Diabeetus!
May 11, 2010 6:43 PM Subscribe
Should I be worried about a higher-than-normal fasting glucose level (117) on my last blood draw? And if so, what should do about it?
So a few weeks ago, I had a routine physical, and mentioned to my doctor three physical complaints I've had: achy muscles/joints, general fatigue, and super heavy periods (not as heavy as some of the women in this thread, but heavy enough). We discussed that some of these problems may be caused or worsened by various edocrine issues. The doctor sent me to get my blood tested for a whole bunch of things.
Anyway, the blood tests came back, and it turned out I had crazy low Vitamin D levels (15) and blood iron (7.4, eek!), which explains the fatigue and maybe the joint pain. But my doctor assured me everything else was fine, so we decided that I should go on a serious course of iron and Vitamin D supplements, and see if going on birth control pills would control my periods (if they don't help, we'll do an ultrasound to see if it's uterine fibroids).
However, I'd asked to see a printout of my blood test results, and when I got home and looked at it, I noticed that my glucose level was listed at 117, which seems to be below the diabetes cut-off but above healthy levels, putting me in the "pre-diabetic" range. Yikes!
I don't know much about "pre-diabetes" and I'm not sure what my next steps should be. I have a follow-up with my GP in a month to check on my periods and my iron/Vitamin D levels. Should I wait till then to ask her about this, or should I call her this week? And what should I ask for? Another test? Or to see a specialist?
Normally I wouldn't freak out if the doctor wasn't worried, but diabetes is Serious Business, and I would like to nip this in the bud if possible.
So a few weeks ago, I had a routine physical, and mentioned to my doctor three physical complaints I've had: achy muscles/joints, general fatigue, and super heavy periods (not as heavy as some of the women in this thread, but heavy enough). We discussed that some of these problems may be caused or worsened by various edocrine issues. The doctor sent me to get my blood tested for a whole bunch of things.
Anyway, the blood tests came back, and it turned out I had crazy low Vitamin D levels (15) and blood iron (7.4, eek!), which explains the fatigue and maybe the joint pain. But my doctor assured me everything else was fine, so we decided that I should go on a serious course of iron and Vitamin D supplements, and see if going on birth control pills would control my periods (if they don't help, we'll do an ultrasound to see if it's uterine fibroids).
However, I'd asked to see a printout of my blood test results, and when I got home and looked at it, I noticed that my glucose level was listed at 117, which seems to be below the diabetes cut-off but above healthy levels, putting me in the "pre-diabetic" range. Yikes!
I don't know much about "pre-diabetes" and I'm not sure what my next steps should be. I have a follow-up with my GP in a month to check on my periods and my iron/Vitamin D levels. Should I wait till then to ask her about this, or should I call her this week? And what should I ask for? Another test? Or to see a specialist?
Normally I wouldn't freak out if the doctor wasn't worried, but diabetes is Serious Business, and I would like to nip this in the bud if possible.
Best answer: Long story short, get serious about exercise and diet.
Exercise: Do you know what'd you like to do, i.e. running or swimming or whatever? If so, get into that. If not, make an effort to spend the next year or the rest of this year trying out various physical activities and finding out which ones you really enjoy. If you don't enjoy, don't make yourself do them, no matter what anyone says, 'cause over time you'll probably come to really hate doing it, associate that hate with doing exercise at all and then stop exercising. Make it your goal to find several things you like and develop your skills with them. The key is to do things you enjoy so you'll want to keep doing them.
Diet: Find a nutritionist or even better a nutritionist that is also a diabetes coordinator. Work with her on changing your eating habits. Start small, with a single meal, just trying to figure out what a healthy breakfast, what you like and finding different ways to ensure that you'll eat a healthy breakfast. Build on those skills you learn doing that to lunch, dinner, snacking and going out to eat.
