You wake up, prick your finger, and the little digital screen flashes a 98. It’s a number that sits in a weird kind of medical purgatory. On one hand, your doctor might glance at your lab results, see that it’s under 100, and give you a thumb’s up before moving on to the next patient.
But is it actually "perfect"?
Technically, a fasting blood sugar 98 mg/dL falls within the "normal" range defined by the American Diabetes Association (ADA). The official cutoff for prediabetes starts at 100 mg/dL. So, you’re safe, right? Well, it’s complicated. If you’ve been hovering at 85 for years and suddenly you’re at 98, that’s a trend worth noticing.
Context matters. A lot.
Why the Number 98 Can Be Deceptive
Blood glucose isn't a static thing like your height. It’s more like a river, constantly rising and falling based on what you ate last night, how well you slept, and even how stressed you are about that 9:00 AM meeting. When you get a result of 98, you’re basically standing on the edge of a cliff. One or two points higher, and you’re officially in the "prediabetes" category.
It's a tightrope walk.
According to research published in The Lancet Diabetes & Endocrinology, individuals with fasting glucose levels at the high end of the "normal" range (90–99 mg/dL) may already have a significantly higher risk of developing Type 2 diabetes compared to those with levels below 85 mg/dL. Your beta cells—the tiny factories in your pancreas that make insulin—might already be working overtime. They’re struggling to keep you under that 100 mg/dL threshold. It’s like a car engine that’s redlining just to keep up with highway traffic.
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Eventually, something might give.
Think about the "Dawn Phenomenon." This is a natural rise in blood sugar that happens in the early morning hours as your body prepares to wake up. It releases cortisol and growth hormone, which tell the liver to dump some glucose for energy. If your fasting blood sugar 98 is a result of this morning spike, your "true" baseline might be lower. But if you’re seeing 98 after a long fast and a relaxed morning, your insulin sensitivity might be slipping.
The Role of Insulin Resistance
You can’t talk about 98 without talking about insulin. Insulin is the key that opens the door to your cells so glucose can get in. When you have insulin resistance, the lock gets rusty. Your body has to pump out more and more insulin to get the same job done.
Here’s the kicker: your fasting glucose can stay "normal" for years while your insulin levels skyrocket.
Dr. Joseph Kraft, a pioneer in glucose tolerance testing, famously argued that "those with cardiovascular disease not identified with diabetes are simply undiagnosed diabetics." He found that many people with a "normal" fasting glucose under 100 actually had hyperinsulinemia—way too much insulin in their blood. By the time your fasting blood sugar 98 climbs to 105 or 110, the underlying metabolic dysfunction has likely been brewing for a decade.
What Else Are You Checking?
If you're worried about that 98, don't look at it in a vacuum. You need a fuller picture.
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- HbA1c: This gives you a three-month average. If your fasting is 98 but your A1c is 5.7%, you’re technically prediabetic regardless of that morning prick.
- Triglyceride-to-HDL Ratio: High triglycerides and low HDL (the "good" cholesterol) are massive red flags for insulin resistance. If your triglycerides are double your HDL, that 98 looks a lot more suspicious.
- Waist Circumference: Be honest. Is the weight sitting mostly around your midsection? Visceral fat—the stuff deep in your belly—is metabolically active and directly drives up fasting glucose.
Is It Just "White Coat Syndrome" or Stress?
Let's be real—sometimes the doctor's office is stressful. If you're getting your blood drawn and you hate needles, your cortisol spikes. Cortisol tells your liver to release sugar. Boom. Your fasting blood sugar 98 might actually be a 90 if you were relaxed at home.
Poor sleep is another silent killer of good numbers. One night of tossing and turning can make you as insulin resistant as someone with Type 2 diabetes the next morning. It’s wild how much a bad night's sleep messes with your metabolism. If you stayed up late scrolling through your phone and then tested at 98, don't panic. Fix the sleep first, then retest.
Hydration plays a role too. When you're dehydrated, your blood volume drops, but the amount of sugar stays the same. This makes the concentration of glucose appear higher. Drinking a glass of water before your test (if your doctor allows it) can sometimes give a more accurate reading of your actual metabolic state.
Lifestyle Tweaks That Actually Move the Needle
If you want to see that 98 drop into the 80s, you don't necessarily need medication. Small, boring changes usually work best.
Stop eating three hours before bed. Seriously. When you eat late at night, your body is still processing those nutrients while you sleep, and your insulin stays elevated. By giving your system a longer break overnight, you allow your liver to settle down.
Walk after dinner. It doesn't have to be a marathon. A 15-minute stroll around the block uses up excess glucose in the bloodstream before it can settle in for the night. Muscle is a "glucose sink." The more muscle you have, the more places your body has to put sugar besides just letting it float around in your blood. Resistance training—lifting heavy things—is arguably more effective for long-term blood sugar control than hours of steady-state cardio.
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The Myth of "Healthy" Carbs
We’ve been told for decades to eat lots of "heart-healthy" grains. But if you’re seeing a fasting blood sugar 98, your body might be telling you it's struggling with the carbohydrate load. Even "complex" carbs like oatmeal or brown rice can spike blood sugar in some people.
Try testing your post-meal glucose. If you're 98 fasting but 160 two hours after eating a bowl of oatmeal, that oatmeal isn't "healthy" for you. Everyone’s microbiome and genetics handle starch differently.
When Should You Actually Worry?
A single reading of 98 isn't a diagnosis. It's a data point.
If you see 98 once, ignore it. If you see 98 every day for a month, pay attention. If you have a family history of diabetes, high blood pressure, or PCOS (Polycystic Ovary Syndrome), that 98 is a nudge to be proactive.
Modern medicine is often reactive. We wait until the "check engine" light (prediabetes/diabetes) comes on at 100 or 126 mg/dL before we do anything. But you have the power to look at the gauges before the light turns on. A 98 is your body saying, "Hey, I'm managing, but I'm working pretty hard over here."
Real-World Steps to Take Today
Don't just stare at the number. Take action.
- Get a Home Monitor: Don't rely on once-a-year lab tests. Buy a cheap glucose meter and test yourself at home in different conditions—after a high-carb meal, after a workout, and after a good night's sleep. Knowledge is power.
- Prioritize Protein: Start your day with eggs or a protein shake instead of cereal or toast. Stabilizing your blood sugar in the morning sets the tone for the whole day.
- Check Your Magnesium: Most people are deficient, and magnesium is crucial for insulin signaling. Low magnesium can lead to higher fasting glucose levels.
- Watch the Alcohol: That glass of wine at night might actually drop your blood sugar temporarily (because the liver stops releasing glucose to process the toxin), but it disrupts sleep and can lead to a rebound spike later.
- Focus on Fiber: Fiber acts as a buffer. If you're going to eat carbs, dress them up in "fiber clothing." Eat the salad before the pasta.
The goal isn't just to be "under 100." The goal is metabolic flexibility—the ability of your body to switch between burning sugar and burning fat with ease. A fasting blood sugar 98 is a sign that you’re doing okay, but there’s definitely room to optimize. It's an invitation to tighten up the ship before you hit rougher waters.
Consistency beats intensity every time. You don't need a radical overhaul; you just need to stop the slow creep upward. Keep an eye on the trends, listen to your body, and don't let a "normal" lab result lull you into a false sense of security if other parts of your health feel off.
Final Practical Takeaways
- Retest in 3 months: One reading is just a snapshot.
- Ask for a C-Peptide test: This measures how much insulin your body is actually producing.
- Don't stress the 98: Stress itself raises glucose; stay calm and make small adjustments.
- Walk more: It is the simplest, most underrated metabolic tool available.