High Fasting Glucose Level

[TromboneAl]

While getting my cholesterol tested at a mall health fair, I had the glucose level done as well. I had fasted for over 12 hours. It was 118, which is "pre-diabetic."

I don't get this, I am not overweight, and never have been (164 pounds at 5'11" same as high school). For the last two years I've exercised hard six days per week, and before that three days per week. I've always eaten well, and I've been eating a low-carb diet for the last five months.

In 2005 my fasting glucose was 83.

So I have to decide whether to pursue this or figure that it's a bad measurement. This is no fun.

 

[wolf]

OP:

Have another test done. Maybe, twice more. Could be just a fluke.

I'm a type 2 diabetic, only take med's. Was older, about 57 or 58 when my

numbers jumped. Diabetes runs in my family, so it was no surprise.

In any case, don't worry. If you become diabetic, life is about the same.

With modern glucose monitors, simple pin prick, and test strips, it's easy to test your sugar levels. and figure out what to eat and what to avoid.

Have many useful tips, but it would take to much time right now.

 

[haha]

Can't hurt to get tested again.

One thing- you don't have to be fat or out of shape to be diabetic. That is just a rumor floated by those who like to blame the sick person for his malady. Plenty of thin diabetics, and plenty of fat non-diabetics.

Ha

 

[Rich_by_the_Bay]

While getting my cholesterol tested at a mall health fair, I had the glucose level done as well. I had fasted for over 12 hours. It was 118, which is "pre-diabetic.

I don't get this, I am not overweight, and never have been (164 pounds at 5'11" same as high school). For the last two years I've exercised hard six days per week, and before that three days per week. I've always eaten well, and I've been eating a low-carb diet for the last five months.

Health fairs are great for my business. For my patients I'm not so sure.

Al, discuss with your PCP and ask about repeating in a reputable lab, perhaps along with a glycohemoglobin (HgbA1C) test. If the latter is normal you are in a very safe situation as far as complications.

The new stricter glucose standards are turning up quite a few people like you. The criteria are more sensitive (pick up more true early diabetics) but less specific (more false alarms). Even if it persists, it is not clear that your long term outlook is any different from that of a classically "normal" glucose group, especially when your lifestyle is already optimal.

I don't recommend health fairs. Too little quality control, too many tests done on the wrong populations, no available follow-up or interpretation, and at least some of them prey on the worried well.

Notwithstanding recent threads about doctors charging to review lab results, there are some instances where it is worth something (can't help but noting a little irony between Al's experience and that thread).

My guess is that this will turn out to be of little consequence. Let us know what you and your doc conclude.

 

[harley]

Al, discuss with your PCP and ask about repeating in a reputable lab, perhaps along with a glycohemoglobin (HgbA1C) test. If the latter is normal you are in a very safe situation as far as complications.

Rich (or any other knowledgeable person), my situation is similar but more extreme. My fasting glucose is high (150-170s), but all my A1cs (over a 5 year period) come back at around 5.7 to 5.9. I had one as high as 6.2, but that's still considered pretty normal. I'm doing the diet and exercise thing, but my doctor doesn't really have any explaination. Have you seen anything like this before? I don't mind being considered diabetic and doing the things to control it. It's better than ignoring it for sure. I'd just like to know how safe/unsafe I am from the complications with these conflicting numbers.

 

[TromboneAl]

Thanks, Rich and others. I will pursue it, but I may be changing to a different health insurance plan, so I'd better wait until after that. Part of the reason for going to a health fair is to keep the info private (that is keep it from the health insurance company). DW was once turned down for a change in coverage, and once you've experienced that you can't help imagining "You've been turned down due to the high fasting glucose measurement of Feb, 2010."

The reason for going to this fair was that I've been eating a lot more meat lately (see this thread), and I wanted to see how it affected my cholesterol levels. I'll report on that at the end of February.

I looked back at the BCBS healthy check records, and saw that in 2002 I had a fasting glucose level of 100, then in 2005, had an 83. That either shows the variability of measurements, or that the level can go down over time. Both of those were also measurements from an on-the-spot machine.

