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August 22, 2002

Diagnosis and Symptoms

Question from Paris, France:

For the last 20 years, I have had treatment for Hashimoto’s thyroiditis, and I have a family history of Hashimoto’s thyroiditis, lupus, psoriatic arthritis, and diabetes. Recently, I had a blood glucose of 160 mg/dl [8.9 mmol/L], so my endocrinologist decided to give me Glucophage. I am very surprised and need a second opinion because I have seen other doctors who said this level is quite normal and I do not have diabetes.


From: DTeam Staff

Hashimoto’s thyroiditis is the most common cause for hypothyroidism in the world. It is caused by an autoimmune reaction that results in thyroid destruction and the need for permanent thyroid hormone replacement.

Type 1 diabetes is also an autoimmune disease. However, type 2 diabetes is not thought to be an autoimmune disease and can be developed by different mechanisms with different genetic predispositions.

A blood sugar of 160 mg/dl [8.9 mmol/L] is questionably high. However, the gold standard is the fasting blood sugar. This needs to be less than 126 mg/dl [7 mmol/L] according to the Classification and Diagnosis of Diabetes Guidelines criteria used by the American Diabetes Association.

I would recommend you have your fasting glucose rechecked. If there is a question, you can have an oral glucose tolerance test which is more sensitive than the fasting glucose test but is more time consuming.