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January 11, 2010

Diagnosis and Symptoms

Question from Columbia Falls, Montana, USA:

About a month ago, I had a blood chemistry done and my blood glucose was found to be 198 mg/dl [11.0 mmol/L], after breakfast. My doctor followed up with a fasting glucose, which was 95 mg/dl [5.3 mmol/L], and an A1c, which was 5.9 – both normal. Since I don’t have any symptoms of diabetes or any obvious risk factors for type 2, my doctor told me she would repeat these tests in a year.

However, I was worried about the high glucose value, so I bought a glucose meter and strips and tested myself over the past month to see whether that high number was an anomaly or not. What I’ve found is that my blood glucose goes up a lot after just about every meal I’ve tested. Two hours after eating, it’s generally between 150 and 200 mg/dl [8.3 and 11.1 mmol/L]. If I eat a lot of carbohydrates or dessert, it’s between 200 and 250 mg/dl [11.1 and 13.9 mmol/L]. The highest value I’ve seen is 262 mg/dl [14.6 mmol/L], but my blood sugar always comes back down on its own and my fasting is always below 100 mg/dl [5.6 mmol/L]. Should I be worried about these numbers or is it okay to wait another 11 months? I don’t feel comfortable going back to my doctor as she was clear that she didn’t want to do anything now. Please let me know if you think there’s anything, besides the obvious of trying to eat well and get exercise, that I should do given these results.


From: DTeam Staff

The current recommendations of the American Diabetes Association is to use the fasting glucose for the diagnosis of diabetes. Even the HbA1c is normal. Everyone’s glucose goes up after meals. The glucose meters used for home glucose testing have up to a 20% error level associated with them. This makes them unacceptable for diagnosing diabetes. If you are concerned enough to want to do another test, I would recommend a 75 gram oral glucose tolerance test where your post-glucose blood sugar can be measured against a known standard. Otherwise, I would agree with your doctor that your studies should be repeated in a year.