From Minneapolis, Minnesota, USA:
Because my routine fasting glucose test was 126 mg/dl [7.0 mmol/L] for one test (the second was 93 mg/dl [5.2 mmolL]), and my only glucose tolerance test was 143 mg/dl [7.9 mmol/L] one hour after drinking the solution, my doctor believes that I have diabetes. My understanding, from all I have researched, is that I do not have diabetes until blood glucose levels are 140 mg/dl [7.8 mmol/L] or above two hours after taking the glucose tolerance test. I have been monitoring my own blood glucose levels both before and one hour after meals for three weeks now. None of the pre-meal tests have been above 90 mg/dl [5.0 mmol/L] (most are around 80 mg/dl [4.4 mmol/L]), and none of the post-meal tests, at one hour, not two, have been above 129 mg/dl [7.1 mmol/L]. Most are between 95 and 105 mg/dl [5.3 and 5.8 mmol/L]. I am concerned that my physician is being too aggressive in her approach to treatment. Now she wants to put me on Glucophage. I have two questions: Do I actually have diabetes? And should I being taking drugs before we use diet and exercise for blood glucose control?
From the numbers you have provided me, you do not meet the criteria for diagnosis of diabetes. These would include two fasting glucose levels greater 126 mg/dl [7.0 mmol/L] (not 140 mg/dl [7.8 mmol/L]) on different occasions, an oral glucose tolerance test with a two-hour glucose greater than 200 mg/dl [11.1 mmol/L], or random glucose levels great than 200 mg/dl [11.1 mmol/L] on two occasions. There is the classification known as impaired glucose tolerance or pre-diabetes that is noted to have lower cutoffs. Usually fasting is greater than 100 mg/dl [5.6 mmol/L], but less than 126 [7.0 mmol/L] on two occasions. You would also qualify as having pre-diabetes if the two-hour glucose on your oral glucose tolerance was greater than 140 mg/dl [7.8 mmol/L] but less than 200 mg/dl [11.1 mmol/L]. There have been published studies where drugs, such as metformin, have been shown to prevent the onset of newly diagnosed type 2 diabetes. If you have other evidence of risk factors for developing diabetes, the use of metformin in the presence of pre-diabetes has been established.
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Last Updated: Tuesday April 06, 2010 15:09:56
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