Several weeks ago I took a 3 hour glucose test (with 75 grams of sugar). My blood was taken 3 times. I failed the test. My doctor told me I had Type 2 diabetes. He gave me a prescription and a diet to follow for thirty days. The first day I took the medication I ended up going into hypoglycemia.
I decided to see another doctor, a diabetic specialist. After monitoring my blood for 10 days, the results (the readings were between 75 and 101) showed I didn't have diabetes, and the test that I failed the first time was due to glucose intolerance.
I'm confused: isn't glucose intolerance the same thing since my sugar level remained high for that 3 hour test that I failed? I'm now not on any special diet (except I'm not eating any cookies, candies, etc.) and my numbers for the most part are in the normal range except for one day that I had pasta for dinner (a large portion 5 1/2 oz.). I checked my blood after 3 hours and it was 190 and then it dropped to 150 an hour and a half later. The next morning it was 107. That has been the only incident, all other times its less that 102 (generally between 82 and 95).
Could someone explain what this glucose intolerance is and can it lead into diabetes?
As people grow older it is fairly common to have an increasing difficulty in converting sugar or starch into energy. The usual test for this is a glucose tolerance test. As you did, you drink a standard amount of glucose and see whether or not the blood sugars over the next two to three hours remain within normal limits. In your case they did not and later on you had another abnormal blood sugar three hours after a big meal of pasta. This is known as glucose intolerance, which is a condition that develops very slowly and is usually due to the body getting increasingly resistant to the action of insulin.
To begin with it is often occasional, but after many months it may progress to the point that blood sugars are always high and some of the excess sugar overflows into the urine. At this stage it is called diabetes (Type 2 diabetes, or NIDDM, or Adult Onset Diabetes Mellitus). Eventually the constantly high blood sugars damage the lining of small blood vessels particularly in the eyes and the kidneys.
To begin with, the treatment is to restrict sugar and starch in the diet. This seems to be what you are now doing; but I think that you would find it helpful to talk to a dietician about the details just to make sure that your total food intake remains adequate. At some future date, and it may be months or years, it is likely that you will again have to start taking tablets to keep blood sugars as near to normal as possible. Ultimately too you may need to take extra insulin.
At this point, it would be wise to see if there is a diabetes care team that you like and to have them look after you. The local office of the American Diabetes Association may be able to help you with this and so may your latest doctor.
The aim of treatment (whether it is diet alone, or with oral medication and/or insulin) is to keep blood sugars as near to normal as possible. To do this you need to measure blood sugars and occasionally to have a glycohemoglobin test which tells you about your average blood sugar over the last three months. Again this is where a diabetes care team can be of great help to you.
Original posting 28 Oct 96
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