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October 18, 2001

Diagnosis and Symptoms

Question from College Station, Texas, USA:

I am an 18 year old female diagnosed with impaired glucose tolerance after random blood sugars of 240 and 177 mg/dl [13.3 and 9.8 mmol/L], a fasting of 98 mg/dl [5.4 mmol/L] with a postprandial level of 77 mg/dl [4.3 mmol/L]. Three weeks later, I was told by another doctor that there was nothing wrong, but I feel weak and dizzy all the time, especially two to four hours after I eat. Could my problem be related to my blood sugar? If not, can anyone tell me what's wrong? No doctors seem to agree, and I would love the chance to get better. I hate being sick all the time.

Answer:

I think your symptoms and blood glucose levels are very suspicious. Are you experiencing a change in bathroom habits (urinating more/more thirsty)? Are you overweight?

It would be helpful to know the details of the postprandial glucose level. Was this done after a typical breakfast or a breakfast loaded with carbs (e.g. pancakes, syrup, juice, etc), or was this after a formal glucose tolerance test? If the latter, did they prepare you properly by having you consume at least 60% of your calories the previous three days with carbohydrates? Did they measure the insulin levels with the glucose levels? Was it a three-hour GTT?

Although I don’t often suggest this, I’d probably suggest a formal oral glucose tolerance test, but make sure it is done correctly, including that the dose of oral glucose should be 1.75 grams per kilogram body weight to a maximum of 75 grams.

DS