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Question:

From Spokane, Washington, USA:

About three months ago, I was diagnosed with pre-diabetes after a glucose tolerance test came back abnormal (150 mg/dl [8.3 mmol/L] at two hours). I started monitoring my blood sugars and my fasting blood sugars were always in 80s mg/dl [4.4 to 4.9 mmol/L] and my post-prandials were general in the 110s mg/dl [6.1 to 6.6 mmol/L]. At that time, my A1c was 5.1.

Since then, I've been more active, but now my fasting glucoses are always over 100 mg/dl [5.6 mmol/L] and my post-prandials are at least 125 mg/dl [6.9 mmol/L] and can go as high as 160 mg/dl [8.9 mmol/L]. My A1c was recently 6.2. Throughout this whole time, I have had episodes of hypoglycemia.

I am almost 21. I weigh 108 pounds at four feet, ten inches. I have no family history of diabetes and I have no high blood pressure or high cholesterol. This seems to have accelerated rather quickly into what I understand to be the diabetic range for the A1c. What could I be looking at? I am scared to be put on pills if this is a form of type 1 but, I don't want to take insulin if it isn't necessary. I don't know how to get antibody testing done, unless I can order the test myself. I am currently having terrible vision problems, and weight seems to slide off quickly, although I am still able to gain it back. How should I talk to my doctor and about what? I see him in three days, and I'm so nervous I don't trust myself to come up with a good plan of attack.

Answer:

If you do not have the usual risks for type 2 diabetes (obesity, family history, older onset), and you are concerned about the onset of type 1 diabetes, your physician should be able to help you. The A1c is not the best test to diagnose diabetes. A fasting glucose needs to be done. If it is elevated above 126 mg/dl [7 mmol/L] on two occasions, this is diabetes. Markers of type 1 diabetes can only be obtained through the laboratory so, your doctor would have to order them. This issue is about talking to your doctor. If you can't do that, consider finding another doctor you can talk to. Your vision problems and difficulty keeping weight on are bothersome.

JTL

DTQ-20050104202846
Original posting 14 Jan 2005
Posted to Diagnosis and Symptoms

  
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Last Updated: Tuesday April 06, 2010 15:10:00
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