Go slow, give yourself time to learn and adjust, it can be hard sometimes. Don't worry if you fall off the wagon, just get back on and try again. You can do this. I'm a Type II Diabetic and these are steps I went through to take weight off and bring my numbers. Losing just 10 or 20 lbs can make a major difference.
posted by Brandon Blatcher at 7:29 PM on May 11, 2010 [1 favorite]
Exercise: Do you know what'd you like to do, i.e. running or swimming or whatever? If so, get into that. If not, make an effort to spend the next year or the rest of this year trying out various physical activities and finding out which ones you really enjoy. If you don't enjoy, don't make yourself do them, no matter what anyone says, 'cause over time you'll probably come to really hate doing it, associate that hate with doing exercise at all and then stop exercising. Make it your goal to find several things you like and develop your skills with them. The key is to do things you enjoy so you'll want to keep doing them.
Diet: Find a nutritionist or even better a nutritionist that is also a diabetes coordinator. Work with her on changing your eating habits. Start small, with a single meal, just trying to figure out what a healthy breakfast, what you like and finding different ways to ensure that you'll eat a healthy breakfast. Build on those skills you learn doing that to lunch, dinner, snacking and going out to eat.
Go slow, give yourself time to learn and adjust, it can be hard sometimes. Don't worry if you fall off the wagon, just get back on and try again. You can do this. I'm a Type II Diabetic and these are steps I went through to take weight off and bring my numbers. Losing just 10 or 20 lbs can make a major difference.
posted by Brandon Blatcher at 7:29 PM on May 11, 2010 [1 favorite]
have you been tested for polycystic ovary syndrome?
I had high fasting glucose at my last bloodwork, but it was lower than yours (108). Both my GP and my OB/GYN were concerned about my fasting glucose levels being so high, but I also have a history of ovarian cysts and a strong family history of diabetes, I don't know if you do. My doctor sent me for a glucose tolerance test to see if I was pre-diabetic. Has your doctor mentioned this as the next step?
I would definitely speak with your doctor about what to do. Mine told me to exercise, avoid processed sugary foods, white flour, and to avoid foods with a high glycemic index.
posted by inertia at 7:44 PM on May 11, 2010
I had high fasting glucose at my last bloodwork, but it was lower than yours (108). Both my GP and my OB/GYN were concerned about my fasting glucose levels being so high, but I also have a history of ovarian cysts and a strong family history of diabetes, I don't know if you do. My doctor sent me for a glucose tolerance test to see if I was pre-diabetic. Has your doctor mentioned this as the next step?
I would definitely speak with your doctor about what to do. Mine told me to exercise, avoid processed sugary foods, white flour, and to avoid foods with a high glycemic index.
posted by inertia at 7:44 PM on May 11, 2010
Normally, if your doctor is not concerned, you should not be. But ask her about it at your upcoming visit, by all means.
Are you somewhat overweight? Losing weight and moderate exercise are the usual recommendations for this situation. BB has some good ideas.
posted by yclipse at 7:50 PM on May 11, 2010
Are you somewhat overweight? Losing weight and moderate exercise are the usual recommendations for this situation. BB has some good ideas.
posted by yclipse at 7:50 PM on May 11, 2010
It takes multiple consecutive high FBS Glucose readings to confirm a diagnosis of Diabetes. When you return to your primary care provider, see if you can't get him to test your HgbA1C (glycosylated hemoglobin). Familiarize yourself with the new guidelines for diabetes diagnosis and make sure that your physician is also aware. In the event that you wind up being diagnosed with diabetes or metabolic syndrome, my current employer has some materials that may be of interest.
posted by The White Hat at 8:24 PM on May 11, 2010 [3 favorites]
posted by The White Hat at 8:24 PM on May 11, 2010 [3 favorites]
Since you didn't say in your question, were you fasting before your blood was drawn? Prediabetes is defined as a FASTING blood glucose between 100 and 126, which means you haven't eaten anything for 8 hours or more before the test. Most doctors don't ask you to fast prior to bloodwork unless they're specifically looking for something like diabetes. If you had food within 8 hours before your blood was drawn, your glucose levels are probably totally normal.
