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  #12 (permalink)  
Old 04-21-2008, 03:58 PM
REDLAN REDLAN is offline
Senior Member
I am a: Type 1
 
Join Date: Jan 2007
Location: UK, Hampshire
Posts: 572
nice post with some interesting numbers...

to answer the question - am I pre-diabetic?

I don't know, and nor does your doctor....

yet

let's first off clear up some of those uncertainties

first off Hba1c's and those average BG's - they were calculated from the DCCT - Diabetes Control and Complications Trial, which looked at type 1's. They're still relevant to type 2's, however there is something that you need to understand about HbA1c's.

there is large variations between individuals. Similar average BG's can lead to HbA1c's to vary by as much as 1.0%. Your 5.5% could be someone else's 4.5%, and you could both have the same average BG. Treat HbA1c as your own personal average BG, and you won't go far wrong. Oh and differences of 0.1 to 0.3% from one reading to the next are of no consequence - effectively they need to be treated as though they are the same. It's down to the accuracy of the machine that measures them.

Now for the fasting glucose test results...

WHO guidelines say that IFG (impaired fasting glucose) are values between 6.0 and 7.0 mmol (108 to 126). So....

technically you do not have impaired fasting glucose, but what is described as a high normal fasting glucose. However your family history means that your high normal is more significant, and may mean that you are at much greater risk of developing diabetes.

so why do they choose 108 as the cut off for IFG? It's all to do with false positives. They chose this value because it excluded a sufficient number of those high normals, to make it an effective cut off point.

A diagnosis is never made on the basis of just one blood sugar test. So could your high fasting glucose be down to your recent sedentary habits and an injury?

It's possible. If your fasting BG stays around it's current level you probably do not have anything to worry about. But don't take my word for it - see your Endo.

another cause for the variation in your fasting glucose. Over winter the body slows down and attempts to store fat. It does this by increasing insulin resistance (specifically your muscles find it harder to absorb glucose, forcing your liver to convert more glucose into fat). In your case it elevates your BG. Now that spring is here the reverse happens - insulin resistance drops and your body starts mobilising those fat stores.

onto glucose tolerance tests.

this is a much more sensitive test i.e. it will catch more people with pre-diabetes, however it will also catch a load more of those high-normals. They may well have borderline OGTT, but never go on to develop diabetes.
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