Blood Sugar 134 mg/dl — Too High? Fasting & After Eating

Taking a morning 134 to the doctor: how the visit usually runs

A fasting 134 on a home meter is high enough that most doctors will want to see you within a few weeks, and low enough that it is rarely urgent if you feel well. Knowing what the appointment involves makes it shorter and more useful. It usually has three parts: a conversation about your history, a brief examination, and an order for blood and urine tests. The diagnosis, if there is one, comes later, once the lab results are back.

The history: what you will be asked

Expect questions in a few areas. It helps to jot down answers beforehand:

• The reading itself. When was it taken, how long since you last ate, which meter, and have there been other readings? Bring the meter or a photo of the log.
• Recent weight and appetite. Any gain, any unplanned loss.
• Medical history. High blood pressure, cholesterol problems, heart disease, polycystic ovary syndrome, past gestational diabetes.
• Medicines and supplements, including steroid courses, inhalers and anything bought over the counter.
• Family. Which relatives have diabetes and roughly at what age it began.
• Daily life. Activity, sleep, smoking, alcohol and the usual pattern of meals.

The examination

The physical part is usually quick. A nurse or doctor measures your weight, height and waist, and your blood pressure. Some doctors look at the skin for darker, velvety patches in skin folds such as the neck or armpits, which can go with insulin resistance. If diabetes is already strongly suspected, the visit may include a foot check for sensation and pulses. None of this is painful, and wearing clothes that make it easy to roll up a sleeve and remove shoes saves time.

The lab orders and what each one answers

The blood tests ordered after a high home reading normally include:

1. Fasting plasma glucose, drawn from a vein after at least eight hours without calories. This replaces your fingerstick with the reference measurement.
2. A1C, an estimate of average glucose over roughly three months, which needs no fasting.
3. A lipid panel for cholesterol and triglycerides, often from the same fasting draw.
4. Kidney tests: a blood creatinine with an estimated filtration rate, and often a urine sample for albumin.

Less often an oral glucose tolerance test is booked as a separate morning appointment, mainly when results are borderline or in pregnancy. Diabetes is diagnosed only when two results are abnormal, either two different tests from the same sample or the same test on two days.

Questions worth asking before you leave

Ask how and when you will get the results, and whether you should keep testing at home in the meantime. Ask what the plan is if the results are borderline. Ask whether any of your current medicines could be affecting glucose, without stopping any yourself. And ask for the actual numbers once they come back, so you can compare later tests with them. The normal blood sugar levels page is a handy reference when the results arrive.