Am I suffering from diabetes?

Dear Logan3,

Congratulations! Even though you have risk factors for diabetes, you are doing things right to maintain a healthy lifestyle and live a long life. Even when a person is diagnosed with diabetes, the first agent of change is diet and exercise (which is sounds as if you are well aware of, and practice diligently).

Not only is diet and exercise sound advice for a diabetic, but can also stave off the actual diagnosis of diabetes for years. You say you are watching your sugar intake; I assume you mean all carbohydrates, as all carbs turn into sugar in your body. Additionally, your fat intake, and type of fat intake is equally important (not only for a diabetic condition, but to prevent heart disease, a complication of diabetes.

Diabetes is diagnosed through various lab tests, the chief one remaining a Fasting Blood Sugar. Usually, if you have a fasting blood sugar over 129, you may have diabetes. I say ‘usually’ as there are many things which can affect your blood sugar, besides diabetes. Chronic infections and medications may both elevate your blood sugar. I don’t know what type of lab tests have been done on you, which would affirm the diabetes diagnosis, so it is difficult to know your current condition. This is a question which your doctor could answer.

Hemoglobin A1c, which you cite in your letter, looks at the control of your blood sugar over a period of time, or approximately 2-3 months. I have included the results reported by the American Endocrinology Association, for your review. These results are for people who have been diagnosed with diabetes. The range of normal for non-diabetics is usually some where between 3 and 6.2%. Depending on which scale your physician is using, may make all the difference with their interpretation. Ask your physician, the next time you see them. I am sure they will be glad to answer any questions you may have.

Hemoglobin A1c

Normal: Less than 6.5
Excellent: 6.5-7.5
Good: 7.5-8.5
Fair: 8.5-9.5
Poor: Greater than 9.5

Interpreting results of the HbA1c can be tricky, as I have already stated. Utilizing different lab regents may give you different ranges of normal. Additionally, given two individuals, both with an HbA1c of the same level, does not equate with the blood glucose level which actually exists. Therefore, variations between individuals exist; although variations between HbA1c for just one person, namely ‘you’, are very important. Finally, HbA1c’s are tied in with the life cycle of your red blood cells. Certain diseases, such as B12 deficiency, may make the life cycle either longer or shorter, which means HbA1c results can either be excessively high or low, but not meaningful for diabetic diagnosis. This is why; HbA1c’s have not traditionally been used for diagnosis.

Your question, Logan3, was excellent, and shows good concern for your over all health. Hopefully I have cleared up some of your confusion. Diabetes is a very complicated subject, and my response to you does not do justice to all the multiple facets this disease exhibits. I have spent a lot of time in my response to discuss HbA1c’s, as your question seemed to rest on your results. As you can see, HbA1c’s are as complicated as the diabetic process.

Please feel free to write again with additional questions, or to let us know how you are doing. Good luck, and keep up the good work.

Roxanne
RN,
"Retired from VA, on to New Ventures"