Words of warning! Have you had your doctor say to you or a family member, “be careful what you eat, your blood sugar is a little high”, or “you have a touch of sugar so watch what you eat!”. I won't go into other phrases that have been used, but many doctors just can't bring themselves to tell a patient they have prediabetes or might be near to a diagnosis of diabetes. Some even delay the diagnosis of diabetes because they are not aware of the damage that may be possible.
Translation of the above comments –you may have prediabetes and you need to take this seriously or you may have the start of diabetes. Why can't they just tell you this and do the remainder of the needed tests. Well, unless you are one of the lucky few that has the right medical insurance and it is prediabetes, you will be billed when it is rejected by the insurance company. If it is diabetes, medical insurance should cover the lab costs providing you have medical insurance. Sad but true.
First, fasting blood glucose levels for a person without diabetes can vary from 70 mg/dl to 99 mg/dl (3.9 to 5.5 mmol/L). One hour post meal testing (postprandial) can vary depending on the food consumed but seldom gets over 120 mg/dl (6.7 mmol/L). Normally a person without diabetes will have two-hour readings back below 100 mg/dl (5.6 mmol/L) or nearer 90 mg/dl (5.0 mmol/L).
For a person with prediabetes, fasting blood glucose levels will vary from 100 mg/dl to 125 mg/dl (5.6 to 6.9 mmol/L). With prediabetes, postprandial one or two hour testing can get to 140 mg/dl (7.8 mmol/L). Within three hours blood glucose readings should return to below 125. Blood glucose readings for prediabetes is also called impaired fasting glucose and impaired glucose tolerance.
For a prediabetes diagnosis, some doctors are using the A1c only which may not be reliable. Doctors use the ADA A1C range of 5.7–6.4%. Most doctors should also be using the oral glucose tolerance test (OGTT) and the fasting blood glucose test. With OGTT the blood sample is drawn two hours after drinking a 75-gram glucose drink. If the results are from 140 to 200 mg/dl (7.8 to 11.1 mmol) it is considered prediabetes. If the results are over 200 mg/dl (11.1 mmol/L) then the diagnosis should be diabetes.
Okay, now you have the diagnosis of prediabetes, what is the next step. Stop blaming yourself – it is not your fault. You may have accelerated the condition by your lifestyle, but you did not cause it. Family genetics has a lot to do with prediabetes and type 2 diabetes.
Yes, if you haven't noticed – others are all too willing to blame you and tell you to lose the weight and stop having diabetes. You do not have to be overweight to have pre-diabetes. If they only knew that they could be diagnosed the next week and they may not be overweight. And how do they account for those that are overweight and never get diabetes. Truth is they don't care, you are their scapegoat now.
Then learn to forget the past and live in the present. The quicker you learn this and put denial behind you, the better you will be able to manage prediabetes and put yourself in a position to possibly prevent the progression to type 2 diabetes, or at least delay it for many years. It is possible.
Previous blogs on prediabetes are – blog 1, blog 2, and blog 3.
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