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Why do I have a higher fasting glucose level than the post prandial level?

Dr DDK Rolston

Q: I am 33 years old. I lost around 8-9 kg during the last 4 years. I have been to various doctors. They got me checked for blood glucose, thyroid and stool and urine examination, which always came normal except minor stool infection. My father is a type-II diabetic. I have got my fasting and PP blood glucose checked around 4 times during the last 4 years and it has always been fasting (around 10-11 hours) between 70-80 mg/dl and PP around 90-100 mg./dl. For the PP blood glucose testing I took normal breakfast with some more sugar in tea. Once I took 75 grams of glucose in one glass of water in addition to the normal breakfast. Now again my doctor got me tested from Lal Path Labs, New Delhi. But now the fasting glucose is 87 mg/dl and PP is 70 mg/dl. I was on a fast for around 10 hours. For PP glucose I took normal breakfast of two chapatis with some vegetable and one sweet item. I also took 75 gm of glucose in one glass of water. My query is what is the reason for fasting glucose level to be more than PP glucose level. Is there any problem or is it normal?

A:Your blood glucose levels are within normal limits and do not indicate that you currently have diabetes. It is a little difficult to explain why your most recent PP blood glucose is lower than your fasting blood glucose. I can tell you that one does see this from time to time. Should you repeat it (I don't suggest you do), you are likely to find that the reading is higher than the fasting level. I might mention that some authorities think that a response such as yours may be an early indication of diabetes because the glucose control system is beginning to show abnormalities. Not everyone agrees with this hypothesis. So I would recommend nothing further be done at this time other than checking your blood glucose once every 2-3 years. With regard to your weight loss, without additional information I am unable to give you any suggestions as to why this happened. I am assuming that your weight has now stabilised.