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Diabetes

Am I really diabetic?

03/10/2008

Question:

One year ago I was diagnosed has being a diabetic type 2. My first A1C test was 8.8. I have had an A1C test every three months since with results of 4.6, 4.4, 4.6, and 4.7.

Yes, I have changed my life style. Replaced sweet drinks with water. Yes, I have lost weight.

When I tell other Doctors that I am a type 2 diabetic and what my A1c test results are I get weird looks. I have even been ask if I was sure about that.

Should I be questioning the fact that I am really diabetic?

If so, How do I question it?

When I was diagnosed I made up my mind that it was my disease to manage, not my health care team`s to manage. My health care team is my best resource to help me manage my disease. (Yes i also get weird looks from members of my health care team)But the test results tell me that maybe we got a bad first test. Just looking for an answer that so that I can justify the results in my head.

Answer:

According to the American Diabetes Association, the HbA1c test should not form the basis for the diagnosis of diabetes.  It would be important to know what other data was available, specifically whether there were blood sugar data performed in a clinical laboratory.  It is certainly possible that all the HbA1c tests have been correct, and that your initial blood sugar control was poor and has improved, particularly if you put in a lot of work to improve lifestyle and the change in results correlate with that.  It is less likely but also possible that there could be some artifacts contributing to the test results.  The key is in other data, blood sugars then and now.

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Response by:

Robert M Cohen, MD Robert M Cohen, MD
Professor of Clinical Medicine
College of Medicine
University of Cincinnati