I am 46 years old. I had a random blood glucose of 132 mg/dl [7.2 mmol/L] four hours after my regular breakfast, my doctor advised me to have a fasting glucose test, and I am very afraid that I may have diabetes. Four years ago, my fasting glucose test result was 112 mg/dl [6,2 mmol/L].Please advise me what precautions I should take to protect myself from this disease. What is normal for random and fasting blood glucose levels?

The revised American Diabetes Association Classification and Diagnosis of Diabetes guidelines recommend use of venous fasting blood glucose levels, and defines diabetes as a fasting glucose level greater than or equal to 126 mg/dl [7 mmol/L], confirmed on repeat test. Additionally, a casual or random (non-fasting) glucose level greater than or equal to 200 mg/dl [11.1 mmol/L] in the presence of classic symptoms of diabetes is also diagnostic. A fasting plasma glucose greater than 110 mg/dl [6.1 mmol/L] but less than 126 mg/dl [7 mmol/L] falls into the category termed “Impaired Fasting Glucose” or prediabetes, and is one of the earliest stages of type�2 diabetes.

You don’t say whether weight management is an issue for you, but optimizing your body weight through a combination of diet and exercise/increased activity can often reverse the disease process, or at the very least slow down the progression to type 2 diabetes. The very best resource regarding your diet is a dietitian who specializes in diabetes management. He or she can assist you in following a carbohydrate controlled, heart healthy plan. You will find additional supportive information among the pages of this website.

Your physician will be rechecking your fasting blood sugar, and may consider performing an oral glucose tolerance test (OGTT) to assess your body’s response to a known glucose load. A two-hour post-load glucose during the OGTT is considered “normal” at less than 140 mg/dl [7.8 mmol/L]. Impaired glucose tolerance (IGT) is 140 -200 mg/dl [7.7-11.1mmol/L], and greater than or equal to 200 mg/dl [11,1 mmol/L] at this two-hour mark on the OGTT is diagnostic for diabetes.

Most importantly, remember that there is much you can do to both prevent disease progression and to manage diabetes through an active, healthy lifestyle.

DMW

[Editor’s comment: See Diabetes Prevention Program (DPP) for information about the study that showed diabetes can be delayed.

SS]