October 8, 2002
Diagnosis and Symptoms
Question from London, Ontario, Canada:
We are doing a screening activity for diabetes with oral glucose tolerance tests in people of Latin American descent with one or more risk factors, and we have found many people with really low levels of blood sugar who are asymptomatic, along with many people whose two-hour readings are less than the fasting levels. What would we do with this patients? Are they at risk of future diabetes or impaired glucose tolerance (IGT)? Is there any relationship between hypoglycemia and diabetes or IGT?
Answer:
Currently, there is no recommendation to treat them in any way. Some have stated that symptomatic hypoglycemia may be a marker of poor insulin secretion, but, when the patients are asymptomatic, there is nothing to change. This is probably a variant of normal. Low post-challenge glucose levels are a manifestation of the acute insulin response. Lower values are not necessarily abnormal. You would have to know what the post-challenge insulin levels were. My understanding is you are not monitoring these at present, but I am not sure they would add anything to your project from a community health position.
JTL
