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Medical Forum / Diseases and Disorders / Diabetes / December 2006

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Pontential Diabetic

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Puckertoe - 07 Dec 2006 15:27 GMT
Greetings Folks,

I suspect I'm diabetic. I guess some quick history:

Week 44 of 48 week treatment from hepatitis c. During that time on
Prednisone for a month. Glucose levels through the roof >300 during routine
bloodtests. Previous blood tests always showed in the normal range. This
caused horrid thirst, non-stop eating, peeing, and blurred vision. The
thirst only lasted for a night or so. The blurred vision for at least a
month.

Vison, thirst, and such is all normal now. This happened about six months
ago.

I've suspected that I'm now diabetic due to this so I bought a Rite-Aid
meter and started taking tests.

The first fasting test showed 55, then two hours after eating 100, 105, and
then 107.

What really concerns me now is that the last three morning tests showed 126,
142, and 133.

From what I've read this could be indicative of a Type II diabetic, correct?
<<sigh>>

I know that my dr is the only one that can diagnose me, but I thought I'd
come out here and find out what you folks thought.

BTW, I'm not very active at all due to the hep treatment. Not sure if that
matters or not.

Thanks for any help,

-Puckertoe
Alice Faber - 07 Dec 2006 16:12 GMT
> Greetings Folks,
>
[quoted text clipped - 29 lines]
>
> Thanks for any help,

Prednisone is known to raise blood sugar levels, and, alas, the effect
doesn't always go away when the pred is stopped. The numbers you
reported certainly suggest T2 diabetes, but you should call your doctor
and discuss the matter with him or her.

Signature

"and the snark alert level has reached "fuschia""
                  ---zig zigalo homes in on the meat of the matter

coonskin@amestwp.com - 07 Dec 2006 17:00 GMT
See:

'Adult Onset Diabetes Mellitus in Hepatitis C Virus Infection'

http://www.hcvadvocate.org/hcsp/articles/Azocar-1.html
oldal4865 - 07 Dec 2006 17:27 GMT
>Greetings Folks,
>
[quoted text clipped - 31 lines]
>
>-Puckertoe

  You're right,  you're not diabetic until a Doctor makes a formal
diagnosis.   That means you can buy life insurance now,  but may not be able
to in a while.

Some of the criteria a doctor should use for the diagnosis include:

 1.   Two sugars above 200 for any reason at any time,  or

 2.    Fasting blood sugars above 126.

e.g.

Diabetes Care
Volume 23 Supplement 1
American Diabetes Association:
Clinical Practice Recommendations 2000

"DIAGNOSTIC CRITERIA FOR DIABETES MELLITUS
The new criteria
The diagnostic criteria for diabetes mellitus have been modified from those
previously recommended by the NDDG (1) or WHO (2). The revised criteria for
the diagnosis of diabetes are shown in Table 3. Three ways to diagnose
diabetes are possible, and each must be confirmed, on a subsequent day, by
any one of the three methods given in Table 3. For example, one instance of
symptoms with casual plasma glucose >200 mg/dl (11.1 mmol/l), confirmed on a
subsequent day by 1) FPG >126 mg/dl (7.0 mmol/l), 2) an OGTT with the 2-h
postload value >200 mg/dl (11.1 mmol/l), or 3) symptoms with a casual plasma
glucose >200 mg/dl (11.1 mmol/l), warrants the diagnosis of diabetes.. . ."

Sorry,  but you look to be a full member of our Club  (the Club nobody wants
to join)

Diabetes is a progressive disease.   Your symptoms suggest that you are in
"The Standard Type 2 Diabetes Progression".      Odds are,  with symptoms
such as you exhibit,  that you will lose more and more control over your
sugars as the disease progresses.

The standard attack on adult-onset diabetes is a lifestyle change.   The
weapons:

  1.  Lose fat lb,  especially abdominal fat
  2.  Gain muscle lb
  3.  Exercise every day.   The more vigorously the better,  but every day
is important
  4.  Reduce your carb intake;  aim for slowly-digesting carb;  spread your
daily carb over several small meals.

If you want to read about "The Progression",  try:

"The Progression and Natural History of Type 2 Diabetes"

A very good speech to doctors by an Endo, given at the 2001 ADA convention,
presented at the URL shown below.

http://www.medscape.com/viewprogram/145

When you get to the site, select  “The Progression and Natural History of
Type 2 Diabetes” in the table of contents.   Note the section on
Macrovascular (damage leading to premature heart attack) complications on
Slide 6 which starts an estimated 5 years before any symptoms, much less any
statistical diagnosis.   Note the extrapolation in Slide 9  which indicates
that eye damage starts 6.5 years before diagnosis.  Note the extrapolation
on Slide 10  which indicates that damage to beta cells from high Insulin
Resistance starts 10 years before diagnosis.

