Topic: People with type 2 diabetes: what made you get it checked out?
Green !StaYqkzUPc started this discussion 4 years ago #103,138
What were your first symptoms?
Anonymous B joined in and replied with this 4 years ago, 3 minutes later[^] [v] #1,164,443
I used MacDonald's to reverse my type 2 diabetes!
Anonymous C joined in and replied with this 4 years ago, 14 minutes later, 18 minutes after the original post[^] [v] #1,164,444
Routine bloodwork caught it.
Anonymous D joined in and replied with this 4 years ago, 3 hours later, 4 hours after the original post[^] [v] #1,164,476
What symptoms do you believe you have?
Green !StaYqkzUPc (OP) replied with this 4 years ago, 2 days later, 2 days after the original post[^] [v] #1,164,885
@previous (D)
I have needed to pee a lot recently. I eat a lot of sugar. Get headaches and random bursts of energy or fatigue. Also it runs in my family.
I have needed to pee a lot recently. I eat a lot of sugar. Get headaches and random bursts of energy or fatigue. Also it runs in my family.
Anonymous D replied with this 4 years ago, 8 hours later, 3 days after the original post[^] [v] #1,164,920
@previous (Green !StaYqkzUPc)
Not sure about the random bursts of energy, but the rest sounds like classic symptoms.
Why not pop down to the nearest pharmacy and buy some blood test strips and a meter? Shouldn't cost you too much and will probably be easier than scheduling and waiting for a doctor's appointment.
Don't eat or drink anything but water for eight hours then test your levels. Easiest to do it when you wake up.
Not sure about the random bursts of energy, but the rest sounds like classic symptoms.
Why not pop down to the nearest pharmacy and buy some blood test strips and a meter? Shouldn't cost you too much and will probably be easier than scheduling and waiting for a doctor's appointment.
Don't eat or drink anything but water for eight hours then test your levels. Easiest to do it when you wake up.
Green !StaYqkzUPc (OP) replied with this 4 years ago, 30 minutes later, 3 days after the original post[^] [v] #1,164,926
@previous (D)
> Not sure about the random bursts of energy, but the rest sounds like classic symptoms.
>
> Why not pop and strip
Getting a test kit from Amazon. I don't need to pee anymore.
> Not sure about the random bursts of energy, but the rest sounds like classic symptoms.
>
> Why not pop and strip
Getting a test kit from Amazon. I don't need to pee anymore.
Anonymous D replied with this 4 years ago, 1 hour later, 3 days after the original post[^] [v] #1,164,940
@previous (Green !StaYqkzUPc)
Just make sure you get the blood test strips. The urine test strips are not that accurate.
Just make sure you get the blood test strips. The urine test strips are not that accurate.
Green !StaYqkzUPc (OP) replied with this 4 years ago, 1 minute later, 3 days after the original post[^] [v] #1,164,941
Anonymous C replied with this 4 years ago, 2 minutes later, 3 days after the original post[^] [v] #1,164,942
Green, no test that you administer yourself will be accurate enough to self-diagnose. Go see a doctor. They will have you do bloodwork which will reveal your A1C number. If that number is able 7, then you have diabetes.
Anonymous D replied with this 4 years ago, 39 minutes later, 3 days after the original post[^] [v] #1,164,952
@previous (C)
This is bullshit. Fully ruling out diabetes can be more difficult and an A1C might be needed. But ruling it in is very easy. This is really not that complicated and trying to make it appear so isn't helpful for anyone (except doctors).
This is bullshit. Fully ruling out diabetes can be more difficult and an A1C might be needed. But ruling it in is very easy. This is really not that complicated and trying to make it appear so isn't helpful for anyone (except doctors).
Anonymous C replied with this 4 years ago, 8 minutes later, 3 days after the original post[^] [v] #1,164,956
@previous (D)
You cannot diagnosis Type 2 diabetes with a blood test that tests your blood sugar level at the current time. The A1C is what doctors use.
You cannot diagnosis Type 2 diabetes with a blood test that tests your blood sugar level at the current time. The A1C is what doctors use.
Anonymous D replied with this 4 years ago, 11 minutes later, 3 days after the original post[^] [v] #1,164,958
@previous (C)
Absolutely false. Here are the current medical guidelines:
> DIAGNOSTIC CRITERIA — The diagnosis of diabetes mellitus is easily established when a patient presents with classic symptoms of hyperglycemia (thirst, polyuria, weight loss, blurry vision) and has a random blood glucose value of 200 mg/dL (11.1 mmol/L) or higher, and confirmed on another occasion.
>
> Other diagnostic criteria have been developed based upon the observed association between glucose levels and the risk for developing retinopathy. Fasting plasma glucose values ≥126 mg/dL (7.0 mmol/L), two-hour post oral glucose challenge values of ≥200 mg/dL (11.1 mmol/L), and A1C values ≥6.5 percent are associated with an increased prevalence of retinopathy [ 3 ]. The diagnosis of diabetes in an asymptomatic individual can be established with any of the above criteria, as described below. An abnormal result should be confirmed by repeat measurement with the same test.
From the UpToDate article on "Diagnosis of diabetes mellitus". This is the de-facto reference manual for physicians in many countries.
Absolutely false. Here are the current medical guidelines:
> DIAGNOSTIC CRITERIA — The diagnosis of diabetes mellitus is easily established when a patient presents with classic symptoms of hyperglycemia (thirst, polyuria, weight loss, blurry vision) and has a random blood glucose value of 200 mg/dL (11.1 mmol/L) or higher, and confirmed on another occasion.
