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    Old 06-23-2004, 11:48 AM   #1
    silverandgold
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    Blood test: High Blood Sugar Level

    I went in for some blood tests recently because I wanted to figure out why I've been so tired. I'm 34 years old and in the past, I have been B-12 deficient and iron deficient. Apprently, my B-12 and iron was fine (within normal range) but my blood sugar level was high (the nurse told me that anything over 100 was high and I was 117). This has never happened before and I'm very concerned. The nurse told me that I have to go back to take another blood test that will be able to determine what my blood sugar levels have been over a 3-month time frame (wonder how they do that??) since the blood test I had done was like a snapshot of what was going on right then at the time of the test. I did not have to fast before my blood test, and in fact, ate a sandwich about 1/2 hour beforehand. I have no other "symptoms" of diabetes other than tiredness/lack of energy. Could the sandwich have affected the reading that much?

     
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    Old 06-23-2004, 02:32 PM   #2
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    Re: Blood test: High Blood Sugar Level

    Silver&Gold,

    The nurse knew you were not fasting, correct? A reading of 117 mg/dL is not high after a meal, at all. If it were a fasting reading, then yes, you would be exhibiting symptoms of insulin resistance. The glycosylated hemoglobin test (HbA1c) that they will do gives you a weighted average of your blood glucose (in % glycosylated hemoglobin), biased towards more recent levels, over the last few weeks (up to 4 months or so). The reference range for normal values is 4-6% for non-diabetics (some use a 6.2% cutoff), while for diabetics, poor control is >7.2% (some now use 7.0%).

     
    Old 06-24-2004, 04:52 AM   #3
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    Re: Blood test: High Blood Sugar Level

    As to how they do the A1C test, when they gave me one, it was only a finger poke type test. You do not have to fast for the A1C test.

     
    Old 06-24-2004, 10:24 PM   #4
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    Re: Blood test: High Blood Sugar Level

    Quote:
    Originally Posted by silverandgold
    I went in for some blood tests recently because I wanted to figure out why I've been so tired. I'm 34 years old and in the past, I have been B-12 deficient and iron deficient. Apprently, my B-12 and iron was fine (within normal range) but my blood sugar level was high (the nurse told me that anything over 100 was high and I was 117). This has never happened before and I'm very concerned. The nurse told me that I have to go back to take another blood test that will be able to determine what my blood sugar levels have been over a 3-month time frame (wonder how they do that??) since the blood test I had done was like a snapshot of what was going on right then at the time of the test. I did not have to fast before my blood test, and in fact, ate a sandwich about 1/2 hour beforehand. I have no other "symptoms" of diabetes other than tiredness/lack of energy. Could the sandwich have affected the reading that much?
    ???>>>>Something isn't right here. If you had a reading of 117 1/2 hr after a sandwich, you're FINE! That nurse needs some education BIG TIME! Talk to the DR....only a FASTING blood sugar of 117 is suspect (not diabetes which is 126).

     
    Old 06-25-2004, 05:07 AM   #5
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    Re: Blood test: High Blood Sugar Level

    Quote:
    Originally Posted by rahod
    ???>>>>Something isn't right here. If you had a reading of 117 1/2 hr after a sandwich, you're FINE! That nurse needs some education BIG TIME! Talk to the DR....only a FASTING blood sugar of 117 is suspect (not diabetes which is 126).
    Actually anything over 110 from a fasting blood glucose test is considered diabetes... The 126 is considered diabetes from a random (non-fasting) blood glucose test.

    But you are right - the nurse is not providing correct information!

     
    Old 06-25-2004, 08:06 AM   #6
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    Re: Blood test: High Blood Sugar Level

    JD, are you sure about the non-fasting > 126 mg/dL (7 mmol/L) diagnosis for diabetes? There might be a more recent pub with more strict criteria I have not seen yet, that maybe you have?

    I think you meant fasting. The non-fasting spot test, unless it's changed is still > 200 mg/dL and even then, my personal opinion is that it is too high a cutoff (as is the non-fasting above). The 200 mg/dL casual check limit is the same cutoff used for the 2-hr check after a 75-g glucose load for a GTT.

    The limits I have seen used for impaired tolerance (IGT) are 110-126 mg/dL fasting and 140-200 mg/dL for the GTT.

    There is an interesting web pub that can be found by searching "diabetes diagnosis criteria." The author is Mayfield.

    On a side note (in that article) I found it interesting that retinopathy increased when the plasma glucose > 109-116 mg/dL fasting! She (the author) also states that they (committee) left the criteria alone for the GTT levels because so much literature is out there with the 200 mg/dL cutoff. I think they need to lower them based on the former statement--I have a feeling you feel the same on that issue.

    Last edited by ubernier; 06-25-2004 at 08:07 AM.

     
    Old 06-25-2004, 09:19 AM   #7
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    Re: Blood test: High Blood Sugar Level

    Actually, I am not sure about anything!!! But here is my understanding...