(Note:  you have to register with Medscape but that's a good idea for any
diabetic.    They don't spam or sell your info and you can make up phony
info anyway)

If you want to read a detailed approach to lifestyle changes,  try
Jennifer's advice to the newly diagnosed at

http://www.alt-support-diabetes.org/NewlyDiagnosed.htm

Three cheers for the meter,  et al.    Most folks end up being ambushed by
the disease.   A couple of years of hidden high blood sugars can do serious
damage to your eyes,  kidneys,  arteries and nerves.    You have a fighting
change to avoid most of that.

In any case,  keep coming back.   Diabetes is one of the odd diseases in
which the patient does all the work and most of the management.  The docs
mostly sit on the sidelines,  cheering us on and writing the occasional
prescription.    The more you learn about this disease and the faster you
learn it,  the better your chances for a long and pain-free life.
Conversely,  ignore the disease and the better your chances for a shortened,
painful life.

One addenda:   I don't understand the relationship between hepatitis and
adult-onset Diabetes.    My readings suggest that you may be a candidate for
insulin injection at some point in time far sooner than typically expected
by the majority of adult-onset diabetics.    (Or I may be "all wet")

Don't shy away from the suggestion of insulin;  it is not only a lifesaver;
it makes your life much easier and more pleasant.  When I first realized
that I would need insulin injections,  I almost threw up.    By the second
day,   they were nothing special.

Reading the diabetes newsgroups   (alt.support.diabetes,
misc.health.diabetes) every night has produced substantial improvements in
my health,  my quality of life,  and,  I'm sure,  my life expectancy.    It
can do the same for you.

Regards
 Old Al
rk - 07 Dec 2006 18:04 GMT
: >Greetings Folks,
: Some of the criteria a doctor should use for the diagnosis include:
:
:  1.   Two sugars above 200 for any reason at any time,  or
:
:  2.    Fasting blood sugars above 126.

still passing BAD info.. *sigh*

it is ANY SINGLE reading at ANY time over 200mg/dL
or
TWO fasting readings over 126mg/dL on different days.

"........
The following lab values are the ADA practice guidelines for the diagnosis
of diabetes:

A random plasma glucose value of 200 mg/dl (11.1 mmol/L) or more (in the
presence of diabetes symptoms)
A plasma glucose value of 126 mg/dl (7 mmol/L) or more
An oral glucose plasma glucose value of 200 mg/dl or higher at 2 hours
post-glucose load

The ADA also maintains that a definitive diabetes diagnosis requires a
second positive test performed on a different day."

http://www.dlife.com/dLife/do/ShowContent/type2_information/diagnosis/diagnosis.html
Chris Malcolm - 07 Dec 2006 20:08 GMT
> : >Greetings Folks,
> : Some of the criteria a doctor should use for the diagnosis include:
> :
> :  1.   Two sugars above 200 for any reason at any time,  or
> :
> :  2.    Fasting blood sugars above 126.

> still passing BAD info.. *sigh*

> it is ANY SINGLE reading at ANY time over 200mg/dL
> or
> TWO fasting readings over 126mg/dL on different days.

> "........
> The following lab values are the ADA practice guidelines for the diagnosis
> of diabetes:

> A random plasma glucose value of 200 mg/dl (11.1 mmol/L) or more (in the
> presence of diabetes symptoms)
> A plasma glucose value of 126 mg/dl (7 mmol/L) or more
> An oral glucose plasma glucose value of 200 mg/dl or higher at 2 hours
> post-glucose load

> The ADA also maintains that a definitive diabetes diagnosis requires a
> second positive test performed on a different day."

> http://www.dlife.com/dLife/do/ShowContent/type2_information/diagnosis/diagnosis.html

What you quote from the ADA doesn't support your single reading
claim. Their recommendation is that any two of the your three cited
tests must be exceeded with readings taken on different days,
including the same test twice. Whether doctors follow their
recommendation is another question...

Signature

Chris Malcolm        cam@infirmatics.ed.ac.uk              DoD #205
IPAB,  Informatics,  JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK
[http://www.dai.ed.ac.uk/homes/cam/]

oldal4865 - 07 Dec 2006 21:41 GMT
>> : >Greetings Folks,
>> : Some of the criteria a doctor should use for the diagnosis include:
[quoted text clipped - 14 lines]
>including the same test twice. Whether doctors follow their
>recommendation is another question...