 

[FIRE'd@51]

T-Al,

I would recommend stopping by Walmart and picking up one of their Relion meter kits for about $10. The test strips run about 50 cents apiece. You don't need a prescription to buy them, and then you can check yourself. If the readings continue to run high you can bring it up with your doctor, who can run other more-conclusive tests.

As HA says, getting diabetes is ultimately genetic. Being overweight can bring it on sooner if you are genetically pre-disposed. In fact, something like 15-20% of the type 2's are not overweight.

 

[FIRE'd@51]

Rich (or any other knowledgeable person), my situation is similar but more extreme. My fasting glucose is high (150-170s), but all my A1cs (over a 5 year period) come back at around 5.7 to 5.9. I had one as high as 6.2, but that's still considered pretty normal. I'm doing the diet and exercise thing, but my doctor doesn't really have any explaination. Have you seen anything like this before? I don't mind being considered diabetic and doing the things to control it. It's better than ignoring it for sure. I'd just like to know how safe/unsafe I am from the complications with these conflicting numbers.

I am not a doctor, but it sounds to me that you may well be diabetic, even though your HbA1c is borderline normal. You are considered diabetic if you have two fasting readings above 126, a test you seem to meet. The HbA1c is an average, so it is influenced by both highs and lows. A HbA1c of 6.2 is in the diabetic range (albeit well-controlled), and is equivalent to an average blood glucose of 143. Even a "normal" Hb1AC of 5.7 corresponds to an average blood glucose of 126, so I would venture to guess that most people with HbA1c's in the the high 5's are at least pre-diabetic or at risk of becoming so.

You seem to be exhibiting a rather extreme "dawn phenomenon", which is chracteristic of most diabetics, even those with well-controlled HbA1c's (below 6.5). Try googling "dawn phenomenon" for lots of information. If your doctor is struggling with an explanation, I would see an endocrinologist.

 

[harley]

I am not a doctor, but it sounds to me that you may well be diabetic, even though your HbA1c is borderline normal. You are considered diabetic if you have two fasting readings above 126, a test you seem to meet. The HbA1c is an average, so it is influenced by both highs and lows. A HbA1c of 6.2 is in the diabetic range (albeit well-controlled), and is equivalent to an average blood glucose of 143. Even a "normal" Hb1AC of 5.7 corresponds to an average blood glucose of 126, so I would venture to guess that most people with HbA1c's in the the high 5's are at least pre-diabetic or at risk of becoming so.

You seem to be exhibiting a rather extreme "dawn phenomenon", which is chracteristic of most diabetics, even those with well-controlled HbA1c's (below 6.5). Try googling "dawn phenomenon" for lots of information. If your doctor is struggling with an explanation, I would see an endocrinologist.

Thanks, but I've done all that . I've read about the dawn phenomenon quite a bit, but it mostly says "this happens, but we don't know why". I'm sure I'm diabetic, but I'm hoping the decent A1cs mean I'm less likely to suffer from the complications from the disease, which is what Rich mentioned. Just looking for a little good news.

T-Al, I agree with Fired@51 about the Relion kit. It's an easy test, and I've done it 3 times with pretty accurate results. At least it's usually within a point or two of the one my doctor runs a couple weeks later (I like to have an idea what she'll see before I get there). You do the blood test, mail it in, and they email you a link a few days later where you can get the result. Bayer is supposedly selling an A1c at home kit through Walmart, but none of the ones I've been in carry it. You wouldn't need that, though, unless you want to check it with some regularity. But the nice thing about the Walmart kits is no pre-existing condition record with the insurance company.

 

[Rich_by_the_Bay]

Harley, your situation and numbers are a bit different. HgbA1C is a decent but imperfect predictor of risk for future complications. Assuming no compounding other risks, a value of 7 is where most studies start clearly seeing risk creep in. But individual variation is strong and a level of 8 may be unassociated with risk in some, while even at a level of 6, a few people get long term complications. Start getting under 6-6.5 and the risk is usually quite low, approaching that of the general population.

