
February 4, 2003
Diagnosis and Symptoms
Question from Lebanon, Pennsylvania, USA:
I have never been tested for diabetes, but I do know that it runs in my family. (My mother has it, my brother was just diagnosed with it, and my grandmother had it when she was living.) I get a lot of chest pain and numbing in my fingers and hands. I also get stomachaches at times, and I get like these hot flashes that make me sweat very much. I don’t have much energy at all, I get very nauseated a lot also, and I have deep and rapid breathing at times. I get dry mouth a lot; most of the day I would have to say. I also get very grouchy, and get the shakes at times, my heart beats really fast, I feel dizzy at times almost like I am going to pass out. I sometimes get confused also. I do get very thirsty, drink a lot in a day, and go to the bathroom a lot. I feel tired a lot also and don’t have very much energy at all. Is this something I should bring to my doctor’s attention?
Answer:
You have enough of the symptoms of diabetes and a marked family history to be very suspicious that you have diabetes. You need to see your physician and have blood testing done to determine if you have diabetes. You should not wait on this. You should not put it off. If it turns out you do not have diabetes, you should be checked yearly for this.
JTL
[Editor’s comment: Testing for diabetes should include blood sugar levels performed by a medical laboratory. The timing of the sample (fasting, random, or postprandial) would influence how high a level is considered abnormal. See Classification and Diagnosis of Diabetes Guidelines for further information.
Occasionally, lab blood sugar testing might be normal in an early case of diabetes, repeat blood sugar testing at the same or a different time, or performing a glucose tolerance test, might be appropriate if there is a high suspicion of diabetes despite normal initial testing. Another test, the glycosylated hemoglobin, might be used to help confirm a suspected diagnosis of diabetes, but the GHB (also called HbA1c or A1c) is not usually considered as appropriate to make an initial diagnosis. Antibody testing is occasionally done as a screening test in high-risk situations, or as confirmatory of type type 1A (autoimmune) diabetes, but is not part of routine testing.
Urine sugar tests or home glucose testing, if done, might be positive, which would make the situation more urgent to get lab testing done to confirm the abnormal results. However, urine or home glucose testing, if negative, would not exclude diabetes.
SS]