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Medical Forum / Diseases and Disorders / Diabetes / December 2006

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OGTT for someone with normal FBG and "diabetic" symptoms

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Adruv - 13 Dec 2006 23:03 GMT
I read a paper [*] - see Table 4 in particular - that suggests that
lean people without a diagnosis of diabetes are more likely to get a
positive result on an OGTT than on a FBG test, and that for overweight
people it's the other way around.

I am 31 years old, of normal weight (BMI = 24), and have a high-normal
FBG level (5.4 (97) and 5.1 (92) on lab tests done in March and July).
During the last 15 years, I've been unusually thirsty and have often
had tingling in my hands and feet. Both symptoms are worse after eating
or after drinking alcohol. I have high blood pressure (particularly
systolic) and have recently developed erectile dysfunction. My lipid
profile is normal.

My doctor is so confident that I don't have diabetes that he is
reluctant to give me an OGTT. I would like to have the OGTT, and think
that the paper supports my request.

I wonder if anyone has any comments?

[*] http://www.bmj.com/cgi/content/full/317/7155/371?ck=nck
Laura@notmy.com - 13 Dec 2006 23:38 GMT
>I read a paper [*] - see Table 4 in particular - that suggests that
>lean people without a diagnosis of diabetes are more likely to get a
[quoted text clipped - 16 lines]
>
>[*] http://www.bmj.com/cgi/content/full/317/7155/371?ck=nck

Hi,
Have you got a Glucose meter that you can use to monitor your fasting,
1 & 2 hour post meal numbers, that you could log and show your doctor
to give him (her?) a real time example of what is going on with you.
It might give the doc the kick in the tush needed to send you in for a
OGTT or possibly give you the peace of mind that comes from knowing
that things are okay.

A lot of folks who don't have insurance to back them up use the
Walmart brand Relion Ultima as the meter itself costs less than ten
bucks and 100 strips for under $50.  My understanding is that while it
doesn't have a lot of bells and whistles, it is pretty accurate and
might fit your need.

Just a thought.
Laura
oldal4865 - 14 Dec 2006 00:41 GMT
>I read a paper [*] - see Table 4 in particular - that suggests that
>lean people without a diagnosis of diabetes are more likely to get a
[quoted text clipped - 16 lines]
>
>[*] http://www.bmj.com/cgi/content/full/317/7155/371?ck=nck

  The OGTT consists of taking 75 gram of glucose on a fasting stomach with
300 ml or so of fluid,   then checking your blood sugar over a 2 hour
period.

If you can get your hands on 75 gram of glucose and a home blood sugar
testing meter,   (Wal-Mart Relion house brands are cheap and "good enough" )
you can do your own OGTT.    You won't do as good a job as the medical pro's
but the data might either reduce your anxiety or convince your doctor.

You can buy "weighed" glucose tabs OTC at most pharmacies.

Note that some folks find OGTT to be a very unpleasant experience.

For a look at some OGTT curves,  and some advice for a do-it-yourself OGTT:

 http://www.rajeun.net/gtt.html#Diabetes and Hypoglycemia

 ( http://tinyurl.com/c5xqo )

The fellow who put this web site together has a few odd opinions but his raw
data are taken from good medical reports.

FWIW,  FbG can be an unreliable indicator.   AIUI,   the European medical
community prefers to interpret after-eating sugars,   the U.S. community
prefers FbG,  but both regard OGTT as a definitive standard.

Regards
 Old Al
Chris Malcolm - 14 Dec 2006 13:55 GMT
> I read a paper [*] - see Table 4 in particular - that suggests that
> lean people without a diagnosis of diabetes are more likely to get a
> positive result on an OGTT than on a FBG test, and that for overweight
> people it's the other way around.

> I am 31 years old, of normal weight (BMI = 24), and have a high-normal
> FBG level (5.4 (97) and 5.1 (92) on lab tests done in March and July).
[quoted text clipped - 3 lines]
> systolic) and have recently developed erectile dysfunction. My lipid
> profile is normal.

