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Is it possible to predict the start of diabetes in a person?

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General & Family Physician
Practicing since : 2009
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If a patient was diagnosed with diabetes oct 2007 (A1c 9.6) with prior blood glucose of 152 Oct 2006/160 Nov 2006. Is it possible to approximate when that patient became Diabetic. If the person ate a few hours before the first lab draw would nomal insullin response prevent spiking of the blood glucose to a high level?
Posted Thu, 13 Feb 2014 in Diabetes
 
 
Answered by Dr. Shoaib Khan 52 minutes later
Brief Answer: Answers to your queries are: No; yes Detailed Answer: Hello sir and welcome. Thank you for writing to us. Based on the HbA1c provided, it is only possible to indicate how well the individuals blood sugar control has been, and based on your HbA1c, your blood sugar control has been poor. With such a level, we can only say that the blood sugar control has been poor from anywhere between 3-12 months, but then again this cannot be accurately predicted sir. So the answer to your first query, is 'No', it would not be possible to find out exactly when you feel into the category of being diabetic. But you should know that this is a gradual process, and not something that can develop overnight, so it would have gradually begun sometime after your last normal blood sugar reading. Yes it would. If normal insulin is being produced by the body, and reaching the receptors adequately, then it would prevent spiking of the blood glucose to a certain extent. Whereas, in an individual with impaired insulin production or an abnormality of the receptors that receive the insulin, the blood glucose levels would reach a high range. I hope you find my response both helpful and informative sir. Please feel free to write back to me for any further clarifications, I would be more than happy to help you sir. Best wishes.
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Follow-up: Is it possible to predict the start of diabetes in a person? 42 minutes later
Based on the prior blood glucose levels of 152 ate approximatley 6 hours before the lab draw on Oct 2006 and the repeat blood glucuse of 160 nov 2006 fasted the entired 8- 12 hrs.. Is it possible I was a diabetic at that time. The doctor told me she thought I was at the time, wrote this on the second lab which I fasted for the entire 8-12 hours but I in denail continued to run workout and ended up in the E.R. approximately 1 year later due to increased symptoms i.e. sleeping all the time unable to get off the couch, breaking my car key off in ignition due to tiredness lack of concentration, urinating all night going to bed at 218lbs, waking up at 210lbs. I lied on the first blood draw of 152 . I stated I ate right before the lab draw because I was in denail and wanted to prove I was not a diabetic. The second blood draw came back even higher of 160 with strict fasting of 160 8-12 hours. The lab draws were approximately one month apart. Again could I have been a Diabetic at that time of the two prior lab draws.
 
 
Answered by Dr. Shoaib Khan 12 minutes later
Brief Answer: I think you could have been pre-diabetic sir Detailed Answer: Hello once again sir. Well here are the facts that indicate that you could have been diabetic at that time itself: 1. Despite of having a 6 hours gap between the meal and your blood sugar test, your blood sugar level was still 152. It should have been much lower if your insulin production were normal 2. Despite an 8-12 hour fasting prior to the blood sugar check, your blood sugar level was 160 These two parameters and facts indicate a possibility of you being diabetic or pre-diabetic at that time itself sir. So, I agree with your doctor that the condition could have already settled in at that time. Not necessarily diabetes, but more close to pre-diabetes. I hope this information helps you sir. I really appreciate the detail and honestly in your query. Please feel free to write back to me for any further clarifications, I would be more than happy to help you sir. Best wishes.
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Follow-up: Is it possible to predict the start of diabetes in a person? 29 minutes later
So in conclusion I could have been Diabetic or prediabetic right ? What sort of follow-up would have been necessary to determine this. I.E. Glucose challenge test, repeat labs ? How would you have folow-up?
 
 
Answered by Dr. Shoaib Khan 29 minutes later
Brief Answer: Yes; I would order a HbA1c test sir Detailed Answer: Hello once again sir. Yes, you would have been diabetic or pre-diabetic sir. A follow-up following the 2 readings that were taken a month apart? If you are asking what I would have done next: I would have ordered a HbA1c there and then, as this would help me to predict whether or not you had chances of having poor control of your blood sugar levels. The HbA1c would give us two possible scenarios: 1. Good control of blood sugar levels: In which case I would not recommend anything but a healthy diet 2. Poor control of blood sugar levels: In which case I would introduce you to a diabetic diet, exercise and oral hypoglycemic drugs and monitor your response to the change in lifestyle and medications for the first 3 months closely, and then once every 3-6 months. Because a HbA1c would help me to learn about whether or not you require any immediate management or not. I hope you find my response helpful sir. If there is anything I have not explained well enough or not responded to adequately enough, please write back to me and I shall be more than happy to assist you. Best wishes.
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