  Here,  read it again.    Then if it doesn't take,  read it again.

Diabetes Care
Volume 23 Supplement 1
American Diabetes Association:
Clinical Practice Recommendations 2000

"DIAGNOSTIC CRITERIA FOR DIABETES MELLITUS
The new criteria
The diagnostic criteria for diabetes mellitus have been modified from those
previously recommended by the NDDG (1) or WHO (2). The revised criteria for
the diagnosis of diabetes are shown in Table 3. Three ways to diagnose
diabetes are possible, and each must be confirmed, on a subsequent day, by
any one of the three methods given in Table 3. For example, one instance of
symptoms with casual plasma glucose >200 mg/dl (11.1 mmol/l), confirmed on a
subsequent day by 1) FPG >126 mg/dl (7.0 mmol/l), 2) an OGTT with the 2-h
postload value >200 mg/dl (11.1 mmol/l), or 3) symptoms with a casual plasma
glucose >200 mg/dl (11.1 mmol/l), warrants the diagnosis of diabetes.. . ."

Old Al
Alan S - 07 Dec 2006 22:29 GMT
Was: Pontential Diabetic

<snip>

>Diabetes Care
>Volume 23 Supplement 1
[quoted text clipped - 14 lines]
>
> Old Al

Hi All

I changed the title because this is a subject basic to these
groups.

A more current, later, version is below. The 2004 USA
criteria are similar but not identical to the 2000 ones;
note the qualifier re the OGTT.

"Main Article:
http://care.diabetesjournals.org/cgi/content/full/27/suppl_1/s5#T2

Diabetes Care 27:S5-S10, 2004
© 2004 by the American Diabetes Association, Inc.

Position Statements
Original Article

Diagnosis and Classification of Diabetes Mellitus"

This covers all types, and includes this Table:

Table 2— Criteria for the diagnosis of diabetes mellitus
http://care.diabetesjournals.org/cgi/content/full/27/suppl_1/s5/T2

1. Symptoms of diabetes plus casual plasma glucose
concentration 200 mg/dl (11.1 mmol/l). Casual is defined as
any time of day without regard to time since last meal. The
classic symptoms of diabetes include polyuria, polydipsia,
and unexplained weight loss.
or
2. FPG 126 mg/dl (7.0 mmol/l). Fasting is defined as no
caloric intake for at least 8 h.
or
3. 2-h postload glucose 200 mg/dl (11.1 mmol/l) during an
OGTT. The test should be performed as described by WHO,
using a glucose load containing the equivalent of 75 g
anhydrous glucose dissolved in water.

In the absence of unequivocal hyperglycemia, these criteria
should be confirmed by repeat testing on a different day.
The third measure (OGTT) is not recommended for routine
clinical use."
Cheers, Alan, T2, Australia.
d&e, metformin 1000mg, ezetrol 10mg
Everything in Moderation - Except Laughter.
--
http://loraldiabetes.blogspot.com/
http://loraltravel.blogspot.com/
latest: Epidaurus
Chris Malcolm - 08 Dec 2006 11:25 GMT
>>> : >Greetings Folks,
>>> : Some of the criteria a doctor should use for the diagnosis include:
[quoted text clipped - 14 lines]
>>including the same test twice. Whether doctors follow their
>>recommendation is another question...

>    Here,  read it again.    Then if it doesn't take,  read it again.

> Diabetes Care
> Volume 23 Supplement 1
> American Diabetes Association:
> Clinical Practice Recommendations 2000

> "DIAGNOSTIC CRITERIA FOR DIABETES MELLITUS
> The new criteria
[quoted text clipped - 7 lines]
> postload value >200 mg/dl (11.1 mmol/l), or 3) symptoms with a casual plasma
> glucose >200 mg/dl (11.1 mmol/l), warrants the diagnosis of diabetes.. . ."

This appears to be addressed to me, and appears to suggest that I
didn't understand the above. I think it quite unequivocally means what
I said it did.

I'll try and phrase it more clearly and simply. There are three
different tests. For diagnosis a positive test from any one of the
three must be confirmed by another positive test from any one of the
three taken on a subsequent day. One and one makes two.

If you disagree, perhaps you could deign to explain why.

Signature

Chris Malcolm        cam@infirmatics.ed.ac.uk              DoD #205
IPAB,  Informatics,  JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK
[http://www.dai.ed.ac.uk/homes/cam/]

 
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