If you were fasting, here's the info from my (2007) med-surg nursing textbook on prediabetes:
"Most people with prediabetes are at increased risk for developing type 2 diabetes, and if no preventive measures are taken, they will usually develop it within 10 years. Long-term damage to the body, especially the heart and blood vessels, may already be occurring in patients with prediabetes. People with prediabetes usually do not have symptoms. Individuals with prediabetes should watch for the symptoms of diabetes, such as polyuria, polyphagia, or polydipsia [peeing a lot, eating a lot, or drinking a lot of liquids].
If action is taken to manage blood glucose, patients with prediabetes can delay or prevent the development of type 2 diabetes. Maintaining a healthy weight, exercising regularly, and eating a healthy diet have all been found to reduce the risk of developing diabetes in people with prediabetes."
So the advice above is all great: exercise, maintain a healthy weight, and try to avoid highly-processed, simple-carbohydrate foods.
posted by vytae at 8:30 PM on May 11, 2010
If you were fasting, here's the info from my (2007) med-surg nursing textbook on prediabetes:
"Most people with prediabetes are at increased risk for developing type 2 diabetes, and if no preventive measures are taken, they will usually develop it within 10 years. Long-term damage to the body, especially the heart and blood vessels, may already be occurring in patients with prediabetes. People with prediabetes usually do not have symptoms. Individuals with prediabetes should watch for the symptoms of diabetes, such as polyuria, polyphagia, or polydipsia [peeing a lot, eating a lot, or drinking a lot of liquids].
If action is taken to manage blood glucose, patients with prediabetes can delay or prevent the development of type 2 diabetes. Maintaining a healthy weight, exercising regularly, and eating a healthy diet have all been found to reduce the risk of developing diabetes in people with prediabetes."
So the advice above is all great: exercise, maintain a healthy weight, and try to avoid highly-processed, simple-carbohydrate foods.
posted by vytae at 8:30 PM on May 11, 2010
It's been said before, but I want to emphasize: diabetes is not diagnosed with a single test.
Blood sugar is part of a complicated endocrine pathway. It has to do with more than insulin and diet. If you are sick, your blood sugar goes up; sometimes, your blood sugar goes up before you realize you're sick. If you drink an unsweetened cup of black coffee in the morning (maybe you did, because it doesn't screw with the other labs that they were more concerned about), it increases your blood sugar.
It's great that you're paying attention to this stuff. Everyone could benefit from paying more attention to their diet and exercising more frequently. The advice to do so is great, but it's also premature to actually worry about pre-diabetes. (There are caveats. You may have other health issues where following popular ideas about diet and exercise might be unsafe. I can't know that, so, duh, don't deviate from your doctor's previous recommendations about diet.)
Even if you are prediabetic, it is not yet time to freak out. This doesn't mean you're at any risk of immediate harm. The increased risks associated with diabetes and prediabetes take years, maybe decades, to add up to serious health problems. A month is a blink of an eye for where you're at now.
Short version: Wait a month, talk about it with your GP. Don't worry about it until then.
posted by nathan v at 9:15 PM on May 11, 2010
Blood sugar is part of a complicated endocrine pathway. It has to do with more than insulin and diet. If you are sick, your blood sugar goes up; sometimes, your blood sugar goes up before you realize you're sick. If you drink an unsweetened cup of black coffee in the morning (maybe you did, because it doesn't screw with the other labs that they were more concerned about), it increases your blood sugar.
It's great that you're paying attention to this stuff. Everyone could benefit from paying more attention to their diet and exercising more frequently. The advice to do so is great, but it's also premature to actually worry about pre-diabetes. (There are caveats. You may have other health issues where following popular ideas about diet and exercise might be unsafe. I can't know that, so, duh, don't deviate from your doctor's previous recommendations about diet.)
Even if you are prediabetic, it is not yet time to freak out. This doesn't mean you're at any risk of immediate harm. The increased risks associated with diabetes and prediabetes take years, maybe decades, to add up to serious health problems. A month is a blink of an eye for where you're at now.
