Worried about Test results

I’m not medical professional, but I spent 30 years selling diabetes products, glucose meters, A1C meters, diabetes meds.
You have no concerns, almost zero. Fasting glucose under 100 is not in diabetic range. A1C of 5.8 is no issue. If it’s under 5.5 you are not pre-diabetic. Very few peps with pre-diabetes convert to diabetes. Obviously, some do but not many.
American Diabetes Association describes type 2 as A1C over 6.5. Fasting glucose over 125.
In fact I’d refuse therapy if I were you. Should the doctor offer.
What I would do is add weight lifting to your fitness routine. Specifically heavy lifting. Weights that really strain you. It causes your body to use stored glucose and increase insulin sensitivity.
Likely your doctor is In “cover your a** mode”. He/she needs to document they discussed the ramifications with you.
The advice to increase insulin sensitivity is very good! Strength training for that - had forgotten that particular benefit. Plus older ladies need to strength training anyway to maintain general fitness. And also be sure to get plenty of protein - we really need it to help maintain muscle mass.

I know that for many older women the conditioning has been to avoid meat and fat for health reasons, but that’s probably the opposite of what you need at that age.
 
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I think you're just fine. Next time before you test, drink plenty of water. I've never had my A1C checked, but every once in a while my fasting glucose will spike over 100, but usually in the 80s.
 
I know that for many older women the conditioning has been is to avoid meat and fat for health reasons, but that’s probably the opposite of what you need at that age.

I know- I struggle with this. I'm doing pretty well at meeting protein requirements with plain Greek yogurt (with chocolate protein powder mixed in- yum!), eggs, a daily protein bar (yeah, processed, I know) and the occasional meal with meat- maybe weekly, more if I'm visiting DS and DDIL.
 
Log everything: Between now and your appointment, document your food and exercise in detail.

Doctors are used to hearing patients say "but I eat right and exercise!" and not believing them, because a lot of people lie to themselves. Go armed with actual data to balance your bloodwork before you get diagnosed or medicated just based on the test. This will also help your doc understand your full picture.

Oh but to add to the choir, yes lift weights. Heavy ones. Not machines, free weights. Not the kind of weight you do 3 sets of 12, but 5 sets of 5, and then lift more the next time.
 
I know- I struggle with this. I'm doing pretty well at meeting protein requirements with plain Greek yogurt (with chocolate protein powder mixed in- yum!), eggs, a daily protein bar (yeah, processed, I know) and the occasional meal with meat- maybe weekly, more if I'm visiting DS and DDIL.
I just want to point out that the some of the frequently published daily protein recommendations for 65+ year old women are criminally low. Here is a better reference:
Experts in the field of protein and aging recommend a protein intake between 1.2 and 2.0 g/kg/day or higher for elderly adults [3,8,15]. The RDA of 0.8 g/kg/day is well below these recommendations and reflects a value at the lowest end of the AMDR. It is estimated that 38% of adult men and 41% of adult women have dietary protein intakes below the RDA [16,17].

More accessible reference:

Adequate protein intake​

We consider adequate protein as roughly 1.2 to 2.0 grams per kilogram (g/kg) of reference body weight per day for adults.

To maximize your nutrition per calorie, we recommend you aim for the higher end of this range, between 1.6 g/kg and 2.0 g/kg.
 
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My wife is diabetic so she tests her daily glucose daily and her A1C about once a month. She trys to keep her daily glucose under ~110 and her A1C below 6. I'll check mine about once a month too and it usually run about 5.5.

Home test kits are readily available with results in ~5 mins. Her PCP accepts the results and post them in her records.

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Log everything: Between now and your appointment, document your food and exercise in detail.

Doctors are used to hearing patients say "but I eat right and exercise!" and not believing them, because a lot of people lie to themselves. Go armed with actual data to balance your bloodwork before you get diagnosed or medicated just based on the test. This will also help your doc understand your full picture.

Oh but to add to the choir, yes lift weights. Heavy ones. Not machines, free weights. Not the kind of weight you do 3 sets of 12, but 5 sets of 5, and then lift more the next time.
There is no medication that is recommended for a 5.8 a1C and 88 fasting glucose. These are considered fairly normal readings, other than slightly elevated a1C.
 
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I just want to point out that the some of the frequently published daily protein recommendations for 65+ year old women are criminally low. Here is a better reference:
<snip>

Thanks. I'd heard we need twice as much as younger people because we don't absorb it as well. based on that standard I'm OK. I did note that on one of my on-line medical records a doc described my musculature as "grossly normal".

