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Question:

From Germantown, Maryland, USA:

I am a 33 year old female, 5'2" 138 lbs. What are normal blood glucose levels? I have a family history of diabetes and have had insulin dependant gestational diabetes with both pregnancies that started at 6 weeks of gestation. I have been monitoring my blood sugars and they seem high. Is there a test to determine if I have diabetes and which type it is?

Answer:

With a family history of Diabetes and with a personal history of gestational diabetes you are certainly justified in occasional screening of blood sugars and you have probably already instigated a program of exercise and obesity avoidance. If you can access a medical library you might be helped by looking at Diabetes Care, Vol.20.1997, page S22. This gives an ADA definition which states that a fasting blood sugar >115 mg/dl or a level taken within 3 hours of a meal that is >160 mg/dl merits further confirmatory testing.

If you found two such values the next step would probably be to ask your doctor about an additional confirmation in a clinical laboratory, an A1c test and perhaps an intravenous glucose tolerance test (IVGTT) which should include insulin levels. Since this is a moderately complex procedure he/she might suggest a period of diet and exercise before carrying it out, especially if you are not already doing this.

A specific diagnosis can nowadays be a rather complex affair and in any case may just be a matter of satisfying intellectual curiosity because what is important irrespective of biochemical detail is to maintain good control. Type 1 Diabetes can almost always be diagnosed by an antibodies test, the details of which you can find out by calling 1-800-425-8361. There are rare forms of diabetes, such as glucokinase deficiency (MODY2) that require rather elaborate and expensive diagnostic procedures. At the moment there is no specific single test for the most probable diagnosis of all which would be is Type 2 Diabetes. It can however be inferred with considerable accuracy from your family history and an IVGGT, that is, if you are not of Hispanic or African American descent.

DO'B

[Editor's comment: The American Diabetes Association will be announcing a revised Classification of Diabetes, with revised cut-off values for blood sugar levels, on June 23, 1997. WWQ]

Original posting 17 Jun 97
Updated 22 Jul 97

  
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Last Updated: Tuesday April 06, 2010 15:08:54
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