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November 14, 2001

Diagnosis and Symptoms

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Question from Parma, Ohio, USA:

I am almost 22 years old, I have a family history of diabetes, and I just visited the clinic on campus today for what I thought was just a recurring yeast infection that I was unable to cure. My doctor diagnosed vaginitis. The next thing I knew she wanted to test my blood sugar which was 152 mg/dl [8.4 mmol/L], but I had eaten within two hours before the test. She ordered a fasting blood sugar test and a hemoglobin test, and made it seem as though diabetes could be a real issue for me. Should I be concerned or is this far-fetched? Could diabetes be a possible diagnosis for me? What factors led the doctor to suspect this disease? If I had diabetes what should the results of the fasting blood sugar and the hemoglobin be? Is this something that I should get a second opinion on before changing my life? How do I know whether I would have type 1 or type 2 diabetes?

Answer:

From: DTeam Staff

One of the things to remember is that physicians or patients are usually struck by some part of the history. The warning symptoms include frequent urination, weight loss, decreased visual acuity, recurrent vaginal yeast infections, or some combination. The 152 mg/dl [8.4 mmol/L] is not necessarily diabetes. The diagnosis is made with two fasting glucose levels greater 126 mg/dl [7 mmol/L] on two separate occasions. Type 2 diabetes can also be diagnosed with an oral glucose tolerance test. The hemoglobin A1c test allows for the evaluation of your average daily blood sugar over the last three months, but it is not as sensitive as the fasting glucose for the diagnosis of diabetes.

In this case, with your sugars not dramatically elevated, the likely diagnosis would be type�2 diabetes. It is clearly a possibility for individuals as young as yourself. We are now seeing type 2 diabetes in individuals less than 20 years old. Most of these patients are from minority groups with family histories of diabetes and obesity. However, individuals can present with type�1 diabetes which is indolent at first, followed by more rapid loss of insulin secretory function. You will need to work through your physician with this.

JTL