I am a 50 year old female with no history of diabetes. My fasting glucose levels were 95 mg/dl [5.3 mmol/L] and 99 mg/dl [5.5 mmol/L], and my insulin level was 4. My practitioner wanted to follow up on these levels, so I did a postprandial test. The results are as follows: fasting – C-Peptide 1.4; glucose 89 mg/dl [4.9 mmol/L]; A1c 5.6; estimated average blood glucose 114 mg/dl [6.3 mmol/L]; two hours after sugar – C-Peptide 8.1; glucose 126 mg/dl [7.0 mmol/L]; insulin 37. Do these levels indicate I am heading in the direction of any of the categories of diabetes? If so, what can I do to improve my situation, if anything? Before the test, my practitioner had wondered if I had the beginnings of LADA, but I have not yet spoken to her and this isn’t her specialty per se.

Although it is important to try to predict diabetes or pre-diabetes and make appropriate recommendations in follow-up, the values you have listed are considered normal. You do not have diabetes and your insulin and C-Peptide levels are not markedly elevated. I would suggest you concentrate on a healthy lifestyle and not worry about the test results. There are no pure cutoffs with regard to the diagnosis of diabetes when you look at insulin and C-Peptide values. Diabetes is only defined by glucose levels. Fasting glucose values greater than or equal to 126 mg/dl [7.0 mmol/L] are considered the usual test for follow-up. Fasting glucose levels greater than 100 mg/dl [5.6 mmol/L] but less than 126 mg/dl [7.0 mmol/L] are considered pre-diabetes. In some, the insulin and C-Peptide values may be high and indicate insulin resistance but diabetes is not diagnosed with C-Peptide or insulin levels.

JTL