September 29, 2006
Diagnosis and Symptoms
Question from India:
I am 36 years old male with a weight loss problem; I’ve lost about 9 kg (almost 20 pounds) over four years. Recently, I got my blood glucose tested. The values were 95 mg/dl [5.3 mmol/L] fasting and 128 mg/dl [7.1 mmol/L] postprandial. The postprandial blood glucose was tested 1 hour 50 minutes after a normal breakfast with additional sugar in tea, one banana and one piece of a sweet. Previously, two years ago, the values were 87 mg/dl [4.8 mmol/L] fasting and 70 mg/dl [3.9 mmol/L] postprandial. The postprandial blood sugar test was done two hours after taking 75 grams of glucon D (glucose) in one glass of water and a breakfast of two bread slices with some cooked vegetable with some sweets. My father is also a diabetic. Why was my postprandial sugar level lower than the fasting one?
As per the doctor’s advice, my urine was also examined recently and the values were: Macroscopic – Quantity 30 ml; Colour-Pale yellow; Appearance-clear; Deposit-Nil; Reaction – Acidic. Biochemical – Albumin-Nil, Sugar-Nil. Microscopic – Pus cells: 1-2/HPF, RBC-Nil, Epithelial Cells: 2-4/HPF, Crystals-Uric acid(+)/HPF, Casts-Nil.
Is my recent blood sugar value normal? Though they seem to be in the reference range, aren’t they on the higher side? On several occasions, I had gotten my blood sugar checked, but the fasting value wasn’t over 80 mg/dl [4.4 mmol/L]. Likewise, the postprandial values were not over 104 mg/dl [5.8 mmol/L]. The most recent test was the only one as high as 128 mg/dl [7.1 mmol/L]. Why is it that the values are increasing for the past two years? Does that show any malfunction? Are there any further tests to clear my status with regard to blood sugar? What is my correct status as far as blood sugar values are concerned? Does the urine test have any abnormality, such as uric acid, and what can be done about that? The tests were done by different laboratories. The two recent tests were done by reputable laboratories.
Answer:
I do not think you should read a lot into the fact that the results are higher. The bottom line is that they are still normal. Whether you can even compare your postprandial values is controversial because the test meals were really different on the different occasions. Postprandial blood sugars may be lower than fasting values as a result of the ability to induce insulin secretion with the meal. It is true that a normal fasting glucose has been labeled as being less than 100 mg/dl [5.6 mmol/L] by the American Diabetes Association. Values between 100 and 125 mg/dl [5.6 and 6.9 mmol/L] have been associated with what has been termed impaired fasting glucose. This has been equated to “pre-diabetes.” Whether this is equivalent to impaired glucose tolerance with an oral glucose tolerance test is debatable. Fasting glucose levels are probably the best way (in that they are easy to do and there are clearly normal values assigned to them) to follow your glucose tolerance over time.
JTL
