• rscollins72 rscollins72
    February 24, 2012
    Normal A1C but abnormal fasting & random numbers, including a one time 325. Should I be concerned?
    rscollins72 rscollins72
    February 24, 2012

    Hello. I am a 39 y/o female who is concerned about pre-diabetes & Type 2 onset.


    Last year I started experiencing Fasting Blood sugar levels over 100 picked up on two yearly physicals. I was admnistered a 2 hr. GTT and "failed" two of the three results according to the tech with a fasting of 108, 1 hr. 254 and 2 hr. 148.  My two A1C tests since then have been within the normal ranges, less than 6. I can count on both hands the number of times over the past year that I have tested my morning fasting blood sugar and had a reading below 100.  Random blood sugars over the year, after eating (various time intervals) have shown blood sugar readings of 200+ and one time even a 325.  Most times though they are below 200. 


    I do not have the usual Type 2 risk factors as I am under 40, a healthy 5'6"  110 lbs, normally active (3 kids under 10 LOL - u can imagine!), eat very limited amt. of fast food and even then I go for salads or meals less than 300 calories, and limit carbs but still can get high numbers if I indulge too much.  This morning my fasting blood sugar (and this was after not having eaten in 10+ hours) was 132.  It normally ranges 100-120.  I have been tested for the Diabetes 1.5 gene and this was negative.  My biggest and only current risk factor appears to be a strong family history of Type 2 diabetes to include both parents (father insulin injection dependent),  grandfather, aunts and uncles (but no siblings!).  After doing research I am beginning to wonder if I or my doctor should be a bit more concerned about my blood sugars and preventing 'hidden" long term effects or am I just being a hypochondriac? Should I investigate this any further?


    I am amazed how all of this has happened in less than a year's time to go from consistently normal fasting sugars per yearly exams to testing every morning and having readings over 200 random.  Any advice or guidance is appreciated.



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  • italiangm February 25, 2012
    February 25, 2012

    First, by the time a fasting glucose result starts becoming consistently high, it is likely that post-meal glucose is already in the diabetic range.  Doctors who specialize in metabolic disorders use fasting glucose results -- especially those taken right after sleep -- to detect the "dawn phenomenon".  This is where the brain says "I need glucose" and the liver provides it just before one wakes up. Since some level of insulin resistance is already present, the liver's release creates high fasting glucose results.


    Second, the abnormally high random glucose results are indicative of impaired glucose tolerance.  The blood glucose of a person who is "normoglycemic" would never reach 325mg/dl at any point throughout a 2 hour timespan. Insulin would increase and cells would accept the excess glucose for energy or storage. Exceptions: The result was an error; corticosteroids, antipsychotic or other meds that alter glucose metabolism are being used; some other medical condition was involved.


    And finally, a person who is "normoglycemic" has an A1C between 4.8% and 5.4%.


    If I fit the situation you described, I would be VERY concerned and seeking a doc who would take these markers seriously. What you described is most certainly not hypochondria.

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