Justin Delgado is husband to Kacie Doyle-Delgado, diagnosed at age 11. After more than a decade together, he considers himself to be an expert carb counter and Dexcom inserter. He graduated with his Master of Science in Finance from the University of Utah in 2013 and has been working in commercial banking since then. He attended his first Friends for Life conference in 2015 and is looking forward to volunteering with the teens.
July 27, 2009
Diagnosis and Symptoms, Type 2
Question from Egypt:
I'm a 27-year-old male doctor and I am overweight. For two weeks, I felt polyuria and polydipsia so I checked my random blood glucose. It was 600 mg/dl [33.3 mmol/L]. My fasting blood sugar was 244 mg/dl [13.6 mmol/L]. After ingesting 75 mg of glucose, my blood sugar was 456 mg/dl [25.3 mmol/L]. My glycosylated hemoglobin was 8.6. I sought medical advice and my doctor recommended Glucovance 500/5, diet, and exercise. I was having great control for about a week when, one day, I forgot to take my medication. Even without the medication, my blood sugars were in range. It's now been four days since I took the Glucovance and my postprandial blood sugars have been between 130 and 140 mg/dl [7.3 and 7.8 mmol/L]. My fasting blood sugars are 80 to 90 mg/dl [4.5 to 5.0 mmol/L]. I'm so confused about that and I don't know if I have type 2 diabetes or not. I plan to keep on dieting and exercising to reduce my weight, but can you help clarify my diagnosis?
From what you have told me, you clearly have type 2 diabetes. It is not a surprise that your blood sugars might remain normal for a while, even though you have stopped your medication. After successful treatment of high blood sugars, no matter how they are decreased (insulin, pills, diet, etc.), the insulin-producing cells in the pancreas recover from the high glucose conditions. What I think you will find, if you remain off the medication, is that your blood sugars will gradually rise again. You might want to talk your physician about using metformin as a single drug. I think the recommendations by the European Association for the Study of Diabetes and the American Diabetes Association recommend this as a first-line drug. There is net weight loss with the medication and no hypoglycemia. With Glucovance, there is a mixture of metformin and glyburide (a sulfonylurea). The glyburide is associated with weight gain and hypoglycemia.