November 14, 2003
Diagnosis and Symptoms
Question from :
From, USA:
I am a 44 year old female. who was diagnosed with type 2 diabetes two years ago. My doctor diagnosed me after a routine physical exam and blood work revealed that my glucose levels were “a little high” (115 mg/dl [mmol/L]). She ordered an oral glucose tolerance test done (three hours, 75 grams) which yielded the following results:
Time
Blood Glucose
Fasting
97 mg/dl [5.4 mmol/L]
30 Minutes
220 mg/dl [mmol/L]
One Hour
218 mg/dl [12.1 mmol/L]
Two Hours
219 mg/dl [12.2 mmol/L]
Three Hours
120 mg/dl [6.7 mmol/L]
Because of this, my physician said I have diabetes and wanted to put me on Glucophage right away, but I resisted to see how my levels were first. I am not under any other medications at this time, I have lost about 30 pounds since my diagnosis, am eating a more healthily (switched to diet sodas, and limit sweets). My fasting levels have been around 85-102 mg/dl [4.7-5.7 mmol/L] for over six months, and sometimes my levels do go up around 169 mg/dl [9.4 mmol/L] two hours after eating. My last A1c was 5.5%. I have several questions:
Do I really have diabetes?
If so, how long may I keep my levels within normal ranges?
Did my doctor happen to catch it early and the weight loss made me go into remission?
Am I a “typical” person with diabetes — diagnosed with the oral glucose tolerance test early-on, with normal fasting levels, and it’ll just progress as time goes on?
What am I to believe so I understand it all?
I’ve been reading all I can about diabetes and haven’t come across any information about people with type two diabetes who have normal fasting levels. I know with the fasting glucose test, I could be classified as “Glucose Impaired, ” or “Pre-Diabetic, ” but was I classified as having diabetes because of the OGTT?
I just want to understand this better! Someone told me some people who have diabetes can have normal fasting levels for up to 10 years, then things may worsen. When I ask my doctor these questions, she just tells me I am in good control, but I don’t feel like I’ve made real major changes.This makes it easy to go into denial.
Answer:
You answered your own question correctly. You are one of the lucky ones who found out you have diabetes sooner rather than later and began to follow a healthier lifestyle to control it. Since diabetes is a progressive illness, you will probably need some medication over time to get the same results you are achieving now just by losing some weight. You would also benefit from visiting a diabetes educator to go over the details of diabetes management such as meal planning, physical activity, foot care and so forth.
JS
[Editor’s comment: To help you understand a little better, the diagnosis of diabetes is made when the two-hour value during an oral glucose tolerance test is greater than 200 mg/dl [11.1 mmol/L]; yours was 219 mg/dl [12.2 mmol/L]. Please see Classification and Diagnosis of Diabetes.
SS]