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August 13, 2002

Diagnosis and Symptoms

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Question from Santa Barbara, California, USA:

My partner was diagnosed with diabetes about six months ago and was taking a low dose of Glucotrol XL, but after two months, he stopped taking it because he felt it was lowering his blood sugars too far. His recent A1c was 4.4%, his sugars have been with in normal range, and the doctor told him that his diabetes has gone away. Can this be possible? What other tests can we do to make sure?

Answer:

From: DTeam Staff

In order to best answer your question, I would need to know exactly how your partner was diagnosed with diabetes. A hemoglobin A1c of 4.4% and low blood sugar from a very low dose of Glucotrol XL makes me wonder if your partner had diabetes at all.

JS

[Editor’s comment: Rather than getting more tests, I’d suggest your partner discuss the laboratory results used to make the initial diagnosis. Testing for diabetes should have included blood sugar levels performed by a medical laboratory. The timing of the sample (fasting, random, or postprandial) would influence how high a level is considered abnormal. See Classification and Diagnosis of Diabetes for further information. Urine sugar tests, if they had been done, might be positive, which would make the situation more urgent to get lab testing done to confirm the abnormal results. However, urine glucose testing, is inappropriate to use to diagnose diabetes. Another test, the glycosylated hemoglobin, might be used to help confirm a suspected diagnosis of diabetes, but the GHB (also called HbA1c or A1c) is not usually considered as appropriate to make an initial diagnosis.

Performing a glucose tolerance test, might be appropriate now, if there is still a high suspicion of diabetes despite normal testing. Antibody testing is occasionally done as a screening test in high-risk situations, or as confirmatory of type 1A (autoimmune) diabetes, but is not part of routine testing.

WWQ]