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March 31, 2010

Other, Type 2

Question from Wyoming, USA:

I have just been diagnosed with type 2 diabetes by my general practitioner and am taking metformin. I went to a health fair and got a random blood sugar reading of 202 mg/dl [11.1 mmol/L] so my doctor did a glucose tolerance test which showed a fasting blood sugar of 116 mg/dl [6.4 mmol/L] and a two-hour blood sugar of 239 mg/dl [13.3 mmol/L]. My A1c was 6.1%. The metformin seems to be bringing down my numbers. My doctor can't explain how I got diabetes and I thought maybe you'd have some insight. I don't have any of the risk factors for type 2 diabetes and, even weirder, I just had a perfectly normal pregnancy and birth less than two years ago. All my tests for gestational diabetes were normal. I never spilled glucose in my urine at my prenatal visits, and my son was born healthy at term and weighed just over 7 pounds. I thought type 2 took a long time to develop and would certainly show up as gestational diabetes or at least some higher blood sugar readings under the stress of pregnancy. As I said, the metformin does seem to be helping, but I wonder if I should be looking into any other causes for the high blood sugars? What I should expect in terms of ongoing treatment?.

Answer:

That is a good question. I do not have readily available explanation for the rapid rise in glucose levels. Interesting that your two-hour glucose would be so high with only a mild rise in HbA1c. All these observations point to a recent onset for your diabetes. I suppose that if you would not have been screened at the health fair, you would have gone on until you became symptomatic. The other thing we commonly find is that unless your relatives were really screened well, there is a lot of undiagnosed diabetes. The absence of a diagnosis of diabetes may not be the same thing as not having diabetes. Glad the metformin is working. Sounds like the correct drug for you.

JTL