January 13, 2002
Diagnosis and Symptoms
Question from :
I am 40 years old, have had three fasting blood sugars 115 mg/dl [6.4 mmol/L], 119 mg/dl [6.6 mmol/L], and 114 mg/dl [6.3 mmol/L] respectively over the past two years, and my most recent A1c was 5.3%. I was told by my doctor that there is nothing to worry about, but he gave me no sense that I should consider my blood sugar high. I thought anything over 110 mg/dl [6.1 mmol/L] was considered “abnormal.” Should I be following up on this or am I considered “normal”?
Answer:
Your concern for blood sugars above “normal” is a healthy one. Though a fasting blood sugar of above 110 mg/dl [6.1 mmol/L] is not normal, the diagnosis of diabetes can’t be made until there are readings of 126 mg/dl [7 mmol/L] or higher on two different days or, after post-meal blood sugars are 200 mg/dl [11.1 mmol/L] or more.
I wouldn’t say there’s “nothing to worry about”. I would look at your risk factors for type 2 diabetes (obesity, high blood pressure, high triglycerides, low HDL cholesterol, family history of diabetes). A person can have normal fasting blood sugars and a normal hemoglobin A1c yet still have diabetes in its earliest stages. On the other hand, you appear to have what we call impaired glucose tolerance which means your body isn’t handling sugar well, and this may turn into diabetes.
I would recommend you talk with someone who knows about insulin resistance and type 2 diabetes, someone who could check your blood pressure and your lipids to know if you were insulin resistant (a condition that precedes type 2 diabetes). If you are concerned about the blood sugar readings, I would recommend you learn how to do home testing of your blood sugar. Then, you can test after meals as well and find out how high your blood sugar goes. This will give both you and your health care provider more information in making a diagnosis. You will also learn which foods raise your blood sugar more and, even if you don’t have diabetes, this will help you to make changes that may delay the onset of diabetes.
TB
[Editor’s comment: See Classification and Diagnosis of Diabetes Guidelines.
SS]
