Diabetes Diagnosis – Right or Wrong?
Last month when I went to see my doctor she ran an A1C test and said my results were high. This was after some 18 hours of fasting. She then told me to take Metformin, one with evening meal, and to start testing my glucose levels with a monitor 3 times a day before meals. I am over weight, but have never had any of the other type 2 diabetes symptoms: excessive thirst/urination, numbness, dizziness, etc. and my cholesterol/blood pressure reading are fine. Since then I have gone to a healthier diet (low proccessed carbs, little red meat, no snacking) and in 4 weeks of this, I have lost more than 10 pounds. All my glucose levels have been between 80-96. I had one 100 reading early one morning after 11 hours of no eating. I am worried about the original diagnosis because the new company I am working for is getting out of group coverage insurance and you know what a diagnosis o f dianbetes does to the cost of private health insurance. I’ll keep up the plan, but any ideas?
The powers that be at the company I work for have decided that they will no longer offer insurance, deciding instead to subsidize private converage at a rate much lower than what it will take for even the healthy to get medical insurance. With a diagnosis of diabetes as a pre-existing condition, I am worried I have been priced out of health insurance. I have NEVER in my adult life ever not had health insurance.
Well … first of all, the results of your A1C have nothing to do with fasting. The A1C is a blood test that can tell what your average blood sugar level has been for the last 3 months. the fasting would have been for the glucose test, and maybe some of your other non-diabetes related tests.
Now, if you’re dieting, exercising and losing weight, your numbers will get better. It doesn’t mean you don’t have diabetes anymore … my understanding of it is, is that you will have to exercise and eat healthy for the rest of your life to keep your numbers in the good range.
admin on November 1st 2009 in Diabetes Diet Meal Plan
Monica responded on 01 Nov 2009 at 6:51 pm #
Well … first of all, the results of your A1C have nothing to do with fasting. The A1C is a blood test that can tell what your average blood sugar level has been for the last 3 months. the fasting would have been for the glucose test, and maybe some of your other non-diabetes related tests.
Now, if you’re dieting, exercising and losing weight, your numbers will get better. It doesn’t mean you don’t have diabetes anymore … my understanding of it is, is that you will have to exercise and eat healthy for the rest of your life to keep your numbers in the good range.
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The mom responded on 01 Nov 2009 at 7:36 pm #
I’m not at all surprised that you were diagnosed with Type 2 diabetes although you didn’t have any of the typical symptoms. Many people are caught by surprise, sometimes they have no reason to suspect anything is wrong until a high blood sugar is detected by accident, or during a routine exam. You are likely a borderline diabetic, and the result of the healthier diet and weight loss have tipped the scales in your favor. Unfortunately, you still have some insulin resistance and always likely will. What the early results suggest is that you will likely be able to manage it eventually with a diet alone. That is, if you stick to the healthier diet, lose the extra weight and exercise. That would reduce your risk of problems, and in turn lower your insurance risks. That’s a lot more attractive to the insurance bean counters than a Type 2 diabetic on insulin, because your risk of complications is a lot lower. It also shows you are highly motivated to control things, and that always helps as well. If you are in good control when they issue the policy, then they would not be able to write off later complications as exempt because they were pre-existing either, because you haven’t developed any physical changes. I’m sure it came as a shock to you, but you seem to have jumped right on it and done exactly what doctors dream of having patients do. Keep at it, and add in some exercise, and you will continue to do well, and likely to eventually drop the medication and avoid the problems. Good luck, and congrats on the good job so far. Wish everyone was as motivated!
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nurse
poke22 responded on 01 Nov 2009 at 7:48 pm #
To make a diagnosis of diabetes you have to have a fasting blood sugar > 126 (that is, with an overnight fast).
OR, two separate random blood sugar readings > 200 + symptoms that you mentioned.
A1C is not used to diagnose diabetes. It is only used to monitor diabetes once you have it. Not sure how you were diagnosed with diabetes only with A1C…
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MD
Bubba responded on 01 Nov 2009 at 8:35 pm #
Most doctors would not make the diagnosis of diabetes lightly since it entails a lifetime of expensive and inconvenient treatments. There are rigid criteria based on fasting sugars that enable him to make that diagnosis. The fact that your sugars are now normal I presume is a tribute to the medication and to a lesser degree your weight loss. If your original fasting sugars were not extreme it is entirely possible with appropriate diet and weight loss that you will be able to eventually discontinue the medication. Sit down with you doctor, explain the situation to him and ask him exactly how he arrived at your diagnosis of diabetes. ADA criteria include two random BS of over 200 with symptoms, or two separate fasting sugars of 126 or greater or a two hour post prandial sugar of 200 or greater.on two occasions.
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Mozz responded on 01 Nov 2009 at 8:55 pm #
The symptoms that people know about (excessive thirst and urination) are far more noticible in type 1 diagnosis. Type 1 is where the body doesn’t make any insulin. With type 2 the body still makes insulin, just not enough, or the body uses it wrong. So your symptoms would pale in comparison to a person who doesn’t make insulin at all. Type 2 can go undetected for quite some time. Your diagnosis sounds correct, especially since the meds yielded better BG results. And eating right is never a bad idea!
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Parent to type 1
cubby responded on 01 Nov 2009 at 9:19 pm #
I was diagnosed with type2 diabetes in August,07. I lost 28lb and no longer have to take my medication. I never had most of the diabetic symptoms, such a extreme thirst, numbness….
I went in December for my A1C test. It was normal. This may be what happened to you. You lost weight. That in its self can help bring ones numbers down, and eating a healthier diet also is a big help.
If you feel that there was an error in your diagnosis then keep a record of your blood glucose reading and share this with your doctor and ask him could the A1c test be wrong in your case. He could always do another to make sure. Mistakes can be made in any lab.
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Ashley responded on 01 Nov 2009 at 9:33 pm #
Type 2 diabetes is actually reversible at first. You may have just had prediabetes and your diet and exercise change may have helped. You should go back to the doctor and see if anything has changed.
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da d responded on 01 Nov 2009 at 10:06 pm #
The diagnosis may be right. Go back with the results you have and talk to the doctor and discuss that with him. It is him that will have the opportunity to reverse the diagnosis.
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