September 27, 2004
Diagnosis and Symptoms, Other
Question from Millington, Michigan, USA:
My daughter has Polycystic Ovary Syndrome (PCOS) and insulin resistance. She also has dark crevices on her neck, which the doctor says indicate type 2 diabetes. Her insulin level reached the 500 mg/dl [27.8 mmol/L] range, which the doctor said was the highest he had ever seen. She has taken two glucose tolerance tests (GTT). One indicated a normal fasting blood sugar of 95 mg/dl [5.3 mmol/L], with a blood sugar of 130 mg/dl [7.2 mmol/L] 30 minutes later. At one hour, her blood sugar was 185 mg/dl [10.3 mmol/L] and at two hours, her blood sugar was 160 mg/dl [8.9 mmol/L]. /p>
After a year of nutritional counseling, my daughter had a second GTT. Her fasting blood sugar was 90 mg/dl [5.0 mmol/L]. At 30 minutes, her blood sugar was 160 mg/dl [8.9 mmol/L]. At one hour, she was 165 mg/dl [9.2 mmol/L] and at two hours, she was 85 mg/dl [4.7 mmol/L]. The family doctor says that she has impaired glucose tolerance, but her endocrinologist says that she has type 2 diabetes.
Does the second test indicate a normal result or is the 165 mg/dl [9.2 mmol/L] at one hour still abnormal? She has lost weight and is doing well with diet and exercise, but the endocrinologist still wants her on medication, which the family doctor doesn’t think is necessary. She gets sick to her stomach on the medicine.
More information about the classification and diagnosis of diabetes can be found at Classification and Diagnosis of Diabetes. Interpretation of her testing is best done by the endocrinologist. I would suggest that you review your concerns with both your family physician and endocrinologist and ask them for assistance in determining the level of treatment your daughter needs. If, however, they continue to disagree, you may be forced to simply follow the advice of the physician that you trust most.