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‘My HbA1c is 7, fasting is 130, and PP is 200. I am not taking any medication, but four hours after meals, my sugar gets low and I feel hypoglycemic. What should I do?'

‘My HbA1c is 7, fasting is 130, and PP is 200. I am not taking any medication, but four hours after meals, my sugar gets low and I feel hypoglycemic. What should I do?'

Indian Express01-08-2025
Not just high, but also low blood sugar levels are a cause for concern. Recently, we came across a Quora post that read 'My HbA1c is 7, fasting sugar is 130, and post-meal sugar is 200. I'm not on medication, but I feel low and shaky 4 hours after meals. What should I do?' So, we decided to bring this to the notice of healthcare practitioners to get expert insights. If this scenario resonates with you, read on.
Dr Vijay Negalur, HOD, diabetology, KIMS Hospitals, Thane, helped us understand the numbers in detail.
HbA1c or glycated hemoglobin test (7 per cent) shows your average blood sugar over the past 2 to 3 months. 'Ideally, it should be under 5.7 per cent. A level of 7 per cent indicates early or mild diabetes,' said Dr Negalur.
Fasting glucose or blood sugar (130 mg/dL) should typically be below 100, said Dr Negalur, elaborating that it refers to the sugar in your blood after you have not consumed anything for more than eight hours.
According to Dr Negalur, post-meal (PP) sugar (200 mg/dL) is higher than the ideal range, which is below 140. 'These values show that your body isn't managing sugar well, even though you're not on medication,' said Dr Negalur.
So, what's the issue?
According to Dr Negalur, this pattern suggests reactive hypoglycemia. 'After a high-carb meal, your sugar spikes, as shown by the 200 reading. Your body releases more insulin to lower the sugar, but it overshoots. This results in a drop in sugar around 3 to 4 hours later. That's when you feel symptoms like shakiness, dizziness, or sweating, which are classic signs of low blood sugar,' said Dr Negalur.
What should I be watching for?
*Sugar fluctuations, including high peaks followed by crashes.
*Feeling tired or hungry shortly after meals.
*Craving sweets or caffeine in the afternoon.
'These may suggest insulin resistance or early-stage diabetes. If this pattern continues, it can get worse over time,' said Dr Negalur.
What can help?
*Balanced meals: Include protein and fibre in every meal to slow sugar absorption.
*Smaller, frequent meals: Eat every 3 to 4 hours to avoid sugar drops.
*Cut refined carbs: Stay away from white bread, sugary drinks, and processed snacks. 'Cut back on simple carbs like white rice, sweets, and sugary drinks,' said Dr Aarti Ullal, physician and diabetologist, Gleneagles Hospital Parel.
*Monitor regularly: Check fasting and post-meal sugars often.
*Track patterns: A short-term CGM (Continuous Glucose Monitor) can provide more insights. 'See the diabetologist as soon as he/she may advise dietary changes or medications to prevent sugar spikes and crashes. Be attentive when it comes to your health if you have diabetes. Timely intervention is key for the successful management of diabetes,' said Dr Ullal.
DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.
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‘My sugar level is 276 mg/dL an hour after lunch without medicine. I am diabetic taking insulin after dinner. What does it indicate?'
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‘My sugar level is 276 mg/dL an hour after lunch without medicine. I am diabetic taking insulin after dinner. What does it indicate?'

