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May 22, 2003

Diagnosis and Symptoms

Question from Acapulco, Mexico:

Yesterday, my husband's doctor sent him for a blood sugar test and the result was 266 mg/dl [14.8 mmol/L]. The doctor said he may have diabetes and should eat only white meat, vegetables, little sugar and return in a week. How do we know whether my husband does, in fact, have diabetes? What would be the course of action if we were living in the US?

Answer:

The diagnosis of diabetes requires two fasting blood sugars greater than or equal to 126 mg/dl [7 mmol/L], or two random blood sugars of 200 mg/dl [11.1 mmol/L] or more. I would probably get another blood sugar to confirm the diagnosis. If your husband is having symptoms of hyperglycemia, including weight loss, frequent thirst and urination, blurring of vision, or fatigue, I would go ahead and treat him. This will allow him to feel better in a short period of time.

With treatment comes the need for education. I would recommend he have contact with a diabetes educator who can teach him how to correctly perform home blood sugar monitoring and avoid hypoglycemia. Finally, he needs nutritional education to address any excess weight and to demonstrate how diet can impact blood sugars. If he does not have these things at his disposal, I would suggest he is not getting state-of-the-art care.

JTL