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October 27, 2004

Diagnosis and Symptoms, Other

Question from Washington, USA:

I am four feet, ten inches tall and 107 pounds. I walk almost everywhere. My symptoms were those of diabetes, on and off, and chronic bladder infections. I had them for eight months. I was also quite tired most of the time. I was diagnosed with "pre-diabetes" when my two hour postprandial blood sugar was 150 mg/dl [8.3 mmol/L]. However, my blood did sit for some time, so it may have been higher. I have been seeing an internal medicine doctor, however, his nurse practitioner was the person who saw me since she is very familiar with this disease. When I went to the doctor, I was more concerned with making sure that they were going to follow-up the diagnosis properly. Unfortunately, I forgot to ask what the diagnosis really means. I know that I will be doing minimal daily self-testing and that in three months my A1c will be taken. I know that I need to alter my diet to work with the glycemic index. I know I need to avoid both weight loss and weight gain at this point. But, I don't know what it means for the future of my health. Therefore, can you tell me what this diagnosis means when it is given to someone in my position? Will I develop diabetes, which the doctor I saw seems to think will happen? If I do, what type?

Answer:

Pre-diabetes is generally made with either an oral glucose tolerance test or a fasting glucose level on more than one occasion, as determined through a clinical laboratory and not a fingerstick glucose. When you meet the criteria of pre-diabetes, the risk of developing type 2 diabetes is very high over a 10-year period. However, do you really have it? Symptoms are not really a part of the pre-diabetes picture. The other issue is that pre-diabetes is associated with a high cardiovascular risk. I think you need to optimize your lifestyle choices and have a regular medical follow-up. The bladder infections may not be part of this at all.

JTL