‘My HbA1c is 5.9% and FBS is 104 mg/dL. What do I do to bring them back to normal?’

Individuals who receive blood sugar test results that fall between normal and abnormal readings may feel uncertain about their health and unsure if they can improve these numbers through lifestyle changes. One Quora user asked, "My HbA1c is 5.9% and FBS (fasting blood sugar) is 104. What do I do to get back to normal?" To provide clarity on what these numbers indicate and how to potentially bring them back to normal, Dr. Aarti Ullal, a physician and diabetologist at Gleneagles Hospital, Parel, was consulted.

HbA1c and fasting blood sugar levels falling within the prediabetes range, between 5.9% and 104 mg/dL respectively, signify that blood sugar levels are elevated but not yet at the diabetes threshold. This does not necessarily mean a person has diabetes, but it is a warning sign that actions should be taken to prevent progression to diabetes.

Dr. Ullal emphasizes the importance of not panicking but also not ignoring the elevated numbers. She explains that with appropriate lifestyle modifications, many individuals can manage their blood sugar levels effectively.

The focus should initially be on preventing diabetes progression while addressing individual risk factors. A key aspect to begin with is dietary changes. Dr. Ullal advises reducing intake of refined carbohydrates, sugary drinks, sweets, and highly processed foods. Instead, consuming vegetables, whole grains, pulses, adequate protein, and high-fiber foods is recommended.

In addition to dietary adjustments, regular physical activity is crucial. Dr. Ullal suggests incorporating walking after meals and strength training into daily routines, as these activities can enhance insulin sensitivity. For those who are overweight, even modest weight loss can significantly help in lowering blood sugar levels.

Regarding the timing of retesting to see if lifestyle changes are effective, Dr. Ullal recommends waiting about three months, as HbA1c reflects average blood glucose levels over the previous three months. Fasting glucose can also be checked periodically, although the exact timing may be determined based on individual risk factors and a healthcare provider's advice.

If blood sugar levels remain in the prediabetes range despite consistent lifestyle changes, it is advisable to consult a diabetologist for further assessment. This may include evaluating weight, waist circumference, lipid profile, blood pressure, and family history. Dr. Ullal underscores the importance of early consultation, particularly if blood sugar readings rise or symptoms of diabetes appear.