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October 18, 2001

Diagnosis and Symptoms

Question from Orlando, Florida, USA:

I am 42 years old, 20 pounds overweight, have been having some hormone problems, and I have a family history of diabetes. Several tests for diabetes in the past have been normal, but I am now having some more exaggerated symptoms, and I have trouble telling the difference between symptoms of hormonal changes and diabetes. Have any studies been done on women my age and older? Are there crossover symptoms? I am very dissatisfied with doctors and tests that read "normal". What's normal for me? What if I feel symptoms more acutely (kind of like an early warning system)? What are the best tests to take when you don' t know what you have?

Answer:

The diagnosis for type�2 diabetes is straightforward. It is a laboratory diagnosis with two fasting values greater than 126 mg/dl [7 mmol/L] on separate occasions. However, it has been shown that the higher the fasting glucose, the more likely it is to develop diabetes. If your fasting is less than 115 mg/dl [6.4 mmol/L], that is better than 120 mg/dl [6.7 mmol/L].

With regard to perimenopausal symptoms, the FSH level can be measured, and when it is greater than 20, there is an increased likelihood of progression toward menopause. This occurs in a continuum, not overnight. I would recommend speaking with your physician about your symptoms and have a discussion about your test results. The problem with symptoms is that they are not specific for any one thing.

JTL