April 17, 2006
Diagnosis and Symptoms
Question from Cairo, Egypt:
I am 60 years old. My fasting blood sugar is 90 mg/dl [5.0 mmol/L]. It rises to 250 mg/dl [13.9 mmol/L] two hours after breakfast, then but it drops 100 mg/dl [5.6 mmol/L] after three hours and may drop further, to 70 mg/dl [3.9 mmol/L] four hours afterwards. During the day, my blood sugar averages between 140 and 160 mg/dl [7.8 to 8.9 mmol/L] two hours after meals. Do I have diabetes, pre-diabetes or neither?
Answer:
The criteria for the diagnosis of diabetes in the United States do not allow for decisions to be made on the basis of fingerstick glucose measurements. Rather, you should use the fasting glucose measurement, an oral glucose tolerance test, or a two-hour post meal glucose. Your sugars, as given in your correspondence, sound as if they were from a glucose meter. These instruments may have up to a 20% error limit and lack precision. You need to see your physician and have these measurements performed by a laboratory to be able to answer the question you ask. I encourage you to do so.
JTL
