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November 8, 2000

Diagnosis and Symptoms

Question from Louisiana, USA:

I have had insulin levels of 30, 33,and 37(fasting). During a glucose tolerance test, my sugar levels were 103 mg/dl [5.7 mmol/L], 245 mg/dl [13.6 mmol/L], 230 mg/dl [12.8 mmol/L], and 130 mg/dl [7.2 mmol/L]. Ten minutes later, I crashed to 34 mg/dl [1.9 mmol/L]. Within two hours after eating, I crash so hard I feel as though I am dying. My doctors are confused. Please give me some insight.

Answer:

A fasting glucose of less than 126 mg/dl [7 mmol/L] is not diabetes. A two-hour glucose after a GTT of less than 200 mg/dl [11.1 mmol/L] is not diabetes. The 245 mg/dl [13.6 mmol/L] and 230 mg/dl [12.8 mmol/L] can come after poor preparation, not enough carbs in the diet or with some glucose intolerance, but is not diabetes. The insulin levels of 30, 37 and 33 are not really high especially with glucoses of 100 mg/dl [5.6 mmol/L]. If the glucose was 34 mg/dl [1.9 mmol/L], then it would be high. So, I don’t really know enough to be sure of all the details.

This can be complicated. You might need to go to the hospital for a fast and some testing. A good endocrinologist knows about this. You may have reactive hypoglycemia, in which the glucose falls between meals and needs food and frequent feeds.

LD