From a dietitian in Brooklyn, New York, USA:
I currently seeing a 35 year old healthy black woman who was recently diagnosed with type 2 diabetes by her primary care physician. She complained of fatigue but no other symptoms, and the family history shows only a maternal grandmother with diabetes. She exercises avidly and has had two sets of labs (six weeks apart) with dietary intervention between the two:
TEST FIRST SET SECOND SET Fasting Blood Glucose 190 mg/dl [10.6 mmol/L] 163 mg/dl [9.1 mmol/L] A1c 6.8% 6.3% GAD-65 antibody --- <1.0 C-peptide --- 1.0
The doctor's recommendation is to start oral medications, but I am wondering if she really has type 2 diabetes as he suspects. Are there other tests she should have? Are there certain medications that might work better than others?
The American Diabetes Association defines diabetes as two venous fasting glucose levels greater than 126 mg/dl [7 mmol/L], so. on the basis of the described fasting glucose levels, she has diabetes. The hemoglobin A1c is elevated, but this is not a sensitive test for diabetes. The labs are also consistent with type 2 diabetes. Her anti-GAD 65 antibody is negative and the C-peptide is not unmeasurable.
My usual recommendation would be to start with metformin because of its ability to normalize the glucose at this level of hyperglycemia without hypoglycemia. In addition, this medication is not associated with weight gain, unlike the other oral hypoglycemic agents.
Original posting 27 Jun 2003
Posted to Diagnosis and Symptoms
|Return to the Top of This Page|
Last Updated: (none)
This Internet site provides information of a general nature and is designed for educational purposes only. If you have any concerns about your own health or the health of your child, you should always consult with a physician or other health care professional.
This site is published by T-1 Today, Inc. (d/b/a Children with Diabetes), a 501c3 not-for-profit organization, which is responsible for its contents. Our mission is to provide education and support to families living with type 1 diabetes.
© Children with Diabetes, Inc. 1995-2018. Comments and Feedback.