Confused - Am I Type 2 or Pre-Diabetic

leosmom · #1 (**permalink**) 11-07-2009, 02:25 PM

I just got my results from last A1C which was 6.1 (yippee skippee). I was dx'd in 2006 with Type 2 and A1C was 7.4. I was on no meds until 2008 (A1C 7.1), then Metformin 1x day. I changed Dr.'s this year. New Dr. put me on Metformin 2x day (A1C was 6.4). 2 months later at 6.7 Dr. added Actos 1x day. The 6.7 earlier this year included a month in which I had hip replacement surgery and my BG was all over the place during that time. Here's my confusion. Dr. sent the latest results with comment "you are probably pre-diabetic". Really? I don't get it. Why add the meds when the A1C's are dropping?

BTW, even though I don't post alot, lurking around on this forum has been a tremendous help in getting me from the 7's to the 6's. Not all the ideas work for me, but some certainly have and I appreciate all of you and your inputs. Thank you.

foxl · #2 (**permalink**) 11-07-2009, 03:08 PM

Well a lot of people do not like the term pre-Diabetic, including me. Because it sounds like you "might get away with it" or something.

But the ADA and I think AACE (Endos group) both seem to recognize it. I think many doctors think of the history of diabetes, and do not like to tell people they are diabetic. So they came up with this pre thing.

Either way, take it seriously.

Moonglo · #3 (**permalink**) 11-07-2009, 03:16 PM

Sometimes even Pre-d's will get put on medicine, the theory being that if you can do something about it now, then you may not develop full-d.

Having said that, I've never heard of anyone going from full-d to pre-d. I would take that comment of his and ignore it. After all, your regimen isn't changing because of your diagnosis. I would continue to take it seriously and hope for the best.

fgummett · #4 (**permalink**) 11-07-2009, 04:22 PM

Your Blood Glucose management system is compromised... your Glucose Tolerance is impaired... does the label really matter, unless it makes some difference to insurance coverage, for example?

Many of us have improved out BG control so that we may now fall into a different range of diagnostic criteria... does that necessarily change our diagnosis or treatment?

'Tis but thy name that is my enemy;
Thou art thyself, though not a Montague.
What's Montague? it is nor hand, nor foot,
Nor arm, nor face, nor any other part
Belonging to a man. O, be some other name!
What's in a name? that which we call a rose
By any other name would smell as sweet;
So Romeo would, were he not Romeo call'd,
Retain that dear perfection which he owes
Without that title. Romeo, doff thy name,
And for that name which is no part of thee
Take all myself.

Moonglo · #5 (**permalink**) 11-07-2009, 04:25 PM

Lol Frank! I love the R&J quote here.

One important key note of what Frank just said here is that we may fall into different DIAGNOSTIC categories once we get our bg under control. We have already been diagnosed, so this is kinda a mute point.

fgummett · #6 (**permalink**) 11-07-2009, 04:27 PM

Quote:

Originally Posted by Moonglo

I love the R&J quote here.

Yup... old Billy-Bob sure had a way with them words

Moonglo · #7 (**permalink**) 11-07-2009, 05:03 PM

Quote:

Originally Posted by fgummett

Yup... old Billy-Bob sure had a way with them words

Lol... indeed he did.

And I didn't mean that you had a mute point, I was trying to point out that once we are diagnosed, we shouldn't have to be diagnosed again, unless it's a case with a t1 being misdiagnosed as t2, or something along those lines.

jenb · #8 (**permalink**) 11-07-2009, 05:18 PM

Moot point. Unless Frank's unable to speak

.

Jen

Lloyd · #9 (**permalink**) 11-07-2009, 05:54 PM

The standard for pre-d is 2 fasting readings over 100, for diabetes it is 2 over 126 (7)

-Lloyd

ShottleBop · #10 (**permalink**) 11-07-2009, 07:02 PM

if you were previously at 7.4 and diagnosed as a T-2, successfully managing your blood sugars down to 6.1 doesn't make you pre-D. It makes you a T-2 with better control over your blood sugars. (Maybe your doctor forgot--or didn't look up--your history when sending you your most recent results, and was reacting to the 6.1 as if you had no prior history of diabetes.)

jillybean · #11 (**permalink**) 11-08-2009, 07:55 AM

Quote:

Originally Posted by ShottleBop

(Maybe your doctor forgot--or didn't look up--your history when sending you your most recent results, and was reacting to the 6.1 as if you had no prior history of diabetes.)

I was thinking the same thing.

Josselyn · #12 (**permalink**) 11-08-2009, 10:33 AM

Quote:

Originally Posted by Lloyd

The standard for pre-d is 2 fasting readings over 100, for diabetes it is 2 over 126 (7)

-Lloyd

Yet, upon dx, I'd never had an FBG at the MD's higher than 99...99 being the highest in a range of 83-99. I still don't have fasting readings that exceed 126. I never did.

My A1c was 6.6 at dx, however, and I failed the OGTT miserably with a 288 at the 2 hour mark

...I'd been low carbing for two weeks prior to the test - BIG mistake; it made me more carb sensitive.

I'm now 6.1...and I promise you that my MD, who is helping me to reverse this if possible, has not declared me "pre-diabetic." I wish.

leosmom · #13 (**permalink**) 11-08-2009, 12:34 PM

Quote:

Originally Posted by ShottleBop

if you were previously at 7.4 and diagnosed as a T-2, successfully managing your blood sugars down to 6.1 doesn't make you pre-D. It makes you a T-2 with better control over your blood sugars. (Maybe your doctor forgot--or didn't look up--your history when sending you your most recent results, and was reacting to the 6.1 as if you had no prior history of diabetes.)

I think you hit the nail on the head here. I'll ignore the Doc's comment about the type and just be glad for the 6.1.

Thanks everyone for the feedback!

mho357 · #14 (**permalink**) 11-08-2009, 03:20 PM

Quote:

Originally Posted by foxl

Well a lot of people do not like the term pre-Diabetic, including me. Because it sounds like you "might get away with it" or something.

But the ADA and I think AACE (Endos group) both seem to recognize it. I think many doctors think of the history of diabetes, and do not like to tell people they are diabetic. So they came up with this pre thing.

Either way, take it seriously.

I agree. I was told by the nurse that I was "pre-d" a year before my dx. I ignored her because she didn't seem to think it was a big deal. If they had said I was diabetic, I might have taken it seriously and started my reform a year earlier.

I think "pre-d" is a misguided and dangerous diagnosis.

But that's just my opinion - your mileage may vary.

Mark

EeyoreButterfly · #15 (**permalink**) 11-08-2009, 08:24 PM

Fastings are just one diagnostic criteria, and not even the best one. Any competent doctor/CDE will tell you that fastings are the last to rise. The actual diagnostic criteria is:

2 or more fasting readings over 100 for pre-D or 126 for full blown D and/or post prandial reading of over 140 for pre-D or any random reading of over 200 for full blown D. So it is possible to be a type 2 and never have a bad fasting reading.

As far as now being Pre-D, that doc has no clue what he is talking about. You are simply a well controlled type 2. Chances are without the meds, your blood sugar would go right back up.