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August 15, 2008

Diagnosis and Symptoms, Hypoglycemia

Question from United Kingdom:

I was diagnosed with reactive hypoglycemia few years ago, with two or three drops in my blood sugar daily, mainly mid-morning, after breakfast. I have a constant fasting blood sugar of 4.7 mmol/L [85 mg/dl] with drops in the 3s mmol/L [54 to 71 mg/dl] and sometimes 2s mmol/L [36 to 53 mg/dl]. This last four weeks, when I got shaky and sweaty, I checked my blood sugar and it was 12 mmol/L [216 mg/dl]. Since then, I have noticed all daytime levels are a lot higher than normal, 7 mmol/L [126 mg/dl] to almost 10.0 mmol/L [180 mg/dl]. I went into local chemist who was testing and they checked my blood sugar an hour after eating a ham roll and it was 9.4 mmol/L [169 mg/dl]. My husband, who ate the same, was 6.3 mmol/L [113 mg/dl], They asked me back for fasting level. I have checked my fasting blood sugar level over the last two weeks and it was constantly 7.2 mmol/L [130 mg/dl]. One morning, when it was 7.2 mmol/L [130 mg/dl] fasting, I went to the chemist, a five minute drive. My blood sugar had dropped to 5.6 mmol/L [101 mg/dl] in that short time, no pills, no food or drink. I went home and checked the glucose meter--yes, it was 5.6 mmol/L [101 mg/dl], so the meter was okay. I have since checked my fasting blood sugar and found it to be 7.1 mmol/L [128 mg/dl] or 7.2 mmol/L [130 mg/dl]. If I go to the doctor, by the time I get there it will have probably dropped to 5.6. Is this normal? Have I got a problem? If I go to the doctor, will he understand what is going on?

Answer:

You need to see your physician to review these numbers. Diabetes is diagnosed on the basis of the numbers, primarily your fasting glucose levels. Remember that glucose meters have a 20% error and the diagnosis is based on blood levels drawn at the clinical laboratory. Therefore, in qualifying any glucose values, they have to be confirmed by the clinical laboratory. This also relates to the diagnosis of diabetes. I would not use glucose meter values to make a diagnosis. It will be essential that you talk with your physician about these numbers so that a strategy for follow-up can be discussed and implemented.

JTL