It's not possible to individualize in this context, but your doc should be able to give you some help next time you happen to be seen.

 

[harley]

Thanks Rich. I'm sure you hate these questions on the internet.

It sucks to be out of the ordinary, even when you are sick. It makes it hard to interpret the information. I'd probably be happier if I didn't read all this stuff and just took my doc's advice, but that's not how I'm put together. It's like being a gearhead's mechanic.

 

[FIRE'd@51]

T-Al, I agree with Fired@51 about the Relion kit. It's an easy test, and I've done it 3 times with pretty accurate results. At least it's usually within a point or two of the one my doctor runs a couple weeks later (I like to have an idea what she'll see before I get there). You do the blood test, mail it in, and they email you a link a few days later where you can get the result.

Just to clarify - the kit to which I was referring is to do simple finger stick measurements of your instantaneous blood glucose level - not an A1c, although evidently Walmart has those too.

 

[SarahW]

While getting my cholesterol tested at a mall health fair, I had the glucose level done as well. I had fasted for over 12 hours. It was 118, which is "pre-diabetic."

I don't get this, I am not overweight, and never have been (164 pounds at 5'11" same as high school). For the last two years I've exercised hard six days per week, and before that three days per week. I've always eaten well, and I've been eating a low-carb diet for the last five months.

In 2005 my fasting glucose was 83.

So I have to decide whether to pursue this or figure that it's a bad measurement. This is no fun.

Ugh, I know exactly how you feel. Last October I had bloodwork done and my fasting glucose level was 108...the doctor's office advised me that I am "pre-diabetic." I'm not overweight and have no family members with diabetes, so I was shocked. After much internet research, reading diabetes forums, buying books...I bought myself a Walmart meter and have checked my own readings many times. I have yet to have a reading over 100, even 1 hour after eating. My A1C number was 6. I have made a few changes to my diet (ala The Glycemic Load Diet book) and I'm exercising daily. I am going to do everything in my power to avoid full-blown diabetes. I was so bummed by this "diagnosis", especially after reading that about 70% of people with pre-diabetes develop full-blown type 2 within 10 years. I suppose in one way a pre-diabetes diagnosis is a good thing...we have a chance to make lifestyle changes or even take medication to try to avoid full-blown onset. Good luck, Al!

 

[Rich_by_the_Bay]

By the way, the term "impaired fasting blood glucose" is more accurate than "pre-diabetes" in most of these examples.

 

[Nords]

By the way, the term "impaired fasting blood glucose" is more accurate than "pre-diabetes" in most of these examples.

Isn't everyone who's not a diabetic considered "pre-diabetic"?

It's like referring to living creatures as "pre-dead"...

 

[rescueme]

By the way, the term "impaired fasting blood glucose" is more accurate than "pre-diabetes" in most of these examples.

Sounds just like a doctor!

Q: Is pre-diabetes the same as Impaired Glucose Tolerance or Impaired Fasting Glucose?
A: Yes. Doctors sometimes refer to this state of elevated blood glucose levels as Impaired Glucose Tolerance or Impaired Fasting Glucose (IGT/IFG), depending on which test was used to detect it.

Pre-Diabetes FAQs - American Diabetes Association

BTW, I'm a T2...

 

[Rich_by_the_Bay]

Sounds just like a doctor!

Q: Is pre-diabetes the same as Impaired Glucose Tolerance or Impaired Fasting Glucose?
A: Yes. Doctors sometimes refer to this state of elevated blood glucose levels as Impaired Glucose Tolerance or Impaired Fasting Glucose (IGT/IFG), depending on which test was used to detect it.

Pre-Diabetes FAQs - American Diabetes Association

BTW, I'm a T2...

That's a useful link, thanks.

You need to bear in mind that a 50% increase in cardiovascular complications in otherwise "average risk" people means an increase from 1% per year to 1.5% a year -- important over time but not panic material.

