August 2, 2004
Diagnosis and Symptoms
Question from Liberty Township, Ohio, USA:
I have one child with type 1 diabetes and am concerned about her sibling. He has shown some warning signs and I have gotten several conflicting answers from different nurses/doctors about what numbers we should be looking for. One nurse told me fasting numbers should be below 110 mg/dl [6.1 mmol/L] another said 126 mg/dl [7 mmol/L]. Then, for blood sugars within two hours of eating, I have heard anywhere from over 126 mg/dl [7 mmol/L] to over 200 mg/dl [11.1mmol/L]. I am trying to clarify because he seems to be borderline. He has lost some weight and has always been thirsty. He has recently started to have stomachaches right after starting to eat. He has had numbers between 146 mg/dl [8.1 mmol/L] and 200 mg/dl [11.1 mmol/L] during that two hour period after eating and middle of the night. His fasting numbers have been around 112 mg/dl [6.2 mmol/L].
Also, is the two hour period from the time he finishes eating or from the time he starts eating?
The classification of diabetes and other irregularities in glucose metabolism gets updated after review of new information. This is from the Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus.
Currently, it is accepted that diabetes is able to be diagnosed when:
There are confirmed elevations in fasting serum glucose (by venipuncture) of greater than 125 mg/dl [6.9 mmol/L] (some prefer to say “equal or greater than 126 mg/dl [7.0 mmol/L]”); OR
There is confirmed elevation in random serum glucose (by venipuncture) of greater or equal to 200 mg/dl [11.1 mmol/L] when there are concurrent symptoms of diabetes (e.g. increased urination, thirst, weight loss); OR
The serum glucose (by venipuncture) at the two hour mark in a properly performed glucose tolerance test is greater or equal to 200 mg/dl [11.1 mmol/L].
“Impaired glucose tolerance” refers to a serum glucose value (by venipuncture) during that glucose tolerance test of greater or equal to 140 mg/dl [7.8 mmol/L].
“Impaired fasting glucose” is now described as a fasting serum glucose (by venipuncture) of more than 100 mg/dl [5.6 mmol/L] but less than 126 mg/dl [7.0 mmol/L].
The two hour time frame begins at the start of the consumption of the meal, not two hours after completing the meal.