    60-110 is normal range for fasting blood glucose test
    110-125 is considered "impaired fasting glucose" (whatever that means) for a fasting blood glucose test, but I have read that they have started using 110+ as the standard for a diabetes diagnosis and 99+ for "high-risk"
    126+ is considered diabetes for a fasting blood glucose test, but I have read that they are now using this range for random (non-fasting) tests, as well.
    60-110 is considered normal 2 hours into a GTT
    140-200 is considered "impaired glucose tolerance" 2 hours into a GTT
    200+ is considered diabetes 2 hours into a GTT

    Of course the mystery result, for which I can find no data, is 111-139 2 hours into a GTT... What do they consider THAT???

    For random tests, I have read it 3 different ways!!! Some say 126, some say 140, and some say 200, but I really think some of this is misinterpreted from the ranges I posted above. It makes sense to me that diabetic ranges are lowered - certainly anything over the "normal range" of 110 is a warning that there is a problem that needs to be addressed! I certainly was affected by this - I think my fasting blood glucose was in the 120-130 range a few years back and they never said a thing to me!!! Apparantly the diagnostic range at the time was still 140+.

    What worries me is this... I think it makes sense to lower the standards for diagnosis so people can gain control of their health, but I am concerned about the pharmaceutical industry taking advantage of this. I have already seen diabetes medications being classified as "anti-aging" drugs - whollymoley!!! That simply amazes me!!! And it infuriates me!!! Will they stop at nothing to sell another pill? Sure, a healthy non-diabetic takes metformin as a cure for "aging" which in turn causes high cholesterol and possibly anxiety, which in turn leads to more drug sales...

     
    Old 06-25-2004, 10:29 AM   #8
    rahod
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    Re: Blood test: High Blood Sugar Level

    Quote:
    Originally Posted by jdimassimo
    Actually anything over 110 from a fasting blood glucose test is considered diabetes... The 126 is considered diabetes from a random (non-fasting) blood glucose test.

    But you are right - the nurse is not providing correct information!
    HMMM..The guidelines state 126 is diagnostic for diabetes in a FASTING state..anything above 110 is considered as glucose intolerance and possibly *pre-diabetes*. A reading of 126 shortly after a meal (30-60 min) is NOT unusual. The guidelines usually show an UPPER range of 140 at 1 hr postprandial.Please show your references.

     
    Old 06-25-2004, 11:19 AM   #9
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    Re: Blood test: High Blood Sugar Level

    Thanks everyone for the info! I feel much better about all this. My follow up blood test is next week.

    To answer some questions...when I went in for my blood test (which was primarily to test my red blood count, B-12, iron) I was not told to fast. When the nurse called me back with the 117 sugar level saying it was high, I asked her, "was I suppose to fast, because I did not. In fact I ate about 1/2 before the test". She said no, it wasn't important to fast (?) and that the sandwich could have affected the reading, but they want to take another blood test to make sure. So now they are going to do another blood test that can look at the sugar levels over a 3-month period. Again, I was not told I needed to fast (but I will anyway, since my appt. is first thing in the morning). I'm assuming they know what they are doing (but you know what happens when you assume!) Maybe they are just being very thorough!!

     
    Old 06-25-2004, 11:31 AM   #10
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    Re: Blood test: High Blood Sugar Level

    Okay, as I stated, I realize what the official guidelines state! I was referencing an article I just read recently that suggested doctors were being encouraged to use the lower numbers (99-110 for fasting, and 126+ for random) and I cannot find the article now. I think this is based on studies they have done that show people with these results are ultimately getting diagnosed within a few years anyway.

    Also, I think the pharmaceutical companies are playing a big role in lowering the guidelines, in this case for the wrong reasons - gotta sell more scripts !!!

     
    Old 06-25-2004, 11:50 AM   #11
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    Re: Blood test: High Blood Sugar Level

    Quote:
    Originally Posted by silverandgold
    Thanks everyone for the info! I feel much better about all this. My follow up blood test is next week.

    To answer some questions...when I went in for my blood test (which was primarily to test my red blood count, B-12, iron) I was not told to fast. When the nurse called me back with the 117 sugar level saying it was high, I asked her, "was I suppose to fast, because I did not. In fact I ate about 1/2 before the test". She said no, it wasn't important to fast (?) and that the sandwich could have affected the reading, but they want to take another blood test to make sure. So now they are going to do another blood test that can look at the sugar levels over a 3-month period. Again, I was not told I needed to fast (but I will anyway, since my appt. is first thing in the morning). I'm assuming they know what they are doing (but you know what happens when you assume!) Maybe they are just being very thorough!!
    The test you describe is a hemoglobin A1c. When the blood glucose is high, it attaches to the hemoglobin protein in red blood cells, forming hemoglobin A1c. Red blood cells have of lifespan of 90 to 120 days, and once the glucose has combined with the hemoglobin in red blood cells, the hemoglobin A1c remains in the blood for that length of time. The amount of hemoglobin A1c in your blood simply reflects an approximation of your glucose levels over the past 3-5 months.

