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Friday, May 24, 2013
I am a male 50 years on Tenromin 100 Losartan 100 Amlodepine 10 Indapamide 1.5 SR. My TSH is normal LIpids are normal but HDL is 31 I have IGT Fasting 115 After 2 Hours 152. My HbAic is 7.7. Is diabetes under progress or am I diabetic Can you guide me.
I would need more information than you have provided in order to interpret the situation. The American Diabetes Association does not recommend using HbA1c for diagnosis of diabetes. You could have an elevated HbA1c for any of several reasons: these include that you could have diabetes that is not adequately controlled or that you have some physiologic alteration causing an elevated HbA1c or because you have something else causing an artifactual elevation of HbA1c.
The general strategy would be to first determine whether the HbA1c result is repeatable. If so, then the next step would be to obtain other data on blood sugar control to determine whether the results are really in agreement with each other: this could take the form of additional blood sugar tests at certain times that would need to be specified; possibly testing HbA1c by some other methods, or using other long term blood sugar control tests based on the amount of sugar attached to other proteins in the blood. The basic aspects of this can be worked out by some primary care physicians or endocrinologists - if it gets to be a particularly challenging question difficult to resolve, there are a number of centers around the world with particular expertise in this area. The University of Cincinnati Division of Endocrinology is one of them. Here are references to two of our recent reviews on the subject:
- Cohen, R.M. A1C: does one size fit all? (Invited Editorial) Diabetes Care 30: 2756-2758, 2007.
- Cohen RM, Joiner CH, Franco RS. Discordant HbA1c - the Hoofbeats Increase (invited editorial). J. Pediatrics 153:7-9, 2008
Robert M Cohen, MD
Professor of Clinical Medicine
College of Medicine
University of Cincinnati