I am 26 years old, one-quarter Native American, I have a BMI [body mass index] of 37, and I had gestational diabetes. I have asthma, and I am constantly ill with colds, stomach bugs, etc. I have a family history of type 2 diabetes and developed borderline hypoglycemia when I was 18 years old. Which test should I suggest my doctor do to determine if I have type 2 diabetes?

You are at high risk to develop type 2 diabetes. Get your fasting level of blood glucose tested, also perhaps even use a meter to see what your glucose is doing about one to two hours after a meal since abnormal postprandial glucoses come first. You might even want to ask your doctor about using a medication such as Glucophage [metformin] soon.

LD

[Editor’s comment: Testing for diabetes should include blood sugar levels performed by a medical laboratory. The timing of the sample (fasting, random, or postprandial) would influence how high a level is considered abnormal. See Classification and Diagnosis of Diabetes for further information.

Occasionally, lab blood sugar testing might be normal in an early case of diabetes, repeat blood sugar testing at the same or a different time, or performing a glucose tolerance test, might be appropriate if there is a high suspicion of diabetes despite normal initial testing. Another test, the glycosylated hemoglobin, might be used to help confirm a suspected diagnosis of diabetes, but the GHB (also called HbA1c or A1c) is not usually considered as appropriate to make an initial diagnosis. Antibody testing is occasionally done as a screening test in high-risk situations, or as confirmatory of type 1A (autoimmune) diabetes, but is not part of routine testing.

Urine sugar tests or home glucose testing, if done, might be positive, which would make the situation more urgent to get lab testing done to confirm the abnormal results. However, urine or home glucose testing, if negative, would not exclude the presence of diabetes.

WWQ]