Q: I am a 51-year-old woman, 5’5”, 118 pounds. A few weeks ago after a routine blood test, my fasting blood glucose was 104. I was diagnosed with pre-diabetes and put on a low-carb diet with no more than 120 grams of carbohydrates per day. I also increased my exercise program from twice a week to six times a week for 30 minutes or more. I walk, run, do weight training, and yoga.
Although I understand this regimen is healthy, I have been feeling worse. I used to have plenty of energy to get through the day, focus on my work, and enjoy exercising. Now, I wake up feeling queasy and faint. An hour after meals I’m hungry again. I find it hard to concentrate on my work and lose focus easily. And, when I exercise, I feel shaky and weak. I am losing weight and now my doctor has told me not to lose any more, but with this regimen, I can’t keep weight on.
I don’t want to develop diabetes and I want to stick to a healthy diet but wonder why it’s making me feel bad. Am I doing something wrong?
Thank you for any advice you can give.
A: While there are minor differences of opinion, the average random blood glucose level of a healthy adult averages between 70 and 130 mg/dL prior to meals and less than 180 mg per d/L two hours after beginning a meal according to the American Diabetes Association. Because a random blood glucose can be performed at any time, readings will depend on when a person last ate. A fasting blood sugar, on the other hand, should be between 70 and 99 mg/dL. Therefore, the question you should answer is if you had been fasting for a minimum of eight or more hours when your blood was drawn or if you had a random screening.
Pre-diabetes is an indication a person’s sugar level is higher than normal but not so high as to be labeled a type 2 diabetic. It pretty much goes without saying that if no action is taken to bring sugar levels back into line, an individual will ultimately be classified as a type 2 diabetic. In any event, increasing one’s physical activities, eating better, and maintaining a healthy weight will go a long way toward this goal – without any intervention of prescription medication. The move from being pre-diabetic to a class 2 diabetic may find an individual experiencing frequent urination, blurred vision, having increased thirst and suffering from fatigue. Those individuals whose bodies don’t process glucose appropriately may suffer from pre-diabetes. Rather than fueling body cells, sugars build up in the bloodstream. And, since most of the glucose ingested originates from the foods we eat, physician’s try to control carbohydrate intake.
Generally speaking, carb intake should be between 45 and 65% of the total calories consumed per day. This implies that if you consume 2200 calories daily, no more than 1430 of those calories should originate from carbohydrates. And, a healthy non-diabetic should aim for at least 130 grams of carbs each day – not taken all at once, but split throughout the day. Because you have been given a figure of 120 grams per day, you fall into the “carbohydrate-friendly diet” of about 30 carbs per serving.
I recommend you make an appointment with an endocrinologist to review your diet, perhaps have other lab work performed such as an A1c, and discuss why you are not at the top of your game. It may be taking a while to acclimate your new exercise regimen but with a review of your caloric intake and some tweaking here and there, I’m sure you can determine and eradicate the cause(s) for your symptoms and weight loss. You may be weak because of hypoglycemia due to too few calofries or too much exercise for your needs.
