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March 3, 2003

Diagnosis and Symptoms

Question from Suffolk, Virginia, USA:

I have had hypoglycemia now for four years. I still have very low blood sugar levels no matter what I do, and I was told that hypoglycemia will some day turn into diabetes. Is this true? I test my blood sugar whenever I feel low. I can tell some times I am higher than what I normally am, and when I check my sugar, I am right. The highest I have been is 220 mg/dl [12.2 mmol/L]. Both of my parents have type 2 diabetes. If my hypoglycemia turns into diabetes will it be type 1 or type 2?

Answer:

The relationship between hypoglycemia and the risk for type 2 diabetes is related to the idea that prior to a diagnosis of diabetes, there is hyperinsulinemia and poorly regulated insulin secretion. This can sometimes lead to low blood sugars. The exact relationship between type 2 diabetes and hypoglycemia has not been worked out.

If you do have blood sugars above 200 mg/dl [11.1 mmol/L] intermittently, I would suggest you see your physician about a test for diabetes. Specifically, I would recommend a fasting glucose performed in the lab or an oral glucose tolerance test.

JTL

[Editor’s comment: As Dr. Lane suggests, testing for diabetes should include blood sugar levels performed by a medical laboratory. The timing of the sample (fasting, random, or postprandial) would influence how high a level is considered abnormal. See Classification and Diagnosis of Diabetes for further information.

WWQ]