Short version: Wait a month, talk about it with your GP. Don't worry about it until then.
posted by nathan v at 9:15 PM on May 11, 2010
If you don't currently exercise, do so. It is one of the best ways to control your blood sugar levels. You aren't at the 'OMG I'm diabetic!' level yet so now is a good time to get a grip on it.
Oh yeah, cut out processed foods too.
posted by MsKim at 10:15 PM on May 11, 2010
Oh yeah, cut out processed foods too.
posted by MsKim at 10:15 PM on May 11, 2010
As someone with polycystic ovarian syndrome ans insulin resistance, The White Hat has it. Nathan v gives good info as well. The A1C test will give you your average blood sugars over the past 3 months as well as your insulin level. Pretty fascinating test in my opinion.
I would definitely pay attention to diet and exercise and ask your doctor about it and ask for a retest in a month. Your sugar can be high for any number of reasons, so this one result just may be a fluke.
posted by MultiFaceted at 11:08 PM on May 11, 2010
I would definitely pay attention to diet and exercise and ask your doctor about it and ask for a retest in a month. Your sugar can be high for any number of reasons, so this one result just may be a fluke.
posted by MultiFaceted at 11:08 PM on May 11, 2010
Yeah, you need an A1c as well as a fasting glucose to get a better idea of where you're at. I ran high (105ish) for a couple of months, but my A1c was consistently decent (below the pre-diabetes 5.7-6.4). I cut out potatoes and white rice, I continue to avoid soda when possible, and I try to hit the exercise bike more days than not. My A1c's gotten lower and my fasting glucose is back below 100, so I guess it's been working out for me.
posted by fairytale of los angeles at 1:00 AM on May 12, 2010
posted by fairytale of los angeles at 1:00 AM on May 12, 2010
Best answer: My understanding is that blood sugar goes up and down a lot during the day, and that one test in isolation doesn't mean much.
(Also - my vitamin D level was 17 a couple of months ago. It's almost up to normal now, memail me if you want the details)
posted by insectosaurus at 7:35 AM on May 12, 2010
(Also - my vitamin D level was 17 a couple of months ago. It's almost up to normal now, memail me if you want the details)
posted by insectosaurus at 7:35 AM on May 12, 2010
It's been said before, but I want to emphasize: diabetes is not diagnosed with a single test.
Nah, it's possible. It really depends on what the glucose level is when tested. 117 isn't such a concern but a sufficiently high number (150? 200? Somewhere up there) would be enough to get you tagged as Type II on the spot.
posted by Brandon Blatcher at 7:42 AM on May 12, 2010
Nah, it's possible. It really depends on what the glucose level is when tested. 117 isn't such a concern but a sufficiently high number (150? 200? Somewhere up there) would be enough to get you tagged as Type II on the spot.
posted by Brandon Blatcher at 7:42 AM on May 12, 2010
Response by poster: inertia - I was tested for PCOS. I was actually quite concerned about this as a possibility because I am overweight, but my FSH, LH and testosterone levels were all within normal ranges. This is something I will keep my eye on though.
insectosaurus, I just memailed you, thanks!
Thanks everyone for the super helpful answers. Especially Brandon Blatcher , that is some really, really helpful advice, especially on the exercise. I'm going to wait till my next appointment, but in the meantime I'll use this as a good wake-up call to change some of my less-healthy habits.
posted by wholebroad at 11:39 PM on May 12, 2010
insectosaurus, I just memailed you, thanks!
Thanks everyone for the super helpful answers. Especially Brandon Blatcher , that is some really, really helpful advice, especially on the exercise. I'm going to wait till my next appointment, but in the meantime I'll use this as a good wake-up call to change some of my less-healthy habits.
posted by wholebroad at 11:39 PM on May 12, 2010
This thread is closed to new comments.
posted by infinitywaltz at 7:17 PM on May 11, 2010