by Helen
(Texarkana, TX)
QUESTION from Helen (Texarkana, TX):
Hi,
A picture of health at 81: I've always been active but have been 'officially' working out at the gym 3 days a week and walking at least 5 days a week since the late 80's.
Never had an overweight problem, all cholesterol levels okay - ratio 2 (taking 10 mg simvastatin once daily), no other known health problems, no one in immediate family was a diabetic.
After being diagnosed as pre-diabetic about 4 years ago, I modified my diet (cutting down portions, counting carbs, and cutting down drastically on bread and potatoes all to the point.
I'm having a little difficulty keeping my weight stable at about 122. I used gymnema sylvestre and Alpha Lipoic Acid (discontinued recently because it didn't seem to be helping) yet still have problem with higher than normal glucose reading most mornings before breakfast and after some meals.
Yet my A1C 5.9% is normal and mean plasma Glucose is 133 mg/dl. My condition doesn't seem to have changed one way or another these last few years.
An HbA1c of 5.9% indicates prediabetes, not diabetes. Stable readings over several years are reassuring, although higher morning glucose deserves monitoring. Simvastatin may slightly raise blood sugar, but it cannot automatically be blamed for prediabetes. At age 81, maintaining nutrition, muscle strength and cardiovascular health is particularly important. Do not stop prescribed medication or restrict your diet further without medical advice.
Answer by
Dr. Albana Greca, MD, MMedSc
Family Physician | IDF Fellow
Hi Helen,
First, congratulations on maintaining such an active lifestyle. Regular exercise and healthy eating are valuable habits. Your question raises several important points about blood glucose, medication and nutrition in older adults.
Your HbA1c of 5.9% falls within the prediabetes range:
Because your HbA1c has remained relatively stable, this is encouraging. Prediabetes does not always progress to diabetes, particularly in older adults.
See our guide to understanding blood glucose test results for more information.
Morning glucose can rise when the liver releases glucose during the night and early-morning hormones increase glucose production. This is sometimes called the dawn phenomenon.
Late meals, poor sleep, illness and medication effects may also influence morning readings.
A laboratory fasting glucose of 100–125 mg/dL indicates prediabetes, while 126 mg/dL or higher falls within the diabetes range and usually requires confirmation.
Our article on normal fasting blood sugar levels explains these differences.
Statins,
Normal cholesterol values while taking simvastatin may simply indicate that the medication is working.
Statins can reduce cardiovascular risk. At age 81, the decision to continue treatment should consider your medical history, cardiovascular risk, treatment tolerance and preferences.
See also cholesterol-lowering medications and blood sugar.
Not necessarily. You mentioned difficulty maintaining your weight around 122 pounds. Without knowing your height and weight history, I cannot determine whether your current weight is appropriate.
However, unintentional weight loss and loss of muscle are important concerns in older adults. Excessively restrictive diets can make these problems worse.
Focus on balanced meals, adequate protein, fiber-rich carbohydrates and continued physical activity. A registered dietitian can help you manage glucose without compromising nutrition.
Our prediabetes food guide offers practical suggestions.
Neither gymnema sylvestre nor alpha-lipoic acid has convincing evidence of preventing progression from prediabetes to diabetes in older adults. Supplements may also interact with medications or cause side effects.
I would not recommend restarting them specifically to lower morning glucose without discussing their safety with your clinician.
One detail worth checking: an HbA1c of 5.9% corresponds to an estimated average glucose of approximately 123 mg/dL, rather than 133 mg/dL. Your reported mean glucose may therefore come from a different measurement.
Helen, your consistent physical activity and stable HbA1c are positive signs. Continue caring for your health, but do not feel you must keep cutting foods or losing weight to achieve a lower glucose number.
At 81, maintaining independence, strength, adequate nutrition and quality of life matters just as much as monitoring blood sugar.
All the best,
Dr. Albana
Medical references:
ADA 2026: Diagnosis |
Prevention |
Older Adults.
Educational information only; individual medical decisions should be made with your healthcare professional.
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QUESTION: Measurement taken before going to bed, then taken again when awake in the morning.
ANSWER: Hi,
There are many factors contributing to high blood sugar levels when you wake in the morning.
First of all, what you eat the night before or at bedtime could influence the results.
In addition, the drugs you are taking at night or at bedtime (drugs or insulin shots). So, you must check the dose of the drugs you are taking.
Furthermore, the morning hormones, the ones that give our body the right "awake-push" to begin the new day, would also raise fasting blood sugar readings.
According to what I mentioned above, it is good to consult with your personal doctor and discuss the real culprits for your case.
Once the real problems are caught in time, you should start the right changes immediately.
Another thing I wanted to add is that you should set your own "blood glucose level" goal together with your doctor.
Please keep in mind that although normal ranges of blood glucose are already set generally, the medical team works together with the patient and try to set the individual normal sugar level.
This is to help both the medical team and the patients to see the progresses and make the most appropriate changes and to avoid the "false" results as much as we can.
So, at last, it is better to consult with your doctor, and discuss all the things I told you earlier hoping this might be of help to you.
All the best!
Dr.Alba
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