June 1, 2002
Diagnosis and Symptoms
Question from Indiana, USA:
I am 50 years old, and have been doing some self-monitoring of blood glucose, and all of my fasting readings for the past three months have been between 110-150 mg/dl [6.1-8.3 mmol/L] with more than one-half of them above 126 mg/dl [7 mmol/L]. My doctor told me not to be concerned because, six months ago, my blood sugar was 127 mg/dl [7.1 mmol/L] (lab test in his office) and my A1c was 5.3%. However, my recent blood sugar in his office was 128 mg/dl [7.1 mmol/L] (lab test), I thought that if you had over fasting blood sugars greater than 126 mg/dl [7 mmol/L] on two different days, you were diagnosed as having diabetes. He said that there is no reason to get re-tested, and I am confused.
Answer:
I would share your concern about the diagnosis of diabetes. Two fasting blood sugars above 126 mg/dl [7 mmol/L] performed in a lab on different days makes the diagnosis of diabetes. Hemoglobin A1c levels cannot be used for diagnosis.
Early therapy may make a difference in the long-term outcome of diabetes. You need counseling regarding monitoring, lifestyle (diet and exercise), and conditions where more aggressive therapy may be indicated. Your blood pressure needs to be monitored. You need a yearly eye exam. You need to have other cardiovascular risk factors addressed.
If your physician is not concerned about this, you may need to find someone who will be.
JTL