>
> Other diagnostic criteria have been developed based upon the observed association between glucose levels and the risk for developing retinopathy. Fasting plasma glucose values ≥126 mg/dL (7.0 mmol/L), two-hour post oral glucose challenge values of ≥200 mg/dL (11.1 mmol/L), and A1C values ≥6.5 percent are associated with an increased prevalence of retinopathy [ 3 ]. The diagnosis of diabetes in an asymptomatic individual can be established with any of the above criteria, as described below. An abnormal result should be confirmed by repeat measurement with the same test.
From the UpToDate article on "Diagnosis of diabetes mellitus". This is the de-facto reference manual for physicians in many countries.
Green !StaYqkzUPc (OP) replied with this 4 years ago, 6 minutes later, 3 days after the original post[^] [v] #1,164,959
If my blood sugar is high I'll see a doctor. If it's in normal range I won't worry. There are other things that can cause these symptoms too.
Anonymous C replied with this 4 years ago, 1 minute later, 3 days after the original post[^] [v] #1,164,964
@previous (Green !StaYqkzUPc)
You can have diabetes, and your blood sugar can still be in normal range at any given time. It will not prove anything.
You can have diabetes, and your blood sugar can still be in normal range at any given time. It will not prove anything.
Anonymous D replied with this 4 years ago, 2 minutes later, 3 days after the original post[^] [v] #1,164,965
@previous (C)
It can rule in a diagnosis. It is harder to rule it out. Stop making this so complicated. Thanks.
It can rule in a diagnosis. It is harder to rule it out. Stop making this so complicated. Thanks.
Anonymous D double-posted this 4 years ago, 54 seconds later, 3 days after the original post[^] [v] #1,164,966
@1,164,959 (Green !StaYqkzUPc)
Repeat the test several times with the fasting. If you keep getting normal results, do a glucose tolerance test. Look it up.
Repeat the test several times with the fasting. If you keep getting normal results, do a glucose tolerance test. Look it up.
Anonymous C replied with this 4 years ago, 14 minutes later, 3 days after the original post[^] [v] #1,164,970
@1,164,965 (D)
If I am concerned that I have Diabetes, I am going to a fucking doctor and not taking a fucking "home test". Jesus. Especially in a country with free fucking healthcare.
If I am concerned that I have Diabetes, I am going to a fucking doctor and not taking a fucking "home test". Jesus. Especially in a country with free fucking healthcare.
Anonymous D replied with this 4 years ago, 4 minutes later, 3 days after the original post[^] [v] #1,164,972
@previous (C)
You do you. The glucose test strips are perfectly effective and are often the same brands that are used in the office for diagnosis. Typically, the only time they'll use strips that are more sensitive than those on the consumer market is when your levels are way out of range. But at that point it isn't for diagnosis any more, but more to figure out how much insulin you need to be given. Not likely a concern anyway for green since he probably doesn't have type I diabetes and isn't likely to have levels beyond the scale of your standard strips.
Not everyone wants to spend time scheduling an appointment and wasting hours of their life going to and waiting in an office for something they can do on their own lol.
You do you. The glucose test strips are perfectly effective and are often the same brands that are used in the office for diagnosis. Typically, the only time they'll use strips that are more sensitive than those on the consumer market is when your levels are way out of range. But at that point it isn't for diagnosis any more, but more to figure out how much insulin you need to be given. Not likely a concern anyway for green since he probably doesn't have type I diabetes and isn't likely to have levels beyond the scale of your standard strips.
Not everyone wants to spend time scheduling an appointment and wasting hours of their life going to and waiting in an office for something they can do on their own lol.
Anonymous C replied with this 4 years ago, 12 minutes later, 3 days after the original post[^] [v] #1,164,975
Anonymous B replied with this 4 years ago, 3 minutes later, 3 days after the original post[^] [v] #1,164,976
Anon C knows something the experts missed!
P.S. I've had diagnosed type 1 diabetes for 25 years, and was diagnosed based on high BG levels. Thanks. Tnx. T.hanks.
P.S. I've had diagnosed type 1 diabetes for 25 years, and was diagnosed based on high BG levels. Thanks. Tnx. T.hanks.
(Edited 10 seconds later.)
Anonymous C replied with this 4 years ago, 43 seconds later, 3 days after the original post[^] [v] #1,164,977
Anonymous D replied with this 4 years ago, 1 minute later, 3 days after the original post[^] [v] #1,164,979
@previous (C)
It isn't. I just quoted you the guidelines for diabetes T1 & T2. Fasting glucose levels are sufficient for either.
@1,164,976 (B)
lol. I literally just quoted the WHO guidelines.
It isn't. I just quoted you the guidelines for diabetes T1 & T2. Fasting glucose levels are sufficient for either.
@1,164,976 (B)
lol. I literally just quoted the WHO guidelines.
Anonymous D double-posted this 4 years ago, 28 seconds later, 3 days after the original post[^] [v] #1,164,980
Anonymous D triple-posted this 4 years ago, 2 minutes later, 3 days after the original post[^] [v] #1,164,982
Further down in the article.
