May 14, 2005
Diagnosis and Symptoms, Type 2
Question from Pittsburgh, Pennsylvania, USA:
I am 27 years old. Type 2 diabetes runs in my father’s side of the family as he has it along with one of my siblings. I have been having the symptoms of diabetes for about a month now. I am always thirsty, lethargic, usually up about three times during the night to use the bathroom. After meals, mostly dinners, I get the shakes real bad and my glucose levels have been slightly high. Working in a health care setting, I have the opportunity to check my blood sugars if I need to. I usually start feeling sick about one to two hours after I eat my last meal of the day, which is usually dinner. The shakes come and then dizziness and a nauseous feeling comes. At those instances is when I check my glucose and they have been about 190 mg/dl [10.6 mmol/L], 137 mg/dl [7.6 mmol/L], 159 mg/dl [8.8 mmol/L], 178 mg/dl [9.9 mmol/L], and 144 mg/dl [8.0 mmol/L] all on different days within a week about two hours after I last eat. I don’t eat sweets or drink any caffeinated beverages.
My doctor did all the normal blood work and such. My fasting glucose came back at a normal level. He instructed me to come in once a month to have my glucose checked. If all the tests came back normal, then why am I still feeling this way after I eat? Why is my glucose so high in the evenings but normal during the day? Could this be an early warning sign or should I ask my doctor to run some more tests?
Answer:
The criteria for diagnosing diabetes are geared towards evaluating the fasting glucose. However, the most sensitive test to perform for the diagnosis of type 2 diabetes is the 75 gram oral glucose tolerance test (OGTT). If you want to have a definitive test, have this done. It will evaluate both the fasting and your post-challenge glucose as part of the test. I am not sure why you have your symptoms. They are fairly nonspecific, except for the time they occur. The sugars you post are higher than you would like, but may not fit into a frankly diabetic range. However, it is possible you might be in the range for impaired glucose tolerance. Sometimes symptoms occur when your sugars fall very rapidly. Having the post-meal challenge test as part of the OGTT will help put this into perspective.
JTL
