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The American Diabetic Association criteria for diagnosing diabetes include three different ways to make the diagnosis
1. symptoms of diabetes (increased urination, increased thirst, and unexplained weight loss) and a random glucose over 200 mg/dl
2. a fasting glucose (no food intake for over 8 hours) over 126mg/dl
3. a 2-hour glucose above 200 mg/dl during a oral glucose tolerance test (OGTT) using a 75 gm oral glucose load.
Your wife does have symptoms that are seen in diabetes but does not have a random (no relation to meals) glucose test that is above 200 so she does not meet criteria 1. Before OGTT you have to fast, and from your post her glucose value when she walked in the door was 70 which is below the 126mg/dl limit so she does not meet criteria 2. None of the values that you listed after she got the oral glucose load was above 200mg/dl cut off that is listed in criteria 3 so she does not meet that criteria either. So by the ADA guidelines she does not have diabetes.
Common factors that non-specifically deteriorate the OGTT include (1) carbohydrate restriction (150 g for 3 days), (2) bed rest (days) or severe inactivity (weeks), (3) medical or surgical stress, (4) drugs (5) smoking during the test, or (6) anxiety from repeated needlesticks. If any of these factors apply the OGTT she took may not be accurate.
In addition to diagnosing frank diabetes the OGTT can also diagnose something called impaired glucose tolerance which is defined as a fasting glucose less than 126 mg/dL and a 2-hour OGTT level between 140 and 200 mg/dL. Although your wife does not meet these criteria, her high value of 135 does come close to the cut off of 140. Impaired glucose tolerance (IGT) is thought of as a precursor to frank diabetes, but we can not reliably predict which people with IGT will go on to develop diabetes. The treatment for IGT is a good well balanced diet, exercise, and continued surveillance for any signs that things are progressing towards diabetes. Given what you have already said she is already doing these things, so she is ahead of the game so to speak when it comes to preventing diabetes.
Normal blood glucose ranges from 70 to 100 and her last value of 55 is considered hypoglycemic. I don’t really understand why it keeps dropping so I will do some reading and maybe one of the other health professional can enlighten us.
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