> WHO criteria — The 2006 WHO criteria define diabetes as a fasting glucose ≥126 mg/dL (7.0 mmol/L) or a two-hour post glucose challenge value ≥200 mg/dL (11.1 mmol/L). Impaired glucose tolerance (IGT) is defined as a fasting glucose <126 (7.0 mmol/L), and a two-hour glucose ≥140 mg/dL (7.8 mmol/L) but <200 mg/dL (11.05 mmol/L) [ 4 ]. Impaired fasting glucose (IFG) is defined as a fasting glucose of 110 to 125 mg/dL (6.1 to 6.9 mmol/L). In 2011, the WHO concluded that an A1C value of ≥6.5 percent (48 mmol/mol) can be used as a diagnostic test for diabetes [ 5 ]. A value of <6.5 percent does not exclude diabetes diagnosed using glucose levels.
> WHO criteria — The 2006 WHO criteria define diabetes as a fasting glucose ≥126 mg/dL (7.0 mmol/L) or a two-hour post glucose challenge value ≥200 mg/dL (11.1 mmol/L). Impaired glucose tolerance (IGT) is defined as a fasting glucose <126 (7.0 mmol/L), and a two-hour glucose ≥140 mg/dL (7.8 mmol/L) but <200 mg/dL (11.05 mmol/L) [ 4 ]. Impaired fasting glucose (IFG) is defined as a fasting glucose of 110 to 125 mg/dL (6.1 to 6.9 mmol/L). In 2011, the WHO concluded that an A1C value of ≥6.5 percent (48 mmol/mol) can be used as a diagnostic test for diabetes [ 5 ]. A value of <6.5 percent does not exclude diabetes diagnosed using glucose levels.
Anonymous C replied with this 4 years ago, 21 seconds later, 3 days after the original post[^] [v] #1,164,983
Anonymous D replied with this 4 years ago, 20 seconds later, 3 days after the original post[^] [v] #1,164,984
INTRODUCTION — The term diabetes mellitus describes several diseases of abnormal carbohydrate metabolism that are characterized by hyperglycemia. It is associated with a relative or absolute impairment in insulin secretion, along with varying degrees of peripheral resistance to the action of insulin. Every few years, the diabetes community reevaluates the current recommendations for the classification, diagnosis, and screening of diabetes, reflecting new information from research and clinical practice.
The American Diabetes Association (ADA) issued diagnostic criteria for diabetes mellitus in 1997, with follow-up in 2003 and 2010 [ 1-3 ]. The diagnosis is based on one of four abnormalities: hemoglobin A1C (A1C), fasting plasma glucose (FPG), random elevated glucose with symptoms, or abnormal oral glucose tolerance test (OGTT) ( table 1 ). Patients with impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) are referred to as having increased risk for diabetes (see 'Diagnostic criteria' below).
Recommendations for routine screening for diabetes are provided elsewhere. The etiologic classification of diabetes mellitus is also discussed separately. (See "Screening for diabetes mellitus" and "Classification of diabetes mellitus and genetic diabetic syndromes" .)
TERMINOLOGY — The 1997 ADA Expert Committee introduced the terms type 1 and type 2 diabetes, and recommended against terms like insulin-dependent, non-insulin-dependent, juvenile-onset, maturity-onset, and adult-onset diabetes [ 2 ]. In addition to type 1 and type 2 diabetes, "specific types" of diabetes are identified: gestational diabetes, and diabetes secondary to recognized genetic defects, diseases of the exocrine pancreas, other endocrinopathies, or to drugs. This change was an attempt to classify diabetes according to etiologic differences rather than descriptions based upon age at onset or type of treatment.
DIAGNOSTIC CRITERIA — The diagnosis of diabetes mellitus is easily established when a patient presents with classic symptoms of hyperglycemia (thirst, polyuria, weight loss, blurry vision) and has a random blood glucose value of 200 mg/dL (11.1 mmol/L) or higher, and confirmed on another occasion.
Other diagnostic criteria have been developed based upon the observed association between glucose levels and the risk for developing retinopathy. Fasting plasma glucose values ≥126 mg/dL (7.0 mmol/L), two-hour post oral glucose challenge values of ≥200 mg/dL (11.1 mmol/L), and A1C values ≥6.5 percent are associated with an increased prevalence of retinopathy [ 3 ]. The diagnosis of diabetes in an asymptomatic individual can be established with any of the above criteria, as described below. An abnormal result should be confirmed by repeat measurement with the same test.
WHO criteria — The 2006 WHO criteria define diabetes as a fasting glucose ≥126 mg/dL (7.0 mmol/L) or a two-hour post glucose challenge value ≥200 mg/dL (11.1 mmol/L). Impaired glucose tolerance (IGT) is defined as a fasting glucose <126 (7.0 mmol/L), and a two-hour glucose ≥140 mg/dL (7.8 mmol/L) but <200 mg/dL (11.05 mmol/L) [ 4 ]. Impaired fasting glucose (IFG) is defined as a fasting glucose of 110 to 125 mg/dL (6.1 to 6.9 mmol/L). In 2011, the WHO concluded that an A1C value of ≥6.5 percent (48 mmol/mol) can be used as a diagnostic test for diabetes [ 5 ]. A value of <6.5 percent does not exclude diabetes diagnosed using glucose levels.
ADA criteria — In 2003, the ADA recommended the use of fasting glucose levels (no caloric intake for at least eight hours) or 75 g glucose tolerance test for diagnosing diabetes [ 2 ]. In 2009, an International Expert Committee recommended using a hemoglobin A1C (A1C) value of ≥6.5 percent (≥48 mmol/mol) to diagnose diabetes [ 6 ], and the ADA affirmed the decision ( table 1 ) [ 3 ]. (See 'Hemoglobin A1C' below.)
