[arzoo]

Hi,

My dad recently did his annual lab tests and sugar came up at 123. Last time it was 134. He doesn't take medication, and has kept the same diet, exercise regimen as before. The only thing I know is that he changed his softdrinks to the 'lite' version (ie. coke lite, pepsi lite) which uses artificial sweeteners as opposed to sugar.

From what I understand, fasting blood sugar should be below 100 for non-diabetics and between 101-125 for pre-diabetics. Anything over is considered diabetic.

Does this mean that he has been able to move back from being diabetic to pre-diabetic? And that it is possible to improve that to become normal again?

I previously read that once you become diabetic there is no 'cure'.

So I am wondering a few things:

1. Can your labs come out as below 100, when you eat less carbs and exercise, but be considered diabetic? pls. explain why because then the labs don't seem to tell much.

2. In connection to question 1, if you stop the diet and do more carbs, sweets, then less/stop exercise then the labs can show numbers way above the diabetic levels?

What I'm trying to understand is how can you really say you are not a diabetic, or you are a diabetic, or are a pre-diabetic.

Thanks.

[Dan Gato]

Hi Arzoo,

2 readings of glucose aren't enough to determine pre or diabetes, it takes a lot more for a diagnosis.
You should tell him to get a glucose monitor and test before breakfast and 2 hrs after each meal, keep a log, & take it to the doctor.

Eating low carbs & avoiding sweets will help.

Make an appoitnment with a doctor for diagnosis.
Keep reading the forums.

See you

[matingara]

Arzoo,

i am a type 2 diabetic. my fasting blood glucose this morning was 90.

2 hours after a breakfast of an egg, ham and some mushrooms my blood glucose was 77.

those numbers, if taken in isolation, are "non diabetic".

if i had had a piece of toast with my breakfast my post breakfast number would have probably been 144 or so. so one piece of toast means a difference of nearly 70 points!

as Don Gato said, 1 or 2 bgl tests are not going to tell the whole story. to find out a rough average of your bgl over the last three months your Dad needs to have an HBA1C test. get him to ask for one.

if that test comes in at 4-6% (approx) then he probably is not a diabetic. or he may be a diabetic who has a diet that keeps his bgls under control.

there is a lot to learn about humans and their bgls.

keep up the good work!

-- Joel.

[xMenace]

If you weren't diabetic, you wouldn't worry about eating any type or quantity of carbs.

[mg_2204]

Originally Posted by arzoo

Does this mean that he has been able to move back from being diabetic to pre-diabetic? And that it is possible to improve that to become normal again?

The golden rule for pre-diabetic and diabetic is this one in my humble opinion : no matter how well you are doing, no matter how simply extraordinary your numbers are... you are and will remain until your last breath pre-diabetic or diabetic. And you must never forget it.

[Ronin]

Hi Arzoo!

Your dad is lucky to have a caring son. When facing the whole issue of Pre-Diabetes, or even full-blown diabetes be cautious about taking one or two test results as meaning that you have a diagnosis. Frankly, there are too many MD's out there who see one Fasting Blood Glucose test above 100 and hand the person a prescription for diabetic medications.

As was mentioned, he needs to get an HbA1c test to confirm that the FBG level is actually pointing to a diabetic problem. If he is then an Oral Glucose Tolerance Test (OGTT) with C-Peptide readings (very important) to determine if he is, in fact a diabetic (purely glucose related) and what type of diabetic he has become.

Important note: Type-2's have high C-Peptide readings while Type-1.5's have low C-Peptide readings and the treatments are totally different - i.e., Type 1.5's respond well to insulin whereas Type-2's have more than enough insulin but they need other drugs to make the body use the insulin it already has.

I presume that your dad is "Over-50" so the confirming tests are important to make an accurate diagnosis. A lot of people are being swept into the Pre-Diabetic ranks when all they have is either a strong Dawn-Effect or simply a slow metabolism. To be sure, a healthy diet with less carbohydrates is good for everyone, but not everyone with a high FBG is a diabetic. Further testing is absolutly required.

