March 12, 2002
Diagnosis and Symptoms
Question from Johnston Atoll (US Territory, 825 miles west of Hawaii):
I am a 58 year old male who weighs 235 pounds, but I dropping about two pounds per week through healthy diet and vigorous daily exercise. In fact, I am walking fast two miles per day and swimming one mile per day. My close family has several people with diabetes, but I have never quite fallen into the category (e.g., my hemoglobin A1c a year ago was 6.1%. My only medications are for blood pressure and vitamin B-12 deficiency. My diet is mostly low glycemic index foods, with monosaccharides preferred over other sugars and starches. I am blessed with low cholesterol (never above 151). However, I do monitor my fasting blood glucose two mornings a week which are normally in the range of 84-86 mg/dl [4.7-4.8 mmol/L]. Should I be concerned that it sometimes drops to the range of 74-76 mg/dl [4.1-4.2 mmol/L]? That is as low as it has ever gotten.
Answer:
I don’t think you should worry about the lows. Lower normal range for blood sugars in healthy individuals is not clear. Your family history does put you at risk. Sounds like you are doing all the right things to remain healthy and maintain normal glucose tolerance. Twenty-five percent of the U.S. population has an element of insulin resistance, but this does not automatically mean type 2 diabetes. Your best bet on the future is to get that weight down.
JTL
