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Monday, December 9, 2013
Diagnosed diabetic with normal blood glucose?
My doctor recently told me that I have diabetes, although I have normal blood glucose levels. She has taken one fasting in the morning, 70, and nonfasting in the afternoon, 77. I monitor at home and it ranges from 77-104, with 98% under 97. I have developed pain and numbness in my toes and one foot and she says this condition is most likely caused by diabetes. I have a family history of diabetes and am 60 lbs overweight.
It is frequently difficult to know what to do with a situation such as yours and there is not really enough information for me to offer a great deal more. The American Diabetes Association recommends that the diagnosis of diabetes be made on the basis of very specific numerical criteria which are modified somewhat by the presence or absence of symptoms commonly associated with diabetes. The information you provide does not comment on some other clinical features that may enter into the risk assessment. There remains the situation of the person who has symptoms like you describe of pain and numbness. While this most commonly is caused by diabetes, diabetes is not the only possible cause. It can be very challenging then to decide how aggressively to look for some of the alternative possible reasons for these symptoms. In theory, there are some other treatable causes besides diabetes and the clinical setting may provide more insight to whether looking for those is worthwhile.
Robert M Cohen, MD
Professor of Clinical Medicine
College of Medicine
University of Cincinnati