[drsanjaynayak]

Hey arzoo and all
i too am having a proble diagnosing my situation ... heres my story ... over the past few years i would have binges wherein i would overeat and have sweet stuff like **** !!! i would have almost two litres of cola or sugarcane juice a day for months .. my body weight was around 123 kgs ... then i started developing symptoms like excessive urination and tested 265 fasting and 315 PP in March of 07. Hb1Ac was 13 ... after medication and strict diet and losing amost 15 kgs in four months my Hb1Ac was 5.9 and BGs well below normal... i was also weaned off medication when i started developing signs of HYPO .... since July 07 i am off medication and watch my diet . i was curious to know whether i was prediabetic or full blown diabetic . I did a oral GTT yesterday ..i couldnt believe my glucometer( Accucheck Active) My fasting was 85 ( its always been that for some time now) ... after one hour it was 209 ( but urine sugar was NEGATIVE) and exactly after two hours the reading showed 99 and 102 ( i did it twice cos i felt something was drastically wrong) i had taken exactly 78 gms of glucose . Now what do i make of this situation?? am i diabetic?? Pre D ??? i want to repeat the test in a lab and find our whether i need to throw away my glucometer . even if we allow an error of 20 % the numbers do not seem much ... help me guys ....
regards
sanjay

[xMenace]

Dr. Sanjay, don't believe in that label pre-diabetic. You are diabetic controlled by weight, diet, and exercise. As an experiment to prove this, start eating like a pig, gain 15kg, and stop exercising. I'll bet you go back on meds PDQ!

You've done a great job! Keep it up. BUt don't throw away that tester. This thing tends to progress. It may take it's time, and it may never happen but not likely. It might be many years before it does, but it's better to test those fasting numbers once a week and catch it early than ending up in DKA and unconcsious for a week or life.

[drsanjaynayak]

Tahnx John
i will surely not throw away my tester .. but i was confused for a moment .... so how do we really know or diagnose diabetes?? . could eating or drinking sugary foods all the time get the body into an "induced state" of diabetes?? and reverse back after the stimulants are removed?? i am still confused
sanjay

[xMenace]

A non-diabetic can eat great quantities of food and stay within normal ranges. If your insulin production cannot 'process' consumed/produced blood glucose to some degree, you are diabetic. Think in degrees of seriousness, even though all forms are serious when relating to complications. A pre-diabetic has many degrees of freedom. They can stray from their diets, exercise, and weight control with little if any effects. For us type 1's, not taking insulin injections is a death sentence. Type II's can be anywhere in between.

[REDLAN]

type 2 diabetes is diagnosed by either a fasting blood sugar or an oral glucose tolerance test.

You can also test for insulin resistance by using a euglycemic clamp - but this is done very rarely.

As far as I know most countries follow the WHO guidelines for diagnosing diabetes.

FBG greater than 7.0 mmol/l (126mg/dl) is considered diagnostic of diabetes

and/or

the oral Glucose tolerance test (OGTT) is defined as diagnostic if BG is greater than 11.1 mmol (198 mg/dl) after 2 hours.

within that there are other categories

impaired fasting BG which is defined as a normal OGTT (<7.8mmol after 2 hours), and a FBG greater than 6.1 mmol/l

and impaired glucose tolerance, which is defined as a FBG <7.0 mmol, but a OGTT between 7.8 and 11.1 mmol

the impaired categories are sometimes used as a diagnostic criteria for pre-diabetes.

As far as causes of type 2 are concerned then that is a very hotly debated subject.

obesity is strongly correlated with type 2 diabetes. This however does not mean that obesity causes type 2. It is clear that insulin resistance causes weight gain, and potentially it might be more correct to say that weight gain is a symptom of type 2. The current evidence linking obesity to type 2 has come entirely from cohort (observational) studies, and at best these studies can only show correlation, they can not be used to show causation.

type 2 caused by eating carbs? - now that is one seriously hot potato - quite literally . Posts between the low carbers and high carbers can ding dong back and forth for a very long time. Suffice to say that evidence linking sugar consumption to type 2 diabetes is extremely tenuous at best, and all comes from observational studies.

