I recently had a physical and my blood sugar level was 110 mg/dl [6.1 mmol/L]. The doctor told me this could be pre-diabetes. One week later, I had an FAA physical for my private pilot license. I failed because I had sugar in my urine. Everything I have read has said your blood sugar must be very high for it to spill over into your urine. I am 46 and in very good shape. I run every day and run marathons at least once a year. My body fat is 12 percent. My blood pressure is 126/80. Could something else be causing this? Should I have more test performed or should I just wait and see?

Your blood sugar would have to get up around 200 mg/dl [11.1 mmol/L] for glucose to spill into the urine. The most sensitive test is to have an oral glucose tolerance test. This is the test where you take the oral glucose and have blood drawn at baseline and two hours after the glucose load. It provides additional information to the fasting glucose. When diabetes occurs, it affects people of all shapes and sizes. If you exercise more, this may have protected you somewhat. It is not a guarantee you can’t get diabetes. These findings need to be followed up. You might want to speak with your physician about strategies geared toward preventing the conversion from pre-diabetes to frank diabetes.

JTL