 65 year old male. Before 12 years, I went for my first master checkup without symptoms. The result showed high 2 hours PPBG while FBG and A1c are normal. The consultant physician advised me to eat less at a time and increase the number of feeds in a day and encouraged me to check BG level once in every three months. Accordingly, I have done the tests both at home and labs every three months. My FBG is always normal that is 80 to 85 (rarely crosses 100 but within 105). My A1c is also quite normal of around 4.2 to 5.4. However, my PP (2 hours) is always in the range of 150 to 176. However, when I take reading after three hours of ingestion, the PP value is in the normal range 120 to 140. I do not take any medicine or Insulin. I have no symptoms like frequent urination or too much thirsty and head reeling. Nevertheless, a few months ago, I suddenly developed tinnitus in both my ears. MRI was taken and found normal. My hearing is excellent. Meniere's disease is ruled out. The volume in left ear is more than right ear (Left 6/10 whereas right 3/10). It is the insect cricket's sound.

Last week, while I was working on my computer sitting in my usual chair, I developed a catching sensation on both my calves all of a sudden. A bit burning sensation in the calves also felt. It continues. I walk without any difficulty and do the routine. No tickling or pinning sensation. I am in a remote village spending my post retirement with family. My wife being a clinical biochemist advised me to rule out peripheral neuropathy as my 2 hour PP test is always in the range of 150 to 176. I also have a mild pulling sensation at the back of my right thigh. Hence, I request you to suggest tests find out the cause of the problem.

Yesterday, my blood sugar levels were FBG 80, PP 176 ( 2 hours after BF bread upma, a teaspoon of ghee and tea with milk) and PP after 3 hours it is 106 (nothing was eaten in between) and randomly done at 7 PM before dinner was 108. Today, my blood sugar levels are as follows: FBG 80, PP 174 (2 hours after BF that contained one full banana, cornflakes, milk and one and a half cups of tea with milk) and 2 hours after lunch 178 (that included one whole banana, 4 pieces of papaya, rice, cabbage, rasam and sambar, buttermilk, one teaspoon of ghee).

My BP is always 110/70 mmHg or 120/80 mmHg. I generally walk 2 km a day. I do not smoke or drink alcohol, and I am a vegetarian. Lipid did a month ago, and it was quite normal. It may be helpful to mention my total cholesterol, and LDL counts are always low (120 and 45 respectively) for several years now. I weigh 67 kg, and my height is 171 cm. Thank you.

Dr. Prabhakar Laxman Jathar

Diabetology General Practitioner
#

Hello,

Welcome to icliniq.com.

On going through the details provided, it is clear that you are in a prediabetes situation. Following are the criteria for diagnosing diabetes:

  1. Normal: Fasting blood glucose (FBG) 70 to 110 mg, PP less than 140 mg and HbA1c% less than 5.9.
  2. Prediabetes: FBG 108 to 125 mg, PP 141 to 199 mg and HbA1c% 5.9 to 6.4.
  3. Diabetes: FBG 126 mg and above, PP 200 mg and above and HbA1c% 6.5 or more.

Considering this, currently, there is no diabetes. You can prevent it from progressing it to diabetes by adopting a modified lifestyle, which includes properly planned balanced diet, with restricted caloric intake, regular exercise for at least 1 hour a day. Brisk walking is a good option. Avoid sweets, deep fried foods, pastries, other bakery items, foods made out of maida, sweetened aerated drinks (colas), sweet corn syrup containing food products, red meat and high-fat dairy. Also, better to refrain from alcohol and smoking.

As regards the sound in the ear (tinnitus), there is hardly any treatment. If it is not really disturbing, then better ignore it. As regards sudden catch in the calf muscle, these are cramps, which may occur due to lack of vitamin D3, calcium and sodium. To see if there is any neuropathy, a test with biothesiometer can be done to see there any affection. Presently, there is absolutely no need for taking any drug. Your blood pressure and lipid profile are quite good. If you have any doubts please do come back, I will be glad to clarify.


Investigations to be done:

Biothesiometer test may be done to see if there is any affection to peripheral nerve sensation.

Preventive measures:

Restricted diet and regular exercise for over one hour every day.

Regarding follow up:

For further information consult a diabetologist online.---> https://www.icliniq.com/ask-a-doctor-online/diabetologist


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