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Diabetes

Pre-diabetes or LADA?

09/28/2010

Question:

I am glad to find an opportunity to ask my question. I am fed up with searching the Net for finding the answer of my question. I have lost my concentration on my work and life , because I am constantly searching the Net in order to find the answer.My doctor does not say the answer.

I am a 31-year old man and about 20 kilograms underweight. My fasting blood sugar was 6,3 about 2 months ago . At that time I did not exercise at all . Afterwards I started dieting and exercising, blood sugar level readings have been 6,1 and 6,2 in the next readings (with rice at the night before as dinner), but my own two last readings at home were 4,8 and 4,9 (today and two days ago, I think this has something to do with replacement of exercising with simple walking). My first H1C was 4,4 ( about 6 weeks ago) and the second was 4,3 ( about 2 weeks ago). I absolutely avoid eating sugar , cookies , coke, beer ,wine and soft drinks as well as coffee and tea after my first test. Before that I did. Specially lots of sugar and rice. I mostly eat chicken and fish and walk 30 minutes everyday ( all of these changes have happened after my first test).I have done myself a number of one-hour and two hours post-meal test and have not found any result out of normal range.The strange thing is my 2 hour post-meal result is usually higher than one-hour one.

Due to my age and weight my main concern is if my elevated fasting blood sugar levels are fitted in only pre-diabetes category or they are the start point of LADA or MODY or any other type of diabetes. I have no history in my family and my cholesterol is normal.I have had some emotional struggles in the last few months and experienced some unpleasant dreams and nightmares before my first reading. In one case somebody said to me that I have blood cancer and I will die within two years which I think probably was start of my problems with blood sugar although I am not sure and don`t know which one has been the cause of other one , my blood test in terms of cancer was OK. I sometimes feel biterness in my mouth (has become better now, it was worse during the past weeks), dryness in my palate (is more recently but not very often) and I have two red sites close to my genital organ on inner part of my thighs on both legs (become better and worse frequently)and some sharp pains in my shins (not very often). My doctor in Sweden says these symptoms have another explanations but I am sure that there is something wrong. What do you think ? what can I do for understanding my situation? And what should I do for halting elevated blood sugar levels from worsening? How fast does it go ahead, my increasing in blood sugar level? I am an Iranian but have been lived in Sweden for about 18 months (in terms of my origin).

Thank you very much indeed in advance.

Answer:

It sounds like you are having a difficult time with your health concerns! Without knowing your complete medical history, the best we can say is that you have mildly elevated blood sugars. Diet and exercise improved your blood sugar levels. Elevated blood sugars can be from diabetes but they could be the result of other things (for example elevated hormone levels such as cortisol or growth hormone.)

You relate other health issues as well; have you ever been evaluated for autoimmune disorders (examples would be hypothyroidism, Graves, Addison's)? After ruling out any secondary cause of elevated blood sugars, classification of diabetes could begin. This could include an extensive medical history (including family history), and physical, and possibly tests for the presence of autoantibodies, genetic testing for rarer causes of diabetes, an oral glucose tolerance test, and a HA1C test. You write that you have seen a doctor; perhaps it would be good to further discuss your concerns with him and see what diagnostic and treatment plan he or she can offer. Good luck to you!

For more information:

Go to the Diabetes health topic, where you can:

Response by:

Margaret G Doyle, RD, LD, CDE Margaret G Doyle, RD, LD, CDE
Formerly
Case Western Reserve University