My doctor ran tests two weeks ago. I haven’t gone over the results yet with the doctor. They did blood tests and a urine test only. They asked me to come in to the office to pick up a glucometer, which I did two weeks ago. I have five readings from 27 mg/dl [1.5 mmol/L] to 60 mg/dl [3.3 mmol/L] before meals and five readings ranging from 180 mg/dl [10.0 mmol/L] to 232 mg/dl [12.9 mmol/L] after meals. Can this indicate diabetes? Should I continue to see my family doctor or should I see an endocrinologist? I’m a 40-year-old female with a BMI of 22. My grandmother on my mom’s side of the family had type 2.

The diagnosis of diabetes is based on specific diagnostic criteria. The criteria, according to the American Diabetes Association, include a fasting glucose on more than one occasion of 126 mg/dl [7.0 mmol/L]. You can also diagnosis diabetes from a 75 gram oral glucose tolerance test. Glucose readings at random times, unless they are over 200 mg/dl [11.1 mmol/L] with symptoms, are not enough to make the diagnosis. You are entitled, as a patient, to make sure that your doctor has adequately gathered the appropriate tests. If you do not have the diagnosis of diabetes, insurance may not pay for the materials that your doctor prescribes. Like pregnancy, you either have diabetes or you do not. None of this “borderline” diabetes stuff is appropriate. At your age, with a BMI of only 22, if this is diabetes, I would be concerned about type 1 diabetes. This is even though your grandmother has had type 2 diabetes. As far as who you should see, if you feel comfortable and your questions are being adequately answered and treatment results are good, referral is not required. If, however, you feel you need more answers, your doctor does not have expertise in diabetes, or you are having trouble meeting treatment goals, you may want to speak to an endocrinologist.

JTL