advertisement
 

  Back to Ask the Diabetes Team Ask the Diabetes Team
Question:

From Elliot Lake, Ontario, Canada:

I am really confused at the moment. For the last two years I have been really sick. I vomit often, have severe stomach cramps, and had a constant period for a year and half (one week period, two days none, then it comes back again). I have had two laproscopic surgeries and the doctor said that he couldn't see any endometriosis, but I did have some scarring on my ovaries from functional cysts. All through this time I urinated a lot, had trouble seeing - things would see fuzzy or not quite right, and lots of infections. I was not tested for diabetes once.

In October 2003, after a series of really strange infections, (cheek infection with no apparent wound, hand infection after a small scratch, etc.), the doctor decided to test me for diabetes. The glucose test on finger that day was 6.5 mmol/L [17 mg/dl] and I hadn't eaten for about six hours. I went back the next day and he said I didn't have diabetes, that my three month average was 7.2. I went back a couple of days later as I was being treated for my cheek infection and was on my fourth set of antibiotics. I saw a different doctor because I had to go to a drop in clinic (no family doctor in that area as I am only 22 and living in a new town). He did a prick test and I was 8.3 mmol [149 mg/dl] and I hadn't eaten for four hours. He said that I definitely had diabetes and told me to contact my family doctor in my home town immediately. He instructed me to get a glucose monitor and to monitor four times a day.

So I did that. I normally eat healthy foods. Then, in December, I started to get dizzy spells, almost blacking out and getting the spots in my eyes again. I also have stopped having my period completely and haven't even had spotting since October. My sugar levels are fairly low in the morning ranging from 2.9 to 3.5 mmol/L [52 to 63 mg/dl]. I have problems not being able to make sentences in my head or get out what I am saying when my sugar reaches lower then 4.5 mmol/L [81 mg/dl]. Once the afternoon hits I start getting higher sugar readings ranging from 8.0 to 20 mmol/L [144 to 360 mg/dl] and once 26 mmol/L [468 mg/dl] and once 33 mmol/L [594 mg/dl] in the past two months.

I am confused at how the three month average test works. A doctor told me that I probably wasn't diagnosed sooner because I go low and high and they may have tested but my range was fine because with the average of it all. Another person I spoke with told me that is not correct. The doctor that told me that the three month average probably didn't show diabetes also said the random glucose tests probably didn't show anything as I am fine until lunch time and most of my high readings are in the late afternoons. Since most of the doctor's appointments in the past have been before 4 p.m., nothing wasn't ever picked up on.

I am currently not on any medication, but I do have a strict diet which I am having a terrible time following. The amount I need to eat seems to be too much. I am being told to eat two starches, two fruits for breakfast, lunch and dinner.;two fruits as a snack in the morning or late evening I get to choose; one protein for breakfast, two for lunch and three for supper; four milks daily at any meal I choose, and five fat choices. At night, I get extremely hungry and can't sleep all night because of how hungry I am even though I have high sugar readings.

Tomorrow I see my doctor. He hasn't seen any of the medical tests since I have been to multiple drop in clinics because of my hours at work. I am worried that I possibly don't have diabetes and that he may treat me with medication that will cause me to go lower then I do in the morning. My father was diagnosed with type 2 diabetes two months after I was diagnosed with diabetes. I assume that I don't have type 1, but I don't fit the type 2 profile either. Could it be something else?

Answer:

Sorry for all the tough times. It does sound like you have diabetes. I am certain of this. The information you have received has been confusing because the people gathering the information have not explained things well to you. The three month test is called the hemoglobin A1c test. This is a measure of the average daily blood sugar over the previous three months. The test is based on the fact that red blood cells circulate in the blood for 120 days and progressive increases in the amount of glucose stuck to the hemoglobin molecule is a reflection of the glucose concentration in your blood over time. It has been shown that the hemoglobin A1C test is not a good test for diagnosing diabetes as it is not sensitive enough. It is true your sugar goes up and down throughout the day with higher numbers later in the day.

It may not be true that you have type 2 diabetes. You need to have your physician help you sort this out. There are some forms of type 1 diabetes that begin looking like type 2 diabetes but are really a form of type 1 diabetes. Your physician will probably want to obtain C-peptide levels and an anti-GAD antibody for you. The C-peptide level will allow determination of how much insulin is being secreted. The anti-GAD antibody level is high for the delayed onset form of type 1 diabetes. These are important distinctions as they may impact the form of treatment your doctor wishes to use.

JTL

DTQ-20040420014218
Original posting 21 Apr 2004
Posted to Diagnosis and Symptoms and A1c, Glycohemoglobin, HgbA1c

  
advertisement


                 
  Home Return to Top

Last Updated: Tuesday April 06, 2010 15:09:56
This Internet site provides information of a general nature and is designed for educational purposes only. If you have any concerns about your own health or the health of your child, you should always consult with a physician or other health care professional.

This site is published by T-1 Today, Inc. (d/b/a Children with Diabetes), a 501c3 not-for-profit organization, which is responsible for its contents.
By using this site, you agree to our Terms of Use, Legal Notice, and Privacy Policy.
© Children with Diabetes, Inc. 1995-2015. Comments and Feedback.