February 28, 2007
Diagnosis and Symptoms, Type 2
Question from Las Vegas, Nevada, USA:
Approximately one and a half years ago, I was diagnosed pre-diabetic based on a fasting blood sugar of 104 mg/dl [5.8 mmol/L] and an A1c of 6.0. Since then, I have changed my diet and started exercising more. I am 5 feet, 2 inches, and was 225 pounds, but have lost 30 pounds. Recently, due to what I thought were symptoms of a UTI, increased urination and burning, my doctor did a urinalysis which ruled out a UTI, but did show 2+ glucose. I then had a fasting glucose and lipid panel done which, according to my doctor, was “normal.” He said that I didn’t need any more follow-up until next year and just to continue with what I have been doing. I have also been having some other symptoms of diabetes such as tiredness, blurry vision and dry mouth. I am worried about ignoring all of this, just because my fasting glucose is normal. Do you think what my doctor has advised is best? Would it be out of line to request my doctor to order a glucose tolerance test?
Answer:
You might want to know what that fasting glucose level was after the urinalysis showed 2+ glucose. If it were under 100 mg/dl [5.6 mmol/L], that would be a pretty good sign that things were not deteriorating. The A1c in really normal people is not 6.0%. They usually run around 5%. However, this test cannot be used to make the diagnosis of diabetes. If you want the most sensitive test for diabetes, the oral glucose tolerance test is the test. With a truly normal fasting glucose, it would be hard to think that you are having severe symptoms of hyperglycemia. If that fasting glucose were truly normal at less than 100 mg/dl [5.6 mmol/L], you are probably okay for the next six months. However, you need to continue working on your lifestyle choices: keep physically active and continue to work on the weight loss. That is best insurance against diabetes.
JTL