The shift from using the FPG to using A1C to diagnose diabetes may decrease the proportion of patients identified as having diabetes [ 7-9 ]. As an example, in a study of 6890 adults without a history of diabetes participating in the National Health and Nutrition Examination Survey (1999 to 2006), the prevalence of diabetes using A1C versus fasting glucose criteria was 2.3 versus 3.6 percent [ 7 ]. Overall, the A1C and FPG criteria resulted in the same classification for 98 percent of the population studied.
The following definitions are from ADA reports ( table 1 and table 2 ) [ 2,3,9,10 ]:
Normal — Fasting plasma glucose (FPG) <100 mg/dL (5.6 mmol/L). Two-hour glucose during OGTT <140 mg/dL (7.8 mmol/L).
Categories of increased risk for diabetes
Impaired fasting glucose (IFG) — Fasting plasma glucose between 100 and 125 mg/dL (5.6 to 6.9 mmol/L).
Impaired glucose tolerance (IGT) — Two-hour plasma glucose value during a 75 g oral glucose tolerance test between 140 and 199 mg/dL (7.8 to 11.0 mmol/L).
A1C — Persons with 5.7 to 6.4 percent (6.0 to 6.4 percent in the International Expert Committee report [ 6 ]) are at highest risk, although there is a continuum of increasing risk across the entire spectrum of A1C levels less than 6.5 percent.
Diabetes mellitus — FPG at or above 126 mg/dL (7.0 mmol/L), A1C ≥6.5 percent (48 mmol/mol), a two-hour value in an OGTT (2-h PG) at or above 200 mg/dL (11.1 mmol/L), or a random (or "casual") plasma glucose concentration ≥200 mg/dL (11.1 mmol/L) in the presence of symptoms ( table 1 ).
In the absence of unequivocal symptomatic hyperglycemia, the diagnosis of diabetes must be confirmed on a subsequent day by repeat measurement, repeating the same test for confirmation. However, if two different tests (eg, FPG and A1C) are available and are concordant for the diagnosis of diabetes, additional testing is not needed. If two different tests are discordant, the test that is diagnostic of diabetes should be repeated to confirm the diagnosis [ 9 ].
The importance of confirming the diagnosis by repeat measurement on a subsequent day, especially when the diagnosis is based upon glucose measurements, is illustrated by a report from the National Health and Nutrition Examination Survey (NHANES) III Second Examination [ 11 ]. The prevalence of diabetes based upon either fasting glucose or two-hour post OGTT glucose significantly decreased when the diagnosis was contingent upon having two abnormal measurements rather than a single abnormal measurement.
EDEG criteria — The European Diabetes Epidemiology Group (EDEG) issued a position statement in 2006 recommending that the original cut-off point for IFG (110 mg/dL or 6.1 mmol/L) be retained [ 12 ]. They also recommend that the term "non-diabetic hyperglycemia" be used in preference to "impaired fasting glucose." These recommendations were based on recognition that the risk for diabetes is a continuous variable with fasting glucose levels, with no clear threshold for risk of diabetes or cardiovascular disease.
HEMOGLOBIN A1C — There has been long-standing interest in the use of hemoglobin A1C (A1C) values for screening and identification of impaired glucose tolerance and diabetes [ 13,14 ]. In the 1999 to 2004 National Health and Nutrition Examination Survey (NHANES) population, an A1C of 5.8 percent had the highest sensitivity (86 percent) and specificity (92 percent) for diagnosing diabetes compared with the fasting glucose criteria (fasting plasma glucose >126 mg/dL [7 mmol/L]) [ 15 ]. Similar results were noted in a systematic review of studies assessing the accuracy of A1C in the detection of type 2 diabetes [ 16 ]. A1C and FPG were found to be similarly effective in diagnosing diabetes. Using an A1C cut-off point of >6.1 percent to diagnose diabetes, sensitivity ranged from 78 to 81 percent and specificity 79 to 84 percent, when compared with diabetes diagnosed with FPG.
A1C values also correlate with the prevalence of retinopathy [ 17,18 ]. As an example, in the 2005 to 2006 NHANES, 1066 individuals ≥40 years had retinal fundus photography and measurements of A1C and fasting plasma glucose [ 19 ]. The prevalence of retinopathy increased above an A1C of 5.5 percent and a FPG of 104 mg/dL (5.8 mmol/L). A1C was more accurate than FPG in identifying cases of retinopathy.
A1C values were not previously recommended to diagnose diabetes because of variation in A1C assays. However, the National Glycohemoglobin Standardization Program (NGSP) has standardized more than 99 percent of the assays used in the United States to the DCCT standard. A strict quality control program has improved precision and accuracy of assays in the US and many international assays. (See "Estimation of blood glucose control in diabetes mellitus", section on 'Assay' .)
An International Expert Committee issued a consensus report in June 2009, recommending that an A1C level ≥6.5 percent be used to diagnose diabetes, and the ADA affirmed this decision [ 3,6 ]. The diagnosis should be confirmed with a repeat A1C. In making the recommendation, the report noted several technical advantages of the A1C assay over glucose testing, increased patient convenience (since there is no special preparation or timing required for the A1C test), and the correlation of A1C levels with retinopathy. The report also noted that if an A1C test is either unavailable or uninterpretable, for example owing to rapid red cell turnover with anemia, the previous diagnostic methods and criteria, using glucose testing, should be used. The A1C assay and potential sources of error are reviewed separately. (See "Estimation of blood glucose control in diabetes mellitus", section on 'Hemoglobin A1C' .)
