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June 22, 2006

Diagnosis and Symptoms

Question from Salinas, California, USA:

I had an A1c done and the result was 5.8%. This is of concern to me. However, my random glucose at the laboratory was 93 mg/dl [5.2 mmol/L]. Also, my one hour oral glucose tolerance test (OGTT) was 113 mg/dl [6.3 mmol/L]. What do you think of this?


The diagnosis of diabetes is made with a fasting glucose or an oral glucose tolerance test. It is not made with a random blood sugar, or at least it has to be greater than 200 mg/dl [11.1 mmol/L] with symptoms on more than one occasion for a random glucose to be diagnostic. The one-hour glucose is not a diagnostic milestone either. The hemoglobin A1c is a powerful tool for following patients. However, it is not a diagnostic test either. Following the fasting glucose is the best bet.