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July 16, 2006

Diagnosis and Symptoms

Question from Salinas, California, USA:

I have been a pretty healthy person up until now. It all started when I suspected that my two and a half year old daughter had diabetes (both of her tests came back normal: 85 mg/dl [4.7 mmol/L] fasting; 5.3% A1c; two months later: 82 mg/dl [4.6 mmol/L] fasting; 5.3% A1c). I started to get really stressed out, not eating right, not exercising, etc. had some blood work done on myself during this time and was surprised that I had an A1c of 5.8%, which seems rather high to me. My random blood sugar was 93 mg/dl [5.2 mmol/L]. Per the advice of your web site, I had a fasting test and an A1c done one month and a week after my first test. My fasting blood sugar was 82 mg/dl [4.6 mmol/L} and my A1c was 5.1%. Could the stress I was under produce such high results in my first test? Do I have some glucose intolerance? Since my first test, I started running four to six miles almost everyday and cutting back on sweets. I have had three children in the past four years with no gestational diabetes; all tests were perfect. Could having so many kids in such a short time cause my pancreas to burn out? There is no history of type 1 in my family. My grandmother had type 2. I don't fit the profile of type 2. I'm 31, 5 feet, 2 inches and weigh 104. I have always been this weight. Am I worrying over nothing?

Answer:

I would relax a bit. You do not have diabetes. Your fasting glucose and A1c is normal. You have improved your lifestyle. Strictly speaking, the A1c is not used to diagnose diabetes. You can have your physician get follow-up studies. The strictest test for glucose tolerance is the oral glucose tolerance test, but I don’t really see a need for that at this point.

JTL