A1C, FPG, AND OGTT AS PREDICTORS OF DIABETES — Although the natural history of IFG and IGT is variable, approximately 25 percent of subjects with either will progress to diabetes over three to five years [ 10 ]. Subjects with additional diabetes risk factors, including obesity and family history, are more likely to develop diabetes. (See "Prediction and prevention of type 2 diabetes mellitus", section on 'Impaired glucose tolerance' and "Prediction and prevention of type 2 diabetes mellitus", section on 'Impaired fasting glucose' .)
A1C values may also be used to predict the incidence of type 2 diabetes. As an example, in a prospective cohort study of 26,563 women followed for 10 years, baseline A1C level was an independent predictor of type 2 diabetes, even at levels considered to be within the normal range [ 20 ]. In those individuals with baseline A1C in the highest quintile (A1C >5.22), the adjusted relative risk of diabetes was 8.2, 95% CI 6.0-11.1. (See "Prediction and prevention of type 2 diabetes mellitus", section on 'Hemoglobin A1C' .)
A1C criteria for identifying patients with impaired glucose regulation were derived using data from the National Health and Nutrition Survey, 2005 to 2006 [ 3 ]. Compared with other cut points, an A1C cut point of 5.7 percent had the best sensitivity (39 percent) and specificity (91 percent) for identifying cases of IFG (FPG ≥100 mg/dL [5.6 mmol/L]).
Although most of the high risk groups have been defined categorically (eg, IFG or IGT), the risk for developing diabetes follows a continuum across the entire spectrum of subdiabetic glycemic values. Higher fasting or 2-h OGTT glucose values or higher A1C values convey higher risk than lower values.
A1C, FPG, AND OGTT AS PREDICTORS OF CARDIOVASCULAR RISK — There is strong, consistent evidence that the relationship between blood glucose levels and cardiovascular risk extends into the nondiabetic range. (See "Glycemic control and vascular complications in type 2 diabetes mellitus", section on 'Prediabetes and cardiovascular risk' .)
The following observations have been made in different reports:
Data from the Atherosclerosis Risk in Communities (ARIC) study showed a relationship between A1C level and coronary heart disease in non-diabetic individuals [ 21 ]. The relative risk of a cardiovascular event was 1.38 (95% CI 1.22-1.56) for every 1 percentage point increase in hemoglobin A1C for subjects without diabetes whose A1C was 5.5 percent or greater.
Several studies have shown that, compared with impaired fasting glucose, impaired glucose tolerance is a better predictor of cardiovascular disease [ 22,23 ] and mortality [ 24,25 ].
In a 10-year prospective study of almost 6800 non-diabetic subjects, each one standard deviation increase in two-hour glucose increased the hazard ratio for both coronary events (1.17, 95% CI 1.05-1.30) and cardiovascular mortality (1.22, 95% CI 1.09-1.37) [ 26 ]. The respective values for a one standard deviation increase in fasting glucose were lower (1.05 and 1.13). These observations suggest that postprandial (OGTT) hyperglycemia is more strongly associated with cardiovascular risk and mortality than FPG.
In addition, the old criteria for impaired fasting glucose, compared with the new criteria, were more predictive of impaired glucose tolerance, CHD, and risk of the metabolic syndrome as defined by NCEP criteria [ 27,28 ]. As an example, in the Framingham Heart Study, the risk of developing CHD over a four-year period was greater in women with IFG based upon the 1997 compared to the 2003 criteria (odds ratios 2.2 [95% CI 1.1-4.4] and 1.7 [95% CI 1.0-3.0], respectively) [ 29 ]. In contrast, men were not at increased risk of developing CHD by either IFG definition.
The American Diabetes Association (ADA) issued diagnostic criteria for diabetes mellitus in 1997, with follow-up in 2003 and 2010 [ 1-3 ]. The diagnosis is based on one of four abnormalities: hemoglobin A1C (A1C), fasting plasma glucose (FPG), random elevated glucose with symptoms, or abnormal oral glucose tolerance test (OGTT) ( table 1 ). Patients with impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) are referred to as having increased risk for diabetes (see 'Diagnostic criteria' below).
Recommendations for routine screening for diabetes are provided elsewhere. The etiologic classification of diabetes mellitus is also discussed separately. (See "Screening for diabetes mellitus" and "Classification of diabetes mellitus and genetic diabetic syndromes" .)
TERMINOLOGY — The 1997 ADA Expert Committee introduced the terms type 1 and type 2 diabetes, and recommended against terms like insulin-dependent, non-insulin-dependent, juvenile-onset, maturity-onset, and adult-onset diabetes [ 2 ]. In addition to type 1 and type 2 diabetes, "specific types" of diabetes are identified: gestational diabetes, and diabetes secondary to recognized genetic defects, diseases of the exocrine pancreas, other endocrinopathies, or to drugs. This change was an attempt to classify diabetes according to etiologic differences rather than descriptions based upon age at onset or type of treatment.
DIAGNOSTIC CRITERIA — The diagnosis of diabetes mellitus is easily established when a patient presents with classic symptoms of hyperglycemia (thirst, polyuria, weight loss, blurry vision) and has a random blood glucose value of 200 mg/dL (11.1 mmol/L) or higher, and confirmed on another occasion.