     
    Old 06-25-2004, 01:52 PM   #12
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    Re: Blood test: High Blood Sugar Level

    Quote:
    Originally Posted by jdimassimo
    Okay, as I stated, I realize what the official guidelines state! I was referencing an article I just read recently that suggested doctors were being encouraged to use the lower numbers (99-110 for fasting, and 126+ for random) and I cannot find the article now. I think this is based on studies they have done that show people with these results are ultimately getting diagnosed within a few years anyway.

    Also, I think the pharmaceutical companies are playing a big role in lowering the guidelines, in this case for the wrong reasons - gotta sell more scripts !!!
    I know they're looking to lower the #s..that's good. I read that 105 may become the new limit for fasting, with anything above that indicating "glucose intollerance"/pre-diabetes. I haven't seen anything on lowering the fasting# of 126 as DIAGNOSTIC for diabetes though. Over 126 random *could* become another red flag, but as I stated, that # is NOT UNUSUAL for a 30-60 min post meal reading! The random #s now are actually set fairly high....I know it's at least 180 and could be as high as 200 . As far as I know there are only TWO test used to DIAGNOSE diabetes: The FASTING at 126 and the GLUCOSE TOLLERANCE at 200.

     
    Old 06-25-2004, 02:02 PM   #13
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    Re: Blood test: High Blood Sugar Level

    OK..here are the guidelines with the DIAGNOSTIC criteria...looks like a random of 200 is also DIAGNOSTIC:

    "A fasting blood glucose test. This test is performed after you have fasted (no food or liquids other than water) for eight hours. A normal fasting blood glucose level is less than 110 mg/dl. A diagnosis of diabetes is made if your blood glucose reading is 126 mg/dl or higher. (In 1997, the American Diabetes Association lowered the level at which diabetes is diagnosed to 126 mg/dl from 140 mg/dl.)


    A "random" blood glucose test taken at any time. A normal blood glucose range is in the low to mid 100s. A diagnosis of diabetes is made if your blood glucose reading is 200 mg/dl or higher and you have symptoms of disease such as fatigue, excessive urination, excessive thirst or unplanned weight loss.


    Another test called the oral glucose tolerance test may be performed instead. For this test, you will be asked, after fasting overnight, to drink a sugar-water solution. Your blood glucose levels will then be tested over several hours. In a person without diabetes, glucose levels rise and then fall quickly after drinking the solution. In a person with diabetes, blood glucose levels rise higher than normal and do not fall as quickly.

    A normal blood glucose reading two hours after drinking the solution is less than 140 mg/dl, and all readings between zero to two hours are less than 200 mg/dl.


    Diabetes is diagnosed if your blood glucose levels are 200 mg/dl or higher."

     
    Old 06-25-2004, 02:03 PM   #14
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    Re: Blood test: High Blood Sugar Level

    Quote:
    Originally Posted by jdimassimo
    Okay, as I stated, I realize what the official guidelines state! I was referencing an article I just read recently that suggested doctors were being encouraged to use the lower numbers (99-110 for fasting, and 126+ for random) and I cannot find the article now. I think this is based on studies they have done that show people with these results are ultimately getting diagnosed within a few years anyway.
    Well, again, I think it's great (my personal opinion) that lowering it is under consideration, because the risk (consequences) are still too great even in the 110-126 mg/dL range. If you do find it, can you post some clues so I can read it?

    Quote:
    Originally Posted by rahod
    I know they're looking to lower the #s..that's good. I read that 105 may become the new limit for fasting, with anything above that indicating "glucose intollerance"/pre-diabetes.
    rahod, do you recall where you read this?

     
    Old 06-25-2004, 02:09 PM   #15
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    Re: Blood test: High Blood Sugar Level

    Quote:
    Originally Posted by jdimassimo
    What worries me is this... I think it makes sense to lower the standards for diagnosis so people can gain control of their health, but I am concerned about the pharmaceutical industry taking advantage of this. I have already seen diabetes medications being classified as "anti-aging" drugs - whollymoley!!! That simply amazes me!!! And it infuriates me!!! Will they stop at nothing to sell another pill? Sure, a healthy non-diabetic takes metformin as a cure for "aging" which in turn causes high cholesterol and possibly anxiety, which in turn leads to more drug sales...
    Well I agree that this should not be an excuse for the pharmaceutical industry to cash in. The first line of treatment needs to be diet, weight loss and exercise for type II. Amazing what can be done without meds in so many cases there...

    I read a pub a while back where a study was conducted comparing diabetic complications for type IIs that controlled their blood glucose through diet and exercise vs. those that require oral medication. The findings were that diabetic complications were significantly different (reduced) in the group that relied only upon diet and exercise. The bottom line is that oral meds may not be able to completely guarantee that diabetic complications won't appear. I will have to dig around to find that manuscript....

     
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