Managing a chronic lifestyle condition like diabetes can be extremely daunting if certain basic parameters are not cared for. This is why monitoring blood sugar readings plays a crucial role. So, when we came across a Quora thread asking, 'My sugar level is 276 mg/dL after 1 hour lunch without medicine. I am diabetic, taking insulin after dinner. What does it indicate?' we decided to understand in detail from experts. Dr Rajiv Kovil, head of diabetology, Zandra Healthcare, and co-founder, Rang De Neela Initiative, called a blood sugar spike of 276 mg/dL just one hour after a meal 'a red flag for your blood vessels'. 'Even brief surges in glucose after eating can trigger what's called acute endothelial dysfunction. Essentially, it is a condition where your blood vessels become stiff, inflamed, and more prone to forming dangerous clots. These sharp post-meal rises, known as glycaemic variability, are now recognised as just as harmful, if not more than sustained high sugar levels,' said Dr Kovil. Adding, Dr Manisha Arora, director, internal medicine, CK Birla Hospital, Delhi, said that a blood sugar level of 276 mg/dL one hour after lunch, even without medicine, is considered quite high. 'This indicates that your body is struggling to manage the carbohydrates you're consuming, and your current treatment may not be sufficient to control post-meal spikes,' said Dr Arora. Think of your arteries as delicate highways. 'Every sugar spike is like a sudden flood, eroding the lining, damaging the road, and increasing the risk of heart attacks, strokes, and kidney damage over time. Science shows that repeated spikes like this, especially after meals, are linked to faster progression of diabetes complications and even higher rates of cardiovascular death,' said Dr Kovil. Managing one-hour post-meal sugars is vital. 'Aim for values ideally under 160 mg/dL consistently,' said Dr Kovil. However, a single reading is not enough to make medication changes or treatment decisions. Dr Arora said it's important to regularly monitor your blood sugar and maintain a detailed chart. You can follow this pattern over a few days to give your doctor a clearer picture: * Day 1: Fasting and 2 hours after breakfast * Day 2: Before lunch and 2 hours after lunch * Day 3: Before dinner and 2 hours after dinner 'In addition to this, you should also get an HbA1c test, which reflects your average blood sugar levels over the past 2–3 months. This is a key marker for long-term glucose control,' said Dr Arora. Consult your doctor with this data so that they can make informed decisions about adjusting your medication or treatment plan. In the meantime, focus on dietary changes: * Avoid high-sugar and refined carbohydrate foods * Limit processed foods and heavy meals * Emphasise whole grains, fibre-rich vegetables, and lean proteins These lifestyle modifications, along with regular monitoring, will help stabilize your blood sugar levels more effectively, said Dr Arora. DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.

Celebrity nutritionist says this ‘ancient Indian herb' can help control cravings, blood sugar under medical advice; diabetologist weighs in
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Celebrity nutritionist says this ‘ancient Indian herb' can help control cravings, blood sugar under medical advice; diabetologist weighs in

Celebrity nutritionist Ryan Fernando recently spoke about three ways to control cravings effectively. While he admitted that chewing gum and dark chocolate help, he also talked about Gymnema Sylvestre or Meshashringi, an ancient Indian herb believed to work. 'It is an ancient Indian herb which reduces cravings, but take medical advice from an ayurvedic or naturopath doctor or a dietitian. But here's the problem. People don't know that they have cravings, which is a result of nutritional deficiency, chiefly of a low-carb diet or very low magnesium or insulin resistance,' he said on his YouTube channel. Reflecting on the same, diabetologist Dr Vijay Negalur, HOD, diabetology, KIMS Hospitals, Thane, said that the perennial vine has been studied for its effects on reducing sugar cravings and managing blood sugar levels. 'It contains gymnemic acids that can temporarily dull the taste of sweetness when consumed. Some evidence also suggests it may help with insulin function and glucose metabolism. However, its effectiveness can differ between individuals and should always be used under supervision,' he said. According to Dr Negalur, it may be considered for adults with prediabetes or early type 2 diabetes, as well as for those with insulin resistance and ongoing sugar cravings. 'It's not advisable for pregnant women, children, or anyone with unstable blood sugar levels unless prescribed by a doctor,' stressed Dr Negalur. What should people keep in mind before using it? Always consult a qualified diabetologist or nutritionist before starting Meshashringi, said Dr Negalur. 'The dosage, purity, and the form in which it's taken are crucial. Self-medication can lead to low blood sugar, especially in those already taking anti-diabetic medications,' said Dr Negalur. Even though natural, Meshashringi can still affect blood sugar control and interact with medications, cautioned Dr Negalur. 'It may hide the symptoms of low blood sugar and could lead to drops in blood sugar levels. There is also a possibility of interactions with other herbs or supplements,' said Dr Negalur. What are other effective ways to manage sugar cravings? High-fibre snacks: Foods high in fibre can keep you full longer and help stabilise blood sugar levels. Magnesium-rich foods: A lack of magnesium can trigger cravings. Include spinach, almonds, or pumpkin seeds in your diet. Mindful hydration: Sometimes, thirst can feel like a sugar craving. Chewing gum with xylitol: This can help distract you and reduce sweet cravings without impacting blood sugar. Dark chocolate with stevia (in moderation): It provides a satisfying option without causing a sugar spike. Sugar cravings often indicate deeper metabolic issues, so it's important to look beyond the symptoms and seek the appropriate tests, said Dr Negalur. DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.