Other diagnostic criteria have been developed based upon the observed association between glucose levels and the risk for developing retinopathy. Fasting plasma glucose values ≥126 mg/dL (7.0 mmol/L), two-hour post oral glucose challenge values of ≥200 mg/dL (11.1 mmol/L), and A1C values ≥6.5 percent are associated with an increased prevalence of retinopathy [ 3 ]. The diagnosis of diabetes in an asymptomatic individual can be established with any of the above criteria, as described below. An abnormal result should be confirmed by repeat measurement with the same test.
WHO criteria — The 2006 WHO criteria define diabetes as a fasting glucose ≥126 mg/dL (7.0 mmol/L) or a two-hour post glucose challenge value ≥200 mg/dL (11.1 mmol/L). Impaired glucose tolerance (IGT) is defined as a fasting glucose <126 (7.0 mmol/L), and a two-hour glucose ≥140 mg/dL (7.8 mmol/L) but <200 mg/dL (11.05 mmol/L) [ 4 ]. Impaired fasting glucose (IFG) is defined as a fasting glucose of 110 to 125 mg/dL (6.1 to 6.9 mmol/L). In 2011, the WHO concluded that an A1C value of ≥6.5 percent (48 mmol/mol) can be used as a diagnostic test for diabetes [ 5 ]. A value of <6.5 percent does not exclude diabetes diagnosed using glucose levels.
ADA criteria — In 2003, the ADA recommended the use of fasting glucose levels (no caloric intake for at least eight hours) or 75 g glucose tolerance test for diagnosing diabetes [ 2 ]. In 2009, an International Expert Committee recommended using a hemoglobin A1C (A1C) value of ≥6.5 percent (≥48 mmol/mol) to diagnose diabetes [ 6 ], and the ADA affirmed the decision ( table 1 ) [ 3 ]. (See 'Hemoglobin A1C' below.)
The shift from using the FPG to using A1C to diagnose diabetes may decrease the proportion of patients identified as having diabetes [ 7-9 ]. As an example, in a study of 6890 adults without a history of diabetes participating in the National Health and Nutrition Examination Survey (1999 to 2006), the prevalence of diabetes using A1C versus fasting glucose criteria was 2.3 versus 3.6 percent [ 7 ]. Overall, the A1C and FPG criteria resulted in the same classification for 98 percent of the population studied.
The following definitions are from ADA reports ( table 1 and table 2 ) [ 2,3,9,10 ]:
Normal — Fasting plasma glucose (FPG) <100 mg/dL (5.6 mmol/L). Two-hour glucose during OGTT <140 mg/dL (7.8 mmol/L).
Categories of increased risk for diabetes
Impaired fasting glucose (IFG) — Fasting plasma glucose between 100 and 125 mg/dL (5.6 to 6.9 mmol/L).
Impaired glucose tolerance (IGT) — Two-hour plasma glucose value during a 75 g oral glucose tolerance test between 140 and 199 mg/dL (7.8 to 11.0 mmol/L).
A1C — Persons with 5.7 to 6.4 percent (6.0 to 6.4 percent in the International Expert Committee report [ 6 ]) are at highest risk, although there is a continuum of increasing risk across the entire spectrum of A1C levels less than 6.5 percent.
Diabetes mellitus — FPG at or above 126 mg/dL (7.0 mmol/L), A1C ≥6.5 percent (48 mmol/mol), a two-hour value in an OGTT (2-h PG) at or above 200 mg/dL (11.1 mmol/L), or a random (or "casual") plasma glucose concentration ≥200 mg/dL (11.1 mmol/L) in the presence of symptoms ( table 1 ).
In the absence of unequivocal symptomatic hyperglycemia, the diagnosis of diabetes must be confirmed on a subsequent day by repeat measurement, repeating the same test for confirmation. However, if two different tests (eg, FPG and A1C) are available and are concordant for the diagnosis of diabetes, additional testing is not needed. If two different tests are discordant, the test that is diagnostic of diabetes should be repeated to confirm the diagnosis [ 9 ].
The importance of confirming the diagnosis by repeat measurement on a subsequent day, especially when the diagnosis is based upon glucose measurements, is illustrated by a report from the National Health and Nutrition Examination Survey (NHANES) III Second Examination [ 11 ]. The prevalence of diabetes based upon either fasting glucose or two-hour post OGTT glucose significantly decreased when the diagnosis was contingent upon having two abnormal measurements rather than a single abnormal measurement.
EDEG criteria — The European Diabetes Epidemiology Group (EDEG) issued a position statement in 2006 recommending that the original cut-off point for IFG (110 mg/dL or 6.1 mmol/L) be retained [ 12 ]. They also recommend that the term "non-diabetic hyperglycemia" be used in preference to "impaired fasting glucose." These recommendations were based on recognition that the risk for diabetes is a continuous variable with fasting glucose levels, with no clear threshold for risk of diabetes or cardiovascular disease.
HEMOGLOBIN A1C — There has been long-standing interest in the use of hemoglobin A1C (A1C) values for screening and identification of impaired glucose tolerance and diabetes [ 13,14 ]. In the 1999 to 2004 National Health and Nutrition Examination Survey (NHANES) population, an A1C of 5.8 percent had the highest sensitivity (86 percent) and specificity (92 percent) for diagnosing diabetes compared with the fasting glucose criteria (fasting plasma glucose >126 mg/dL [7 mmol/L]) [ 15 ]. Similar results were noted in a systematic review of studies assessing the accuracy of A1C in the detection of type 2 diabetes [ 16 ]. A1C and FPG were found to be similarly effective in diagnosing diabetes. Using an A1C cut-off point of >6.1 percent to diagnose diabetes, sensitivity ranged from 78 to 81 percent and specificity 79 to 84 percent, when compared with diabetes diagnosed with FPG.
