My mother-in-law has been having bad headaches and not feeling up to par. She exercises and doesn’t eat sweets. She is about 20 pounds overweight, but is solid. She had a fasting blood sugar done and the results were 121 mg/dl [6.7 mmol/L]. Her doctor said that was fine. Her mother did have diabetes, diet controlled. Does she need a second opinion? Can the headaches be related?

She has evidence of impaired fasting glucose. This is a form of pre-diabetes. She is at increased risk for developing diabetes, compared to the population. She should make sure she is working on a healthy lifestyle with exercise and attempting to lose that extra weight. In addition, her blood sugars should be checked more than once a year with that kind of value. She may even want to talk to her physician about several options available for diabetes prevention. In addition, people who have pre-diabetes are also at increased risk of cardiovascular disease so all her cardiac risk factors should be addressed, including blood pressure, lipids, smoking status, and the use of low-dose aspirin. Most people will suggest that the status of pre-diabetes should be confirmed with a second fasting glucose in the range of 100 mg/dl [5.6 mmol/L] to 125 mg/dl [6.9 mmol/L]. Values above 126 mg/dl [7.0 mmol/L] are consistent with diabetes. This is the definition used by the American Diabetes Association.

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