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Question:

From California, USA:

I am a 38 year old male, diagnosed with diabetes about three months ago. At the time of diagnosis, my lab tests were: fasting blood sugar --120 mg/dl [6.7 mmol/L], A1c -- 7%, cholesterol-- 206, triglycerides -- 304, HDL -- 27 and LDL --118. I weighed a 168 pounds at that time and had a BP of 150/100.

My doctor put me on Niacin for cholesterol control, and advised me to take a sulfonylurea as well. At my request, my doctor decided to wait on the diabetes medication.

I started exercising more frequently (five to seven days of aerobic exercise), and eating a lot more carefully (I am a vegetarian, but I love sweets and fatty stuff. Kept these to a minimum). I now weigh 135 pounds, with a fasting blood sugar of of 102 mg/dl [5.7 mmol/L], an A1c of 5.9%, a cholesterol of 147, triglycerides of 99, HDL of 45, and LDL of 82. My BP reads at 120/80 or lower.

Have I been misdiagnosed? Is it possible that I don't have diabetes at all? I was emphatically told that there is no such thing as "borderline" diabetes, and I am diabetic, and that it can never go away.

Answer:

First of all, congratulations on the very positive steps you've taken to improve your health. It is clear from your beginning blood glucose and hemoglobin A1c numbers that you do have a significant glucose tolerance abnormality.

What you have done is effective treatment for that abnormality -- both the exercise and the weight loss have most likely reduced the insulin resistance that is a common feature of type 2 diabetes. With less resistance, your body insulin is once again able to handle the food you are eating.

Rest assured, however, that the problem has not gone away. This is a genetically based disease, inherent in the way your body functions, and is not "cured." With a reduction in activity, more liberal food intake or even just the simple passage of time, you will probably see more abnormal blood sugars reappear at some point.

Early in the course of type 2 diabetes, the kind of steps you have taken often return blood sugar to normal. This doesn't mean you're cured -- it means the treatment of food management and exercise is working as it should.

BB

Additional comments from Dr. David Schwartz:

It should be noted that a well-described side effect of high doses of niacin (which is used for the treatment of hyperlipidemia) is worsening of blood sugar control. Since there are alternative medications for hyperlipidemia, you should discuss the possibility of switching with your physician.

IDS

DTQ-20010622165313
Original posting 25 Jul 2001
Posted to Diagnosis and Symptoms

  
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Last Updated: Tuesday April 06, 2010 15:09:24
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