A1C values also correlate with the prevalence of retinopathy [ 17,18 ]. As an example, in the 2005 to 2006 NHANES, 1066 individuals ≥40 years had retinal fundus photography and measurements of A1C and fasting plasma glucose [ 19 ]. The prevalence of retinopathy increased above an A1C of 5.5 percent and a FPG of 104 mg/dL (5.8 mmol/L). A1C was more accurate than FPG in identifying cases of retinopathy.
A1C values were not previously recommended to diagnose diabetes because of variation in A1C assays. However, the National Glycohemoglobin Standardization Program (NGSP) has standardized more than 99 percent of the assays used in the United States to the DCCT standard. A strict quality control program has improved precision and accuracy of assays in the US and many international assays. (See "Estimation of blood glucose control in diabetes mellitus", section on 'Assay' .)
An International Expert Committee issued a consensus report in June 2009, recommending that an A1C level ≥6.5 percent be used to diagnose diabetes, and the ADA affirmed this decision [ 3,6 ]. The diagnosis should be confirmed with a repeat A1C. In making the recommendation, the report noted several technical advantages of the A1C assay over glucose testing, increased patient convenience (since there is no special preparation or timing required for the A1C test), and the correlation of A1C levels with retinopathy. The report also noted that if an A1C test is either unavailable or uninterpretable, for example owing to rapid red cell turnover with anemia, the previous diagnostic methods and criteria, using glucose testing, should be used. The A1C assay and potential sources of error are reviewed separately. (See "Estimation of blood glucose control in diabetes mellitus", section on 'Hemoglobin A1C' .)
A1C, FPG, AND OGTT AS PREDICTORS OF DIABETES — Although the natural history of IFG and IGT is variable, approximately 25 percent of subjects with either will progress to diabetes over three to five years [ 10 ]. Subjects with additional diabetes risk factors, including obesity and family history, are more likely to develop diabetes. (See "Prediction and prevention of type 2 diabetes mellitus", section on 'Impaired glucose tolerance' and "Prediction and prevention of type 2 diabetes mellitus", section on 'Impaired fasting glucose' .)
A1C values may also be used to predict the incidence of type 2 diabetes. As an example, in a prospective cohort study of 26,563 women followed for 10 years, baseline A1C level was an independent predictor of type 2 diabetes, even at levels considered to be within the normal range [ 20 ]. In those individuals with baseline A1C in the highest quintile (A1C >5.22), the adjusted relative risk of diabetes was 8.2, 95% CI 6.0-11.1. (See "Prediction and prevention of type 2 diabetes mellitus", section on 'Hemoglobin A1C' .)
A1C criteria for identifying patients with impaired glucose regulation were derived using data from the National Health and Nutrition Survey, 2005 to 2006 [ 3 ]. Compared with other cut points, an A1C cut point of 5.7 percent had the best sensitivity (39 percent) and specificity (91 percent) for identifying cases of IFG (FPG ≥100 mg/dL [5.6 mmol/L]).
Although most of the high risk groups have been defined categorically (eg, IFG or IGT), the risk for developing diabetes follows a continuum across the entire spectrum of subdiabetic glycemic values. Higher fasting or 2-h OGTT glucose values or higher A1C values convey higher risk than lower values.
A1C, FPG, AND OGTT AS PREDICTORS OF CARDIOVASCULAR RISK — There is strong, consistent evidence that the relationship between blood glucose levels and cardiovascular risk extends into the nondiabetic range. (See "Glycemic control and vascular complications in type 2 diabetes mellitus", section on 'Prediabetes and cardiovascular risk' .)
The following observations have been made in different reports:
Data from the Atherosclerosis Risk in Communities (ARIC) study showed a relationship between A1C level and coronary heart disease in non-diabetic individuals [ 21 ]. The relative risk of a cardiovascular event was 1.38 (95% CI 1.22-1.56) for every 1 percentage point increase in hemoglobin A1C for subjects without diabetes whose A1C was 5.5 percent or greater.
Several studies have shown that, compared with impaired fasting glucose, impaired glucose tolerance is a better predictor of cardiovascular disease [ 22,23 ] and mortality [ 24,25 ].
In a 10-year prospective study of almost 6800 non-diabetic subjects, each one standard deviation increase in two-hour glucose increased the hazard ratio for both coronary events (1.17, 95% CI 1.05-1.30) and cardiovascular mortality (1.22, 95% CI 1.09-1.37) [ 26 ]. The respective values for a one standard deviation increase in fasting glucose were lower (1.05 and 1.13). These observations suggest that postprandial (OGTT) hyperglycemia is more strongly associated with cardiovascular risk and mortality than FPG.
In addition, the old criteria for impaired fasting glucose, compared with the new criteria, were more predictive of impaired glucose tolerance, CHD, and risk of the metabolic syndrome as defined by NCEP criteria [ 27,28 ]. As an example, in the Framingham Heart Study, the risk of developing CHD over a four-year period was greater in women with IFG based upon the 1997 compared to the 2003 criteria (odds ratios 2.2 [95% CI 1.1-4.4] and 1.7 [95% CI 1.0-3.0], respectively) [ 29 ]. In contrast, men were not at increased risk of developing CHD by either IFG definition.
