I had a blood sugar of 205 mg/dl [11.4 mmol/L] so I had a two-hour test done. My fasting level was 95 mg/dl [5.3 mmol/L], and my two-hour level was 116 mg/dl [6.4 mmol/L]. The doctor said this was well within the normal range, and I haven’t had any increased level since. The nurse insists that I see a dietitian, but I’m doing okay without spending the extra money we don’t have. If I still had high sugar levels, I wouldn’t have a problem going to the dietitian. What do you think?

You have asked a good question and I will answer two ways:

If you have family members with diabetes or are at risk for other reasons, such as being over weight, of ethnic background such as African American, Native American, Hispanic or Asian, are over 40 years old, or had diabetes during pregnancy, or delivered a baby over nine pounds, I would suggest that you keep a close eye on your after meal blood sugar now and in the future. An after eating blood sugar greater than 140 mg/dl [7.8 mmol/L] is suspicious of impaired glucose tolerance, and can put a person at risk down the road of heart disease if not brought back to normal range. You could purchase a blood glucose monitor at your local pharmacy quite inexpensively and check up on your blood sugar a few times a month, especially after eating large meals — then you can see if you do have times when your blood sugar rises outside of normal range as in your first test.

If you do have diabetes in your family or have any of the other risk factors I mentioned, than investing in a visit with a diabetes educator or a dietitian with specific expertise in diabetes might be helpful proactively. Learning about carbohydrates, the impact of exercise on maintaining normal blood sugars, and many other tips could save you problems in the future. I think it would be money well spent to ensure early detection and treatment if and when you see your blood sugars start to rise.

If you do not have any of the risk factors mentioned above, I would recommend that you have a two-hour glucose after eating tested at least once a year to ensure that your blood sugar remains within normal range.

Remember, there are no signs and symptoms of a slightly elevated blood sugar. You would not know if this was happening except by testing your blood. This makes it all the more important to keep this test up-to-date so that, if and when you do have elevated blood sugars, it is detected early and treated aggressively to keep the body from being exposed to this for years before being found.

KS