Diabetic or not?

[devon]

Hi,
last week l was told over the phone by a doctor at my surgery that my fasting tests of 7.0 and a
second test of 6.6 showed l was diabetic.
Today l saw a different doctor who tells me l am in a "grey area." When l told him my own fasting results were 9.9 and 8.5 he said, "anything under 10 is ok." l am totally confused now as it goes against what l have read, he says to leave it for a year, no treatment.
What would be your opinion, please?
db

 

[hanadr]

My opinion is that anything over 6 for fasting iss suspect and numbers like 8.5 or 9 are definitive if done by the lab. Have they done any other tests? Do you have any other symptoms?
Intil you can get more tests done, I would reduce carbs. that might be all it needs to get back to the true non-diabetic fasting level of around 5 (4.5 -5.5) A consistent 7 would be diabetic. Doctors tend to set higher targets than we, on this forum, would

 

[ally5555]

I think you should ask for a second opnion and ask for a glucose tolerance test .

 

[DiabeticGeek]

If you are talking about a fasting test then, the line of "anything under 10 is OK" is absolute rubbish! The medical textbooks say that a fasting test greater than 7 recorded on more than one occasion indicates diabetes. A non-diabetic will usually have a fasting BG in the 4.5 - 5.5 range. If the test is taken after meals, then a non-diabetic will quite often briefly go as high as 8 or 9 and might just make it into double figures after a major blow-out, but it will come down again very quickly.

Diagnosis should be based on blood drawn from a vein by a doctor or nurse, not a finger-prick test. A glucose tolerance test is by far the most sensitive method of diagnosing diabetes, so I agree with Ally - you should ask for one. If the doctor who said that "anything under 10 is OK" was really talking about a fasting test, then that tells me that you need a new doctor :evil:

 

[ally5555]

i agree - that was the advice 15 years ago!

 

[hanadr]

I was told they don't do glucose tolerance in this area any more and that consistent high fasting BGs are diagnostic

 

[ally5555]

mmm we do when we get odd results - i wonder if that is cost cutting!

 

[DiabeticGeek]

It is true that two high fasting tests are considered diagnostic, but a GTT is much more sensitive when the results are borderline. The OP had a fasting test of 7.0 and 6.6. Technically this doesn't meet the "two tests greater than 7" trigger, but it is so close as to be well within the likely margin of error. This is exactly the sort of case where a GTT would be useful. They may not be as widespread as they used to be, but they are certainly still used in some areas, at least. When I was diagnosed I had a GTT, but I had to provide my own glucose! I mean this quite literally - I was told to bring a bottle of lucozade! I should have realised then that this didn't bode well for my prospects of getting test strips or anything else useful out of my PCT :roll:

 

[ally5555]

gosh i am astounded - I have never heard of that

 

[wiflib]

I had the same sort of readings. 7.4 and 7.5
As I was completely asymptomatic, I requested a GTT and my GP agreed with me.

And yep, I had to supply my own lucozade. This is pretty standard practice in Leicestershire. Glucose can be described if requested but it's not very palatable.

wiflib

 

[devon]

hi,
Thankyou, for repyling.
The symptom that may or may not be related to diabetes is l have tingling feet, on the soles. l am tired anyway because l have hypothyroidism so it's difficult to know what symptom belongs to what, but, the tingling feet has been going on for a few weeks now, yet l have had the hypothyroidism for over 2 years and not had tingly feet before.

This particular gp doesn't fill me with confidence because when my voice went very hoarse he said, "it isn't to do with your thyroid because your voice box is nowhere near your thyroid" eeeek!
Do you think he was telling me l was deformed? :lol:
The first gp had told me to make an appointment with the diabetes nurse, would she be likely to do a glucose tolerance test, do you think?

l should say that the gp l saw today did put me on statins and asprin today, which seems at odds with what he is saying.
Many thanks for your expertise, it is much appreciated.
db

 

[IanD]

If you take the statins, watch out for muscle pain. Do you know your cholesterol levels? Suggest you ask.

The muscles where I had tingling sensation were the first to react to statins.

Statins may of course not affect you. 90% of people tolerate them. See the August "Readers Digest."

 

[DiabeticGeek]

Your tests are borderline, so without more information (particularly a GTT) then it isn't possible to say whether or not you have diabetes. However, even if you aren't diabetic, the figures you gave definitely put you in the "pre-diabetes" category. I am at home now, and have an endocrinology book to check my figures - I have a lousy memory for such things! The normal fasting BG is less than 6.1 mmol/l (usually it is a lot less than this, but anything less than 6.1 is considered normal). Diabetics have a fasting BG of greater than 7.0 mmol/l, and anything in between the two is considered "pre-diabetic". The difference between diabetes and pre-diabetes is that pre-diabetes is a reversible condition, whereas once it becomes full-blown diabetes then you are stuck with it for life. Given that your best reading is in the pre-diabetic category, this suggests that if you aren't already diabetic you are on the way there! However, in either case the immediate treatment is the same. Change your diet to substantially cut down on carbohydrates, and start doing more exercise. If you are overweight then try to loose weight (which may well happen anyway once you are on a low cab diet). Also, if you smoke then seriously try to give up. If you have diabetes, then this is the sort of lifestyle change that you will need to make in order to avoid the likelihood major health problems at some stage in the future. If you have pre-diabetes, then by doing this you might be able to prevent it from progressing to actual diabetes.

 

[devon]

Thankyou, your advice has been really helpful, everyone.
l don't know what my cholesterol levels are, they haven't done them for 18months or so, and l forget what that was.

l've started on the low carb diet, and have lost a 1lb per day now, so 6lbs now. l am quite overweight
so l can afford to lose quite a bit. l have stuck to the diet zealously, l have a big incentive now, if
l am not to tip over into full blown diabetes.

l see an endocrinologist in Oct for my thyroid, so l will see if he will do a glucose tolerance test.
Your expertise has been really appreciated.
db

 

[padulica]

Hi,
I have a similar problem. I had a GGT done 18 months ago , my starving was 6.4 and my 2 hour was 6.6. I was told it was abnormal but no action was to be taken. I was told the 2hr blood was normal so it out weighed the starving one !!!!
I went to the a locum Dr yesterday for something else and my blood sugar was bought up , she told me I was pre diabetic and that I should be on asprin and statins.
I have in the last 3 months with no help from my GP reduced my starving to between 4.7 and 5.6( with a moniter) Does this still class me as pre diabetic ? So would I still need the statins and asprin?

 

[DiabeticGeek]

I have in the last 3 months with no help from my GP reduced my starving to between 4.7 and 5.6( with a moniter) Does this still class me as pre diabetic ?

This is within the normal range, however very well controlled diabetics sometimes have figures like this. A GTT is much more sensitive, and will answer this question. If you have a glucose meter (you sound as though you do) then, if you wish, you could have a go yourself. I have posted instructions for a simplified GTT on another thread. If you are no longer pre-diabetic then that means you got to it in time to reverse the damage, and that is great. However, do keep up your new diet and exercise regime - otherwise, if you fall back into your old ways, then the problem could easily recur.

So would I still need the statins and asprin?

Statins and aspirin are not going to help you ward off diabetes - they are prescribed to lower cholesterol and reduce the risk of heart disease. Whether or not you need them is determined by what is called your "Blood Lipid Profile", which measures the levels of various different circulating fats. You need to discuss this with your GP. Although you can buy kits for measuring cholesterol over the counter from a pharmacist - that isn't a very useful figure. To make a sensible decision as to whether or not you need statins you need a full blood lipid profile, and that has to be done in a lab, from a blood sample drawn from a vein by a doctor or nurse.