September 15, 2004
Diagnosis and Symptoms, Traveling
Question from Atlanta, Georgia, USA:
I went in for a physical and my fasting glucose was 116 mg/dl [6.4 mmol/L]. The doctor said to “cut down on sweets”. I’m a Caucasian, fit, 30-something, male, who eats minimal processed foods, exercises regularly, and has phenomenal cholesterol. So, those results were surprising. The office didn’t seem to want to call a 116 mg/dl [6.4 mmol/L] “pre-diabetes”. I then got another test and the fasting glucose was 101 mg/dl [5.6 mmol/L] (abnormal, slightly high); A1c was 5.5% (normal, high) and fasting insulin was 3.5 (abnormal, low). The doctor said these results are fine.
I didn’t get any clarification on whether a low fasting insulin was bad or good, though, just “abnormal”. Do these results make sense? Am I considered healthy or would you recommend more tests? What do they tell you? My blood pressure is also 140/90, which doesn’t make a lot of sense.
Answer:
It sounds like you may have “pre-diabetes”, which is diagnosed with a fasting blood sugar between 100 and 125 mg/dl [5.6 and 6.9 mmol/L]. It’s a good thing that you keep yourself fit because the results would probably be much worse if you didn’t. I think you should ask your doctor about having a two hour glucose tolerance test where you drink 75 grams of a special glucose solution and have your blood sugar checked every 30 minutes for two hours. Sometimes this test is positive and the fasting blood sugar is still somewhat normal.
JS
