Remember that the information presented here is not intended to replace the care of your own doctor. Before making any changes in the management of your own illness, you should consult your physician or other qualified medical professionals.
Question
I am 39 and was recently diagnosed with
type 2 diabetes,
with an HbA1c of 5.8.
I do have a family history of heart disease and diabetes, and I did have
gestational diabetes
with my second child, and have been on 500 mg/day of Glucophage XR for about one year
to combat
Impaired Glucose Tolerance.
But isn't that number well in the normal range? I thought anything below 6 was a
normal A1c result.
I exercise, eat right, and keep my weight in check — my
BMI
is well within the normal range. I want to have a face to face with my doctor but want to be prepared with the right questions about my diagnosis. Is this really diabetes?
Answer
The diagnosis of diabetes is not based on
HbA1c
values. The diagnosis
is based on
serum glucose
levels, by venipuncture:
A confirmed fasting serum glucose level of > 125 mg/dL defines
diabetes; as does:
- A random serum level >200 if there are classic symptoms such as
increased thirst or urination; as does
-
A level > 200 at the 2 hour mark during a properly performed
glucose tolerance test.
There are different techniques and assays to assess glycohemoglobin
and things other than glucose can influence it. I assume that you do
have glucose intolerance and the
Glucophage
is not an unreasonable
choice. But if your glucose levels are good, and you are exercising and
watching your diet, then you can talk to your physician about
consideration of a trial without it.
But if you do indeed have type 2 diabetes, you would do well to stay on
your current plan as you are well controlled, at least based on the
HbA1c value you provide.
ids
Also, your A1c might be in "normal" range
because you have been taking Glucophage XR for a year already.
As Dr. Schwartz indicates, to diagnose type 2 diabetes, three tests can be done:
- a Fasting Plasma Glucose (FPG), (no food for 8 hours), performed on two different days.
- a random blood glucose; drawings performed on two different days (time of day doesn't matter).
- an Oral Glucose Tolerance Test.
slb
Return to DQ&A main page
|
| |
31Oct2004
| |
| |
|
|
|
