I’m a 27 year old female who has had Hodgkin’s Disease IIIB for 12 years and is being treated with chemotherapy and radiation. I have not been diagnosed with diabetes, and have no family history. I have normal fasting blood sugars (80-90 mg/dl [4.4 to 5])mmol/L] range, and an A1c of 4.4%. However, my two-hour postprandial blood sugars range from 154-208 mg/dl [8.6-11.6 mmol/L]. Is there cause for alarm?

The American Diabetes Association Clinical Practice Recommendations say that there are three possible ways to diagnose diabetes. Each must be confirmed, on a subsequent day, by any one of the three methods:

A “casual” (nonfasting) plasma glucose greater than 200 mg/dl [11.1 mmol/L]
A fasting plasma glucose greater than 126 mg/dl [7.0 mmol/L]
An oral glucose tolerance test with the two- hour value greater than 200 mg/dl [11.1 mmol/L].

So, some of your two-hour postprandial glucose levels are slightly above the cutoff of 200 mg/dl [11.1 mmol/L], but the hemoglobin A1c of 4.4% indicates that overall your glucose levels are averaging less than 100 mg/dl [5.6 mmol/L]. You may have “impaired glucose tolerance” which seems to be mild at this point, but may mean that you are at risk for developing diabetes in the future. I would not be alarmed, but would recommend that you have blood glucose levels checked once or twice a year to be sure that they are not worsening.

I do not know of any connection between Hodgkin’s disease and diabetes, except that glucose levels could rise during the treatment with some forms of chemotherapy because of the prednisone (a steroid that can raise glucose levels), but then would be expected to return to normal when the prednisone is stopped.

ML