[lisalu]

I am also confused about the numbers in diagnosing Pre-D and full blown Type-2.

I noticed when I bought the glucose meter that it explained that the capillary (plasma) test will show levels 10%-15% higher than a venous sample. So what does that do to numbers right on the borderline?

My labs done a couple of months ago by my MD showed 109 fasting which warranted a "come back and retest in two months" (no other explanation).

After two months of diet, exercise and weight loss I have begun doing some occasional testing on my own and found my morning levels are always in the 110's. But then my numbers seem to stay in a pretty stable range all day, mostly between 100-130 whether pre-meal, post-meal, post exercise or whatever. I don't see any big swings in the numbers.

So with the cut off for diagnosing Type-2 being 126 fasting (venous sample I assume) would there be a different number at which I should be alarmed from the plasma tests? I feel like I am right on the edge, I don't know if I am in a good range or knocking on the door of Type-2!

[Ronin]

Hi Lisalu!

The FBG test is not a difinitive test to make a diagnosis of any type of diabetes. The FBG is one indicator, to make an accurate diagnosis any MD worth the diploma will require an HbA1c, and if that comes back high, an Oral Glucose Tollerance test with C-Peptide readings. Then, and only then, can a difiniative diagnosis be made.

Like you, when I first encounted the world of "diabetes" I was scared, over-reactive, and did not understand what is going on. Fortunately the folks here on DF helped me to get my head on straight.

If you are really concerned get all of the appropriate tests starting with an HbA1c (if your MD won't authorize it you can get an over-the-counter test kit -- I use Biosafe and I have checked it against the lab that does my other blood work and found them to be accurate. They are available through Amazon.com.) Then, if you HbA1c is in the diabetic range demand an OGTT with C-Peptide readings for an absolute diagnosis.

Knowledge is much more important than anxieties.

[drsanjaynayak]

Originally Posted by REDLAN

type 2 diabetes is diagnosed by either a fasting blood sugar or an oral glucose tolerance test.

You can also test for insulin resistance by using a euglycemic clamp - but this is done very rarely.

As far as I know most countries follow the WHO guidelines for diagnosing diabetes.

FBG greater than 7.0 mmol/l (126mg/dl) is considered diagnostic of diabetes

and/or

the oral Glucose tolerance test (OGTT) is defined as diagnostic if BG is greater than 11.1 mmol (198 mg/dl) after 2 hours.

within that there are other categories

impaired fasting BG which is defined as a normal OGTT (<7.8mmol after 2 hours), and a FBG greater than 6.1 mmol/l

and impaired glucose tolerance, which is defined as a FBG <7.0 mmol, but a OGTT between 7.8 and 11.1 mmol

the impaired categories are sometimes used as a diagnostic criteria for pre-diabetes.

As far as causes of type 2 are concerned then that is a very hotly debated subject.

obesity is strongly correlated with type 2 diabetes. This however does not mean that obesity causes type 2. It is clear that insulin resistance causes weight gain, and potentially it might be more correct to say that weight gain is a symptom of type 2. The current evidence linking obesity to type 2 has come entirely from cohort (observational) studies, and at best these studies can only show correlation, they can not be used to show causation.

type 2 caused by eating carbs? - now that is one seriously hot potato - quite literally . Posts between the low carbers and high carbers can ding dong back and forth for a very long time. Suffice to say that evidence linking sugar consumption to type 2 diabetes is extremely tenuous at best, and all comes from observational studies.

agreed with the observations ... but my fasting was 85 and then after one hour it spiked to 209 without any trace in urine and then after two hours it was 99 . Then after about 20 mins i started feeling almost Hypoglycemic and sweaty and my hands were shaking like a leaf . what i am worried is the spike after one hour of 75 gms of glucose .Is that normal?? i had done this test with a glucometer and i have always thought that in the fingerprick or capillary test the values are about 10 % higher than a blood sample from a vein?? now i am confused .
regards
sanjay