Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For Fatigue, Breathlessness, Anxiety And Weakness
Question: Dear Doctor,
My question is pertaining to my blood glucose .
Few weeks ago i experienced symptoms of fatigue , shortness of breath, anxiety and weakness.
due to my medical history of heart aneurysm, my first instinct was to consult a cardiologist . I was ordered an ecg and echo both of which showed normal heart results.
as such i wemt for a lab blood and urinalysis test.
I overfasted and took my fasting blood glucose at 18 hours fasting. The results came back at 4.2 mmol/l
of glucose and trace of ketones in my urine. The lab expert told me that it is normal and even diabetics wouldnt get such low figues with fasting 18 hours.
I was anxious and purchaed a blood glucose meter from the pharmacy. What worries me is that for both days i tested preprandial results in the morning are of 5.7 to 6.0 mmol/l. and my usual average 2 hours postprandial are 6.4 mmol/l after high carb lunches.
I am worried that i may be prediabetic and dont know if i should trust the glucose meter or the lab test.
My question is pertaining to my blood glucose .
Few weeks ago i experienced symptoms of fatigue , shortness of breath, anxiety and weakness.
due to my medical history of heart aneurysm, my first instinct was to consult a cardiologist . I was ordered an ecg and echo both of which showed normal heart results.
as such i wemt for a lab blood and urinalysis test.
I overfasted and took my fasting blood glucose at 18 hours fasting. The results came back at 4.2 mmol/l
of glucose and trace of ketones in my urine. The lab expert told me that it is normal and even diabetics wouldnt get such low figues with fasting 18 hours.
I was anxious and purchaed a blood glucose meter from the pharmacy. What worries me is that for both days i tested preprandial results in the morning are of 5.7 to 6.0 mmol/l. and my usual average 2 hours postprandial are 6.4 mmol/l after high carb lunches.
I am worried that i may be prediabetic and dont know if i should trust the glucose meter or the lab test.
Brief Answer:
Glucose
Detailed Answer:
I follow what you are saying.
There is no need to worry.
All four blood glucose values, whether they were laboratory or home meter readings, are within normal limits.
The trace of ketones is likely due to the extended fasting.
This type of testing is fine and it essentially rules out any pre diabetes/diabetes. However the gold standard is the glucose tolerance test:
OGTT PROTOCOL FOR NON PREGNANT ADULTS TO SCREEN FOR DIABETES
1 OGTT = ORAL GLUCOSE TOLERANCE TEST
2 PLEASE FAST OVERNIGHT FOR 8 TO 14 HOURS
3 IT IS ALL RIGHT TO DRINK WATER AND TAKE ALL/ANY OF YOUR PILLS BEFORE THE TEST IN THE MORNING
4 DO NOT RESTRICT YOUR USUAL DIETARY CARBOHYDRATE INTAKE DURING THE 3 DAYS PRECEDING THE TEST.
5 AFTER THE FIRST BLOOD SAMPLE IS TAKEN FOR BLOOD GLUCOSE AT 0 HOURS, YOU WILL BE OFFERED A GLUCOSE DRINK THAT CONTAINS 75 GRAMS OF GLUCOSE IN WATER. PLEASE DRINK THAT WITHIN A FEW MINUTES AND BE SEATED FOR 2 HOURS.
6 DURING THESE 2 HOURS PLEASE DO NOT EAT OR DRINK ANYTHING NOR SHOULD YOU WALK AROUND. WATER IS OK. YOU MAY READ SOMETHING IF YOU WISH, WHILE SEATED
7 EXACTLY 120 MINUTES AFTER YOUR FIRST BLOOD SAMPLE WAS TAKEN, YOU WILL BE CALLED FOR A SECOND BLOOD DRAW FOR CHECKING BLOOD GLUCOSE LEVELS
8 THIS CONCLUDES THE TEST
9 PLEASE NOTE THERE IS NO NEED FOR ANY URINE SAMPLE, EVEN IF THE LABORATORY INSISTS ON IT
10 FURTHER, THERE IS NO NEED TO HAVE BLOOD SAMPLES TAKEN MORE THAN TWICE AT THE ABOVE RECOMMENDED PRECISE TIMES. REFUSE SUCH INCORRECT TESTING EVEN IF THE LABORATORY PERSONNEL INSIST
So this is the deal way to determine if you have diabetes/ pre diabetes or not.
There is another convenient test called Glycosylated Hemoglobin A1c, often abbreviated as HbA1c. Fasting is not required for this test and it can be performed at any time of the day or night. It is also a good screening test, although the OGTT still is the most reliable.
Glucose
Detailed Answer:
I follow what you are saying.
There is no need to worry.
All four blood glucose values, whether they were laboratory or home meter readings, are within normal limits.
The trace of ketones is likely due to the extended fasting.
