May 14, 2005
Diagnosis and Symptoms, Hypoglycemia
Question from Michigan, USA:
I am 30. I eat relatively well, am 5 feet, 5 inches and 120 pounds, work out regularly and have no other health problems that I know about. But, for nearly 10 years I have had many of the symptoms of diabetes. When I went to the doctor 10 years ago, he pricked my finger and said I had low blood sugar and to watch what I eat (he didn’t offer me any testing as an option). I since have been pretty careful about my diet, but there’s no question that there’s something wrong with me. More often than not, it seems that I get symptoms of hypoglycemia after I eat. My vision often becomes blurry and I feel lightheaded. Sometimes, I get numbness in my fingers and I shake. I finally went to my doctor and asked to be tested for diabetes so she will be giving me a fasting test.
Could this accurately show that I could be diabetic, since I often don’t have the symptoms until AFTER I eat? Also, if I could indeed be diabetic, I would assume it would be type 1. Why would I have had relatively minor symptoms for this long of a time? My understanding is that the symptoms occur quickly.
Answer:
You are asking about diagnosing two different problems. One is elevated blood sugars from diabetes. The other is the diagnosis of post-meal hypoglycemia. The current criteria for the diagnosis of diabetes does include a cutoff of greater than or equal to 126 mg/dl [7.0 mmol/L] on more than one occasion for the diagnosis of diabetes. However, postprandial hypoglycemia is a symptom complex and is best managed with avoidance of large amounts of simple sugars that induce insulin vigorously and cause a rapid fall in blood sugars before correcting back upward. In other words, the body has a hard time making the transition from adequate amounts of insulin post-meal and happens to make too much before having to shut it off. Some people have pointed to the idea that this may be a pre-diabetes event associated with disordered insulin secretion, but there is not adequate data to support that. Having the fasting blood glucose periodically will be helpful. Your age, weight, and symptoms do not sound like diabetes.
JTL
