September 20, 2005
Diagnosis and Symptoms, Type 2
Question from Nepal:
I am a 45 year old male, 5 feet, 8 inches, 98 kg (216 pounds). I had a Glucose Tolerance Test (GTT) with the following results: fasting blood sugar–127 mg/dl [7.1 mmol/L]; 30 minutes–209 mg/dl [11.6 mmol/L]; one hour–236 mg/dl [13.1 mmol/L]; 90 minutes–203 mg/dl [11.3 mmol/L] (insulin level 99); and two hours–177 mg/dl [9.8 mmol/L].
After dieting, I was retested. My fasting blood sugar was 100 mg/dl [5.6 mmol/L] and my two hour post-prandial reading was 116 mg/dl [6.4 mmol/L]. One doctor has said I have insulin resistant oriented obesity, not diabetes. Another doctor described it as pre-diabetes because I am asymptomatic. Do I have mild diabetes or insulin resistance?
Answer:
The American Diabetes Association classifies a person as having diabetes if the fasting glucose is greater than 127 mg/dl [7.1 mmol/L] on two occasions. The laboratory tests should be run in a clinical laboratory and not with fingerstick glucose meters. Your fasting glucose of 127 mg/dl [7.1 mmol/L] exceeds the limit. The diagnosis should be confirmed with another fasting glucose. At the least, you have pre-diabetes. Your two-hour post-glucose load was abnormal, too. I would recommend, as your next step toward proper diagnosis, the determination of another fasting glucose to see if the glucose levels stay up or not.
JTL
