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Friday, March 7, 2014
Elevated fasting blood glucose
I have had 2 elevated fasting blood glucose results. One was 108 and the second one..about 6 months later was 102 (ref range 65 to 99). At one point, my blood sugar was checked about 2 hours after eating and it was 160. What would you suggest as the next step? (? GTT, hgb A1c ?) Thanks.
The first question is whether these were lab glucoses or fingerstick tests: if they were fingerstick tests, then I would have testing done with clinical lab tests. If these are clinical lab tests, they meet the criteria for impaired fasting glucose. The question then is the context of the information: Some would say do the formal oGTT, making sure that it is done with necessary preparation of being on an adequate carbohydrate intake for several days prior to testing. some would say that if the HbA1c is normal, then undertake diet and exercise measures as if you have diabetes and monitor. If there is any other clinical evidence of diabetes, I would be more aggressive.
Robert M Cohen, MD
Professor of Clinical Medicine
College of Medicine
University of Cincinnati