
September 25, 2002
Daily Care, Diagnosis and Symptoms
Question from Mount Pleasant, Pennsylvania, USA:
My 59 year old father, who is in relatively good health, was recently diagnosed with diabetes and hypolipidemia by his internist. He is seen on a regular basis to check up on his high blood pressure which has been controlled for years, and he gets continued care through this doctor for all of his other needs.
Recently, my father was asked to come and get a repeat blood sugar because the doctor explained the first one was high (118 mg/dl [6.6 mmol/L]), and his second came was 178 mg/dl [9.9 mmol/L]. They re-tested him because he was not instructed to fast, and it was 109 mg/dl [6.1 mmol/L]. This doctor said he has diabetes and started him on oral medications. He also is sending him to a dietitian and gave him another paper which very clearly read hypolipidemia, Is it possible he meant to write hyperlipidemia, or the secretary who wrote up the diagnosis misread it? That diagnosis makes no sense to me.
I am also concerned that this doctor wanted to put him on medication so quickly. The blood sugars did not seem that out of balance to me. I would think that for a man his age they would try diet first. Quite frankly, the sugars do not sound bad to me. (However, I don’t an “MD” after my name. I’m just a concerned daughter.) Should he seriously consider a second opinion with an endocrinologist who specializes in diabetes treatment?
Answer:
I would have to agree with you. The diagnostic criteria for diabetes are two fasting blood sugars over 126 mg/dl [7 mmol/L]. I did not see two sugars above this number so that to say he has diabetes may not be correct.
I would also question the diagnosis of hypolipidemia. I agree it sounds more likely he has hyperlipidemia as this is a frequent concurrent problem with diabetes.
It is true that there are medications that have been shown to help prevent the onset of diabetes. However, these were more helpful in the younger, more obese group. Lifestyle changes were more potent in individuals such as your father.
JTL