‘My HbA1c is 7, fasting is 130, and PP is 200. I am not taking any medication, but four hours after meals, my sugar gets low and I feel hypoglycemic. What should I do?'
‘My HbA1c is 7, fasting is 130, and PP is 200. I am not taking any medication, but four hours after meals, my sugar gets low and I feel hypoglycemic. What should I do?'

Indian Express

time01-08-2025

  • Indian Express

‘My HbA1c is 7, fasting is 130, and PP is 200. I am not taking any medication, but four hours after meals, my sugar gets low and I feel hypoglycemic. What should I do?'

Not just high, but also low blood sugar levels are a cause for concern. Recently, we came across a Quora post that read 'My HbA1c is 7, fasting sugar is 130, and post-meal sugar is 200. I'm not on medication, but I feel low and shaky 4 hours after meals. What should I do?' So, we decided to bring this to the notice of healthcare practitioners to get expert insights. If this scenario resonates with you, read on. Dr Vijay Negalur, HOD, diabetology, KIMS Hospitals, Thane, helped us understand the numbers in detail. HbA1c or glycated hemoglobin test (7 per cent) shows your average blood sugar over the past 2 to 3 months. 'Ideally, it should be under 5.7 per cent. A level of 7 per cent indicates early or mild diabetes,' said Dr Negalur. Fasting glucose or blood sugar (130 mg/dL) should typically be below 100, said Dr Negalur, elaborating that it refers to the sugar in your blood after you have not consumed anything for more than eight hours. According to Dr Negalur, post-meal (PP) sugar (200 mg/dL) is higher than the ideal range, which is below 140. 'These values show that your body isn't managing sugar well, even though you're not on medication,' said Dr Negalur. So, what's the issue? According to Dr Negalur, this pattern suggests reactive hypoglycemia. 'After a high-carb meal, your sugar spikes, as shown by the 200 reading. Your body releases more insulin to lower the sugar, but it overshoots. This results in a drop in sugar around 3 to 4 hours later. That's when you feel symptoms like shakiness, dizziness, or sweating, which are classic signs of low blood sugar,' said Dr Negalur. What should I be watching for? *Sugar fluctuations, including high peaks followed by crashes. *Feeling tired or hungry shortly after meals. *Craving sweets or caffeine in the afternoon. 'These may suggest insulin resistance or early-stage diabetes. If this pattern continues, it can get worse over time,' said Dr Negalur. What can help? *Balanced meals: Include protein and fibre in every meal to slow sugar absorption. *Smaller, frequent meals: Eat every 3 to 4 hours to avoid sugar drops. *Cut refined carbs: Stay away from white bread, sugary drinks, and processed snacks. 'Cut back on simple carbs like white rice, sweets, and sugary drinks,' said Dr Aarti Ullal, physician and diabetologist, Gleneagles Hospital Parel. *Monitor regularly: Check fasting and post-meal sugars often. *Track patterns: A short-term CGM (Continuous Glucose Monitor) can provide more insights. 'See the diabetologist as soon as he/she may advise dietary changes or medications to prevent sugar spikes and crashes. Be attentive when it comes to your health if you have diabetes. Timely intervention is key for the successful management of diabetes,' said Dr Ullal. DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.

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