> My doctor is so confident that I don't have diabetes that he is
> reluctant to give me an OGTT. I would like to have the OGTT, and think
> that the paper supports my request.

> I wonder if anyone has any comments?

Although I had a T2 diabetic mother, my doctor kept telling me don't
worry, you're not yet diabetic, because I was a) not fat, b) not
pissing sugar, c) my random blood sample taken when I turned up in his
surgery were fine, and d) when I made a fuss and he checked my fbg,
that was fine too. Why did I mkae a fuss? Because I was already
showing some symptoms consistent with diabetes, such as peripheral
neuropathy, confusion and drowsiness after meals, and a heart
attack. But according to my doc these were all more easily explained
by the simple fact that I was suffering from age. He could tell that
from my date of birth. No need to suggest the unlikely possibility of
diabetes, unlikely because I wasn't fat etc..

Then I bought a cheap BG meter and made a graph of my BG response to
my healthy breakfast of muesli with milk and no added sugar or
fruit. I showed it to my doctor. He explained that I must be one of
those untypical diabetics who have ok fbgs and aren't fat.

Incidentally, once I discovered I was diabetic and started controlling
my BGs by diet (I was already exercising to keep the heart problems at
bay), many of those symptoms of age I'd been suffering from started to
improve. Including the heart problems. Exercise and medication had
helped a bit, but adapting my already heart-healthy diet in the
direction of a low-spike diet with the aid of my meter made a lot
faster anf bigger improvement in my cardiac symptoms than the previous
treatment by exercise, medication, and a heart-healthy diet. Stripping
the BG spiking carbs out of my already heart-healthy diet were what
made the biggest improvement.

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/]

Michelle - 14 Dec 2006 22:36 GMT
I would definitely press for the OGTT.  In "most" (but not) Type 2's, the
post-prandial sugars show abnormalities before the FBG.  I am a case in
point.  My FBG runs about 90, however, if I eat a starchy food--bread, rice,
fruit juice--my post-prandial sugar will spike at 180 at 1 hr.  It then
falls to below 140 at the 2 hour mark.  Before I eliminated the foods that
caused that spike from my diet, I felt pretty crappy.  I was tired all the
time, and hungry all the time.  I feel so much better on the controlled
diet.

If your doctor refuses the OGTT, then I would suggest that you get a
glucometer and test yourself.  This is what I did.  Then if you find that
your post-prandial sugars are abnormal, you've got information to give to
your doctor so that he/she can see what you're talking about.
Signature

Michelle, T2
diet & exercise

>I read a paper [*] - see Table 4 in particular - that suggests that
> lean people without a diagnosis of diabetes are more likely to get a
[quoted text clipped - 16 lines]
>
> [*] http://www.bmj.com/cgi/content/full/317/7155/371?ck=nck
Susan - 15 Dec 2006 00:56 GMT
> I would definitely press for the OGTT.  In "most" (but not) Type 2's, the
> post-prandial sugars show abnormalities before the FBG.  I am a case in
[quoted text clipped - 9 lines]
> your post-prandial sugars are abnormal, you've got information to give to
> your doctor so that he/she can see what you're talking about.

Whereas I would much prefer to drill hot screws through my eyeballs
before I'd every have an oral GTT again.

A meter does the trick just fine, thanks.  ;-)

Susan
Michelle - 15 Dec 2006 19:34 GMT
> x-no-archive: yes
>
[quoted text clipped - 18 lines]
>
> Susan

Personally, I'm with you Susan.  I've never had one--my glucometer readings
were good enough for me--but I've administered quite a few as a lab tech.
Those 5 hour OGTTs are killers!
Signature

Michelle, T2
diet & exercise

Priscilla H. Ballou - 15 Dec 2006 20:59 GMT
> x-no-archive: yes
>
[quoted text clipped - 15 lines]
> Whereas I would much prefer to drill hot screws through my eyeballs
> before I'd every have an oral GTT again.

A hot screw through my eyebrow is what mine felt like, 15-20 years ago.  
Migraine city!

> A meter does the trick just fine, thanks.  ;-)

Yup.

Priscilla
 
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