This type of testing is fine and it essentially rules out any pre diabetes/diabetes. However the gold standard is the glucose tolerance test:
OGTT PROTOCOL FOR NON PREGNANT ADULTS TO SCREEN FOR DIABETES
1 OGTT = ORAL GLUCOSE TOLERANCE TEST
2 PLEASE FAST OVERNIGHT FOR 8 TO 14 HOURS
3 IT IS ALL RIGHT TO DRINK WATER AND TAKE ALL/ANY OF YOUR PILLS BEFORE THE TEST IN THE MORNING
4 DO NOT RESTRICT YOUR USUAL DIETARY CARBOHYDRATE INTAKE DURING THE 3 DAYS PRECEDING THE TEST.
5 AFTER THE FIRST BLOOD SAMPLE IS TAKEN FOR BLOOD GLUCOSE AT 0 HOURS, YOU WILL BE OFFERED A GLUCOSE DRINK THAT CONTAINS 75 GRAMS OF GLUCOSE IN WATER. PLEASE DRINK THAT WITHIN A FEW MINUTES AND BE SEATED FOR 2 HOURS.
6 DURING THESE 2 HOURS PLEASE DO NOT EAT OR DRINK ANYTHING NOR SHOULD YOU WALK AROUND. WATER IS OK. YOU MAY READ SOMETHING IF YOU WISH, WHILE SEATED
7 EXACTLY 120 MINUTES AFTER YOUR FIRST BLOOD SAMPLE WAS TAKEN, YOU WILL BE CALLED FOR A SECOND BLOOD DRAW FOR CHECKING BLOOD GLUCOSE LEVELS
8 THIS CONCLUDES THE TEST
9 PLEASE NOTE THERE IS NO NEED FOR ANY URINE SAMPLE, EVEN IF THE LABORATORY INSISTS ON IT
10 FURTHER, THERE IS NO NEED TO HAVE BLOOD SAMPLES TAKEN MORE THAN TWICE AT THE ABOVE RECOMMENDED PRECISE TIMES. REFUSE SUCH INCORRECT TESTING EVEN IF THE LABORATORY PERSONNEL INSIST
So this is the deal way to determine if you have diabetes/ pre diabetes or not.
There is another convenient test called Glycosylated Hemoglobin A1c, often abbreviated as HbA1c. Fasting is not required for this test and it can be performed at any time of the day or night. It is also a good screening test, although the OGTT still is the most reliable.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr Shehzad,
Thank you for your response .
I am still, slightly worried about the high 6.0mmol/l fasting glucose levels i took with the meter at home.
I am also still feeling some fatigue that i thought could associate with the high level of stress and inpact on my sleep from my worrying.
Would you advice on any possible reasons that might give such a high average fasting blood glucose reading with the meter in the morning?
usually i take my dinner around 8 Pm at Night and test my glucose around 8 am in the morning and 8:30 after showering. The results from between 8:00 and 8:30 can differ significantly sometimes. e.g. 6.0 and 5.5 .
I might consider taking an OGTT with my local gp.
With Thanks, XXXXXXX
Thank you for your response .
I am still, slightly worried about the high 6.0mmol/l fasting glucose levels i took with the meter at home.
I am also still feeling some fatigue that i thought could associate with the high level of stress and inpact on my sleep from my worrying.
Would you advice on any possible reasons that might give such a high average fasting blood glucose reading with the meter in the morning?
usually i take my dinner around 8 Pm at Night and test my glucose around 8 am in the morning and 8:30 after showering. The results from between 8:00 and 8:30 can differ significantly sometimes. e.g. 6.0 and 5.5 .
I might consider taking an OGTT with my local gp.
With Thanks, XXXXXXX
Brief Answer:
Follow up
Detailed Answer:
1 Stress can have various types of negative effects on the body.
Fatigue and gradual rise in blood glucoses are some of them.
2 The meter is not 100% accurate. There can be unto 20% variation from the actual reading in the blood which is accurately measured by taking a blood sample in a laboratory from your veins.
3 OGTT is therefore the best option
Follow up
Detailed Answer:
1 Stress can have various types of negative effects on the body.
Fatigue and gradual rise in blood glucoses are some of them.
2 The meter is not 100% accurate. There can be unto 20% variation from the actual reading in the blood which is accurately measured by taking a blood sample in a laboratory from your veins.
3 OGTT is therefore the best option
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Doctor would you recommend hba1c along ogtt, or is the ogtt itself sufficient to diagnose or clear any doubts i have.
Thank You, XXXXXXX
Thank You, XXXXXXX
Brief Answer:
Second Follow up
Detailed Answer:
OGTT alone is sufficient. I would still recommend the HbA1c test in addition simply because it will serve asa baseline for future monitoring of trends and patterns n your 'glycemic metabolism' status. The advantage of this test is that it will not require any fasting or 2 hour reading. This convenience lets one perform this test once or twice a year to see if the individual is progressing to diabetes, or staying in the pre diabetes range or has succeeded in reversing to normal, all with a single random blood sample
Second Follow up
Detailed Answer:
OGTT alone is sufficient. I would still recommend the HbA1c test in addition simply because it will serve asa baseline for future monitoring of trends and patterns n your 'glycemic metabolism' status. The advantage of this test is that it will not require any fasting or 2 hour reading. This convenience lets one perform this test once or twice a year to see if the individual is progressing to diabetes, or staying in the pre diabetes range or has succeeded in reversing to normal, all with a single random blood sample
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