And, closer to the OT, someone, somewhere in my records noted that I was "pre-diabetic". My a1c has never been over 6.0 (was at 6.0 once in 2025) and my fasting glucose, from records I have going back 10 years, has never exceeded 111. They never told me. I would have remembered. The only reason I started having my a1c tested was when I noted my somewhat-high fasting glucose level and learned (here) that a1c was a much better indicator of diabetes risk.
 
Thanks. I'd heard we need twice as much as younger people because we don't absorb it as well. based on that standard I'm OK. I did note that on one of my on-line medical records a doc described my musculature as "grossly normal".

And, closer to the OT, someone, somewhere in my records noted that I was "pre-diabetic". My a1c has never been over 6.0 (was at 6.0 once in 2025) and my fasting glucose, from records I have going back 10 years, has never exceeded 111. They never told me. I would have remembered. The only reason I started having my a1c tested was when I noted my somewhat-high fasting glucose level and learned (here) that a1c was a much better indicator of diabetes risk.
5.7 A1C is considered Pre-diabetic now.
 
5.7 A1C is considered Pre-diabetic now.
My frustration with that is "at what age?"

While it's obviously not good to be diabetic, at what age does sustaining "pre-diabetic" for several years really, really matter?

We're all on a death march, the only question is what age it ends and the pace along the way. I'm thinking I'm willing to spend decades as "pre-diabetic" as long as I am able to be as active as I want and the skeleton, muscles, and critical body parts hold up. And I'm willing to call it at some point. At 65 now, not sure where that is, but if I start to deteriorate, but it's probably sooner than when I'm 95.
 
Thanks. I'd heard we need twice as much as younger people because we don't absorb it as well. based on that standard I'm OK. I did note that on one of my on-line medical records a doc described my musculature as "grossly normal".
Referring to protein, I would like to eat more - but have read various articles on how too much protein stresses the kidneys. There is no win, as Yoda might say.
 
I would like to ask for the forum's insights and advice.

Just turned 68, had my yearly blood tests, and the lab results, which appeared the next day, were a shock. I'm prediabetic (A1C 5.8, fasting glucose 88). I've always had normal fasting glucose, and this is the first time the doctor ordered an A1C for me, so I have no idea how long it's been too high. I understand that the A1Cis a better indicator, as a snapshot of the last 3 months rather than just the day before.

My family history: I never heard that either mom or dad had diabetes, nor saw anything that could be considered diabetic "symptoms." I would have heard about it, if they had. However, my 2 older siblings, obese and sedentary, have been on T2 diabetes medication for many years. Both are in very poor health.

I'm thin (BMI 20.1), very active (many hours a week of cardio, resistance, stretching, plus I do my own housework and yardwork), lean (14% bodyfat, 4% visceral fat). I eat a lot of vegetables, and avoid ultra-processed food. The only thing I've noticed (and it's not that big of a change) is that I do seem to go to the bathroom more often.

The doctor's office has scheduled me to see him in a month. Medication, if any, will depend on whatever AMA algorithm he uses. He may want more tests. I fully expect to hear about exercising more and eating more vegetables, controlling my stress (yeah, right), etc. Given I already do those things to a great extent, what additional insights are out there?

Thanks,

Amethyst
I too have had my last A1C at 5.8. It’s been 5.8 one time before but my fasting glucose are usually low to mid 70s. Quite frankly that number really freaked me out. My doctor doesn’t seem too worried. They just told me to exercise more and watch what I eat. Diabetes runs in my family but I have a BMI of 21 and eat healthy and exercise regularly. I’ve tried to go radical
with strict keto and absolutely no sweet but that’s unsustainable long term so on occasion I have some bread and deserts. I did read that it’s normal to have your A1C increase as you age and doctors should be careful medicating older people with glucose lowering drugs because of the risk of hypoglycemia (fall risk of too of course).
 
Referring to protein, I would like to eat more - but have read various articles on how too much protein stresses the kidneys. There is no win, as Yoda might say.
You need to look at your kidney numbers with your blood work. My husband and I eat alot of protein/meat, and our numbers are very good. It's keto diet that damages kidneys.
 
Referring to protein, I would like to eat more - but have read various articles on how too much protein stresses the kidneys. There is no win, as Yoda might say.
Honestly, protein is just fine if you have normal kidneys and even sub-optimal kidney function. Severely diseased kidneys are another matter. They’ve even done studies on diabetic patients at a doctor’s practice with type 2 diabetes patients switching to a lower carb higher protein diet and kidney function actually improved! What ruins kidneys? Advanced type 2 diabetes!* Avoiding that is the game, IMO, not protein itself.

