Recently had fasting lab-work and debriefed with my new doctor. It showed elevated Glycohemoglobin (6.1, range 4.0-5.6) and the doc warned that this is pre-diabetic.
My problem is this is the first time Ive shown increased blood glucose levels. Labs from January showed Glucose at 100mg/dL, and labs from March were 92mg/dL (neither fasted). I don’t have any symptoms of diabetes.
In fact, like most of the people here, I am very aware of my diet and exercise (5’11”, 205#). I work as a personal/group fitness trainer (25hrs a week) commute to work on a bicycle, lift 4-5x per week (including olympic lifting and 2 sessions of Crossfit a week), and go for at least 1 run a week.
I will saw that my Neurologist from January had me using Meloxicam once a day for several months to treat nerve pain, but the doc from March saw low Billirubin (0.2) and elevated AST (37), so he took me off of Meloxicam.
Is this anything I should worry about? Net searches about glucose levels in athletes and heavily active people seem to give mixed answers.
Yes, this would deserve some additional evaluation.
Additional pertinent variables would include things like your waist measurement, any family history of diabetes, and some additional lab parameters like your lipid panel, among other things.
It is possible for healthy people to have an increased HbA1c for benign reasons, for example due to significant increases in red blood cell lifespan or in situations of very prolonged endurance exercise, which can cause “exercise-induced insulin resistance”.
However, these are what we call “diagnoses of exclusion” – meaning we would want to make sure you truly do not have any significant metabolic issues before attributing it to one of these causes. Repeating the A1c, as well as other tests like an oral glucose tolerance test, & fasting triglyceride + glucose level (to calculate a triglyceride-glucose index), etc may be helpful.
As an aside, I am not sure whether the tests you report were actually the reason for taking you off Meloxicam, as there is no such thing as a “low” bilirubin, nor is an AST of 37 a reason to discontinue an NSAID, as that is a trivial AST elevation better explained by your regular exercise (see here)