Impaired Fasting blood sugar levels 110-126 mg/dl

"My fasting blood sugar levels are 110-126 mg/dl most of the time I measure them. Why?"

This is a question frequently noted when visiting my patients. They are not diabetic, but their blood sugar fluctuated between 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, and 125.

People with insulin resistance or prediabetes, also known as impaired fasting glucose, commonly exhibit fasting blood glucose levels between 110 and 126 mg/dL.

This indicates that your blood sugar levels are above normal, but not high enough to warrant a diagnosis of diabetes. It is an early warning sign that your body is having difficulty handling glucose efficiently. At this stage, with lifestyle changes such as healthier eating, more physical activity, weight control, and regular monitoring, it is often possible to improve your blood sugar levels and reduce the risk of progressing to type 2 diabetes.

Does 110–126 mg/dL mean I already have diabetes?

No, a fasting blood sugar between 110 and 126 mg/dL by itself usually does not mean you already have diabetes. This range is generally called impaired fasting glucose or prediabetes.

Diabetes is typically diagnosed when fasting blood glucose is 126 mg/dL or higher on two separate tests, or when other tests (like A1C or an oral glucose tolerance test) meet diabetes criteria.

However, this 110–126 mg/dL range is a serious warning sign. It means your risk of developing type 2 diabetes and heart disease is higher, and it’s the right time to start lifestyle changes and regular follow-up.

Is impaired fasting glucose reversible?

Indeed, it is frequently possible to reverse impaired fasting glucose, particularly if you take prompt, consistent action. By improving their diet (less sugar and refined carbohydrates, more vegetables, whole grains, and healthy fats), increasing daily physical activity, and losing a small amount of weight (approximately 5–10% of body weight), many people can return their fasting levels to the normal range.

Your body uses insulin more efficiently when you get more sleep, control your stress, and stop smoking. Although there are no guarantees, these small lifestyle adjustments can delay or even prevent type 2 diabetes in many people with impaired fasting glucose.

What is my risk of developing diabetes?

A fasting blood sugar of 110–126 mg/dL means you are in the prediabetes/impaired fasting glucose range, which carries a significantly higher risk of developing type 2 diabetes than someone with normal levels.

On average, without lifestyle changes, about 5–10% of people with prediabetes progress to diabetes each year, and many more over a 10-year period.

Your exact risk depends on your weight, family history, activity level, blood pressure, cholesterol, and age. The good news: losing 5–10% of your body weight and being physically active most days can cut your risk of progressing to diabetes by about 50%.

Do I need medication for impaired fasting glucose?

In most people, lifestyle changes are the first and most important treatment for impaired fasting glucose: healthier eating, weight loss (5–10% of body weight), and regular physical activity. These alone can greatly reduce your risk of developing type 2 diabetes.

Medication, usually metformin, may be considered if your risk is higher—for example, if you are overweight/obese, have a strong family history, are younger than 60, had gestational diabetes, or your numbers are getting closer to the diabetes range.

The decision is individual, so it’s essential to discuss your overall risk profile and best strategy with your doctor.

How often should I recheck my blood sugar?

Many clinicians advise repeating testing approximately once a year if your fasting blood sugar is 110–126 mg/dL (impaired fasting glucose) and you are otherwise low risk.

Your doctor might want to reevaluate you every three to six months to see how things are going if you're actively changing your lifestyle (diet, exercise, weight loss) or if your numbers are near the diabetes range.

If you experience symptoms like excessive thirst, frequent urination, or unexplained weight loss, you might also need to repeat tests sooner. Always adhere to the regimen that your physician suggests for your particular risk profile.

Can impaired fasting glucose cause symptoms?

Most people with impaired fasting glucose (110–126 mg/dL) have no obvious symptoms. That’s why it’s often called a “silent” warning sign. Blood sugar in this range is higher than normal but usually not high enough to trigger the classic symptoms of diabetes, such as intense thirst, frequent urination, blurry vision, or unexplained weight loss.

However, some people do report more subtle changes: feeling more exhausted than usual, mild brain fog, or increased hunger, especially for sweets or refined carbs. These symptoms are not specific and can have many other causes (stress, poor sleep, anemia, thyroid issues, etc.), so they can’t be used alone to diagnose prediabetes.

The key message: even without symptoms, impaired fasting glucose still increases the risk of type 2 diabetes and heart disease. That’s why regular check-ups, lab tests (fasting glucose, A1C), and early lifestyle changes are so important—before more obvious symptoms and complications appear.

Why do I get fasting blood sugar 110-126 mg/dl?

To understand why impaired blood glucose (IBG) happens, we should go through the mechanism of insulin resistance and defects in secreting insulin. These defects would cause dysfunction in beta cells in the pancreas.

Overall, insulin resistance involves:

-          Reduced sensitivity to insulin

-          Hyperinsulinemia in return to compensate for what is lacking.

So more insulin is circulating, while less is functioning properly.

With the passing of time, the pancreas beta cells will decrease the ability to secrete insulin, leading to low insulin levels.

 So, gradually, impaired fasting glucose will turn into diabetes.

 Another aspect to consider while having fasting blood sugar of 110-126 mg/dl is hypoglycemia (low blood glucose) the person might be experiencing during the night. This can be confirmed by measuring BSL at midnight, recording the results, and passing them to your doctor.

If nocturnal hypoglycemia is confirmed, then the body will react by increasing the release of glucagon. This will get the sugar out of the body deposits to increase blood sugar levels, which are at a lower range.

The effect of glucagon and other sugar-releasing processes will be notable even in the morning while measuring fasting blood glucose. The result will be IBG.

What’s the Treatment?

The goal of treatment is to keep fasting glucose within a normal range to prevent diabetes onset.

There are various treatment approaches, including

  • Therapeutic lifestyle changes
  • Losing weight
  • Good Dietary changes
  • Increased physical activity
  • Medications. Mostly used medications to regulate blood glucose and prevent the onset of type 2 diabetes include metformin and acarbose.

All these changes will also help cut the risk for cardiovascular disease, although the effect of medications is not well documented in the research.

Other modifications that can reduce the risk for cardiovascular diseases include treating:

  • Obesity
  • Hypertension
  • Dyslipidemia

correctly.

Written by Dr.Albana Greca Sejdini, Md, MMedSc       

Medically reviewed by Dr.Ruden Cakoni, MD, Endocrinologist

References

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