There is a lot of anti-protein literature out there and IMO a lot of it is food politics and poorly done epidemiological studies.

*

What are the most common causes of kidney failure?​

Diabetes and high blood pressure are the most common causes of chronic kidney disease and kidney failure.

Unmanaged diabetes can lead to high blood sugar levels (hyperglycemia). Consistently high blood sugar can damage your kidneys as well as other organs.

High blood pressure means blood travels forcefully through your body’s blood vessels. Over time and without treatment, the extra force can damage your kidneys’ tissue.
 
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You need to look at your kidney numbers with your blood work. My husband and I eat alot of protein/meat, and our numbers are very good. It's keto diet that damages kidneys.
I do not think being in ketosis ruins kidneys. I have never ever heard that before, and I have studied very low carb diets a lot.


There is a considerable body of research suggesting that a very low carbohydrate ketogenic diet is safe in individuals with moderately diminished kidney function, even in studies that had higher protein intake than what is recommended for kidney disease and diets that are not plant-based. The diet can be safely prescribed in patients with T2D for treating and remitting diabetes even if they have underlying stage 2 or 3 CKD or reduced kidney function. Beyond safety, mechanistic plausibility, preclinical data, and even some RCT studies suggest that carbohydrate-restricted diets may be beneficial in improving moderate kidney dysfunction and in reducing progression of CKD.
 
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Referring to protein, I would like to eat more - but have read various articles on how too much protein stresses the kidneys. There is no win, as Yoda might say.
It would be very hard to do this on a diet under 2500 calories per day. If you aim for at least 100 gms of protein per day that would be a good start, and not remotely be considered too much
 
It would be very hard to do this on a diet under 2500 calories per day. If you aim for at least 100 gms of protein per day that would be a good start, and not remotely be considered too much
You have to consume a good bit of chicken, fish and Greek yogurt to get 100 grams per day. I use a whey protein shakes with berries and almond milk to increase my intake.
 
My test results show my Glucose at 90 and the report lists normal to be 70-100. I agree with others that OP at 88 is ok, based on normal being 70-100. My doc has never said that I was pre-diabetic at 90 glucose and I don't see A1c in my test results so apparently I've never had an A1c test.
 
I do not think being in ketosis ruins kidneys. I have never ever heard that before, and I have studied very low carb diets a lot.



I have read alot about effects of ketosis on kidneys and have come to the conclusion that it does. Obviously, out of control diabetes damages kidneys even more.

 
I have read alot about effects of ketosis on kidneys and have come to the conclusion that it does. Obviously, out of control diabetes damages kidneys even more.


There is a large amount of work out there that finds ketones are kidney protective, so my conclusion is the opposite. :)

Highlights​

from https://www.sciencedirect.com/science/article/pii/S2667137921000096#:~:text=Ketones support kidney energy metabolism,SGLT2 inhibitors in the kidney.

Ketones are a valuable therapy for many medical issues including dementia!

And restricting carbs lowers blood pressure because the kidneys are able to release excess water once insulin is low most of the time. Chronic high insulin levels (hyperinsulinemia) damages blood vessels and organs long before chronic high blood glucose organ damage starts to occur (chronic high glucose indicates that the pancreas has started to give out about 20 years later), and a low-carb diet directly addresses these problems (lowered insulin, lowered blood sugar and lowered blood pressure). Also for many people a low-carb diet has eliminated their GERD.
 
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Thanks for your insights. I agree that resistance exercises are important for all sorts of reasons. Have lifted as heavy as I can tolerate since I was 34 years old, at least 3x a week for all the major muscle groups.
Some athletes will have very slightly elevated A1Cs due to the stress (it's good stress, but still stress) of workouts. Prolonged workouts can cause a sort of temporary insulin resistance. It's not considered a problem, but you can see slight elevations in A1Cs.

Many countries set the "pre-diabetes" cutoff at 6.0 rather than 5.7.

A keto diet is probably not the best choice as they actually increase insulin resistance a bit and are often associated with increased saturated fat intake.
 
A CGM could be interesting to try, to see how you react to different foods. I’ve used the Stelo device and it’s easy to use. That would give you more insight to your glucose levels over time and should give let you know if you need to be concerned, or what foods to avoid, etc.
 
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