Lifestyle change probably all but mitigates the "disease" for many patients. So I use IFBG as my descriptor. Pre-diabetes has an inevitability to it that I don't care for. I'd rather emphasize the proactive, preventive side.

 

[TromboneAl]

So I use IFBG as my descriptor. Pre-diabetes has an inevitability to it that I don't care for. I'd rather emphasize the proactive, preventive side.

Yes, I would be much less bummed out if it weren't called pre-diabetes. IFBG says "You've got a problem." I know it's unreasonable, but to me "pre-diabetes" says "You may think you're a tough old fit guy, but soon you're just going to be a sickly old diabetic."

The shock value would be motivational for someone who is 30 pounds overweight, sedentary, and eats junk food, but there isn't much I can do. I haven't had a real cookie, piece of cake, rice, bread, potato or sweet drink in five months. DW already calls me "Anorexic Al."

I got a monitor yesterday (rode 38 miles to get it), and will get some readings to take with me to the doctor's.

BTW, don't be fooled by the low cost of the monitors. Most or all come with no test strips, which you must purchase for $30 to $120 (most brands >$70).

 

[SarahW]

Yes, I would be much less bummed out if it weren't called pre-diabetes. IFBG says "You've got a problem." I know it's unreasonable, but to me "pre-diabetes" says "You may think you're a tough old fit guy, but soon you're just going to be a sickly old diabetic."

The shock value would be motivational for someone who is 30 pounds overweight, sedentary, and eats junk food, but there isn't much I can do. I haven't had a real cookie, piece of cake, rice, bread, potato or sweet drink in five months. DW already calls me "Anorexic Al."

I got a monitor yesterday (rode 38 miles to get it), and will get some readings to take with me to the doctor's.

BTW, don't be fooled by the low cost of the monitors. Most or all come with no test strips, which you must purchase for $30 to $120 (most brands >$70).

Ya, the strips are the high-cost item. Thankfully for most diabetics, access to the test meter and strips can be much cheaper than for those of us just buying off the shelf to test ourselves.

I have to say that your "diagnosis" surprises me, too, since you don't fit "the profile." I'm not overweight, but my diet needs improvement (too many soft drinks) and I wasn't making any effort to exercise. I have begun making changes and I feel better overall. One thing I have learned from reading everything I could find about Type II diabetes is that a diagnosis is not the end of the world--the disease can be controlled with a bit of vigilance and proper care. I just want to avoid that if it's in my power to do so.

 

[SarahW]

...So I use IFBG as my descriptor. Pre-diabetes has an inevitability to it that I don't care for. I'd rather emphasize the proactive, preventive side.

That may be true, Rich. However in my case, I feel that the "pre-diabetes" pronouncement put the fear into me...whereas I'm not so sure "IFBG" would.

 

[rescueme]

...you don't fit "the profile.

Neither did I, at the time of diagnosis. In my case, it was traced back to a government program to give all young men of a certain age a free trip to a marvelous part of the world ...

Agent Orange and Type 2 Diabetes - American Diabetes Association

I'm certainly grateful to the government with providing me extra (tax-free) income over the years. Is this a great country, or what

 

[MikeD]

You seem to be exhibiting a rather extreme "dawn phenomenon", which is chracteristic of most diabetics, even those with well-controlled HbA1c's (below 6.5).

My former sub commander/internist once told me that the "Dawn Effect" was the name of the phenomenon that all girls named Dawn had big breasts, or words to that effect.



Mike D.

 

[rescueme]

My former sub commander/internist once told me that the "Dawn Effect" was the name of the phenomenon that all girls named Dawn had big breasts, or words to that effect.



Mike D.

YouTube - Frankie Valli & The Four Seasons - Dawn (live) - [STEREO]

 

[Bestwifeever]

Isn't everyone who's not a diabetic considered "pre-diabetic"?

It's like referring to living creatures as "pre-dead"...

Is diabetes a given for all of us, like death is?

 

[rescueme]

Is diabetes a given for all of us, like death is?

Heck - you're not going to live forever?