Anonymous C replied with this 4 years ago, 43 seconds later, 3 days after the original post[^] [v] #1,164,985
Anonymous D replied with this 4 years ago, 8 seconds later, 3 days after the original post[^] [v] #1,164,986
Anonymous B replied with this 4 years ago, 20 seconds later, 3 days after the original post[^] [v] #1,164,987
@1,164,982 (D)
Yes. A1C is used more as a measure of how well diabetes is controlled than a direct indicator of diabetes. Thanks.
Yes. A1C is used more as a measure of how well diabetes is controlled than a direct indicator of diabetes. Thanks.
Anonymous D replied with this 4 years ago, 28 seconds later, 3 days after the original post[^] [v] #1,164,988
Anonymous D double-posted this 4 years ago, 17 seconds later, 3 days after the original post[^] [v] #1,164,989
Anonymous C replied with this 4 years ago, 13 minutes later, 3 days after the original post[^] [v] #1,164,996
If practicing medicine were as easy as reading an article, then why would medical schools exist? You see, much more goes into diagnosis than a layman reading an article. There are many things to consider that we, the non-doctors, do not even know enough. That is why I trust experts. But, you do you.
Anonymous D replied with this 4 years ago, 58 minutes later, 3 days after the original post[^] [v] #1,165,002
@previous (C)
If practicing shtick were as easy as reading an article, then why would shtick schools exist?
If practicing shtick were as easy as reading an article, then why would shtick schools exist?
Anonymous B replied with this 4 years ago, 7 minutes later, 3 days after the original post[^] [v] #1,165,003
@1,164,977 (C)
> Diabetes for 25 years
You do realize I'm a professional diabetic at this point, right? I know there's a difference between childhood onset diabetes and "Halp, I can't stahp eating like a pig" diabetes. However, problems with high, and even low, BG levels can be present with either type.
Source: 25 years of being diabetic, and being in direct contact with people who have/had type 2 diabetes.
> Diabetes for 25 years
You do realize I'm a professional diabetic at this point, right? I know there's a difference between childhood onset diabetes and "Halp, I can't stahp eating like a pig" diabetes. However, problems with high, and even low, BG levels can be present with either type.
Source: 25 years of being diabetic, and being in direct contact with people who have/had type 2 diabetes.
(Edited 9 minutes later.)
Anonymous C replied with this 4 years ago, 2 minutes later, 3 days after the original post[^] [v] #1,165,004
@previous (B)
It's not the same as going to medical school. It's anecdotal evidence. Yes, you know your personal condition well I arm sure, but there's much more to medicine than that.
It's not the same as going to medical school. It's anecdotal evidence. Yes, you know your personal condition well I arm sure, but there's much more to medicine than that.
Anonymous B replied with this 4 years ago, 4 minutes later, 3 days after the original post[^] [v] #1,165,005
@previous (C)I'm not a medical professional, but I've literally had diabetes for as long as a certain poster has been obsessed with an elderly man he met online. Are you trying to say that people living with diabetes don't gain knowledge over how the disease effects people?
Anonymous D replied with this 4 years ago, 37 seconds later, 3 days after the original post[^] [v] #1,165,006
@1,165,003 (B)
Anon C is apparently very stupid and only capable of making arguments relying on an appeal to authority. Don't waste time replying to him unless you're bored and have nothing better to do.
Anon C is apparently very stupid and only capable of making arguments relying on an appeal to authority. Don't waste time replying to him unless you're bored and have nothing better to do.
Anonymous D double-posted this 4 years ago, 59 seconds later, 3 days after the original post[^] [v] #1,165,007
cccuuunnttt !.cATkimmOo joined in and replied with this 4 years ago, 1 minute later, 3 days after the original post[^] [v] #1,165,008
your literally retarded. thx
Anonymous C replied with this 4 years ago, 40 minutes later, 3 days after the original post[^] [v] #1,165,029
Cletus double-posted this 4 years ago, 41 seconds later, 3 days after the original post[^] [v] #1,165,031
I don't need no big city, fancy, book-learnin' medical school! Why, I'd can jes read an article and it's the same thing!
Anonymous F joined in and replied with this 4 years ago, 4 minutes later, 3 days after the original post[^] [v] #1,165,043
Meowth joined in and replied with this 4 years ago, 4 hours later, 3 days after the original post[^] [v] #1,165,089
Green !StaYqkzUPc (OP) replied with this 4 years ago, 2 hours later, 3 days after the original post[^] [v] #1,165,111
Green !StaYqkzUPc (OP) double-posted this 3 years ago, 23 hours later, 4 days after the original post[^] [v] #1,165,366
Green !StaYqkzUPc (OP) triple-posted this 3 years ago, 1 minute later, 4 days after the original post[^] [v] #1,165,367
Anyway, I think the neverending peeing could be caused by a strained prostate. It feels like a pressure in my pelvic area, meaning I can't hold pee as well. I do intense kegels but I will try and relax it on my kegels now and see if it helps.
Kook !!rcSrAtaAC joined in and replied with this 3 years ago, 4 hours later, 4 days after the original post[^] [v] #1,165,398
Achmed from Kent replied with this 3 years ago, 3 hours later, 5 days after the original post[^] [v] #1,165,416
@1,165,367 (Green !StaYqkzUPc)
This issue deserves a visit to the doctor. It could be any number of things.
This issue deserves a visit to the doctor. It could be any number of things.
Green !StaYqkzUPc (OP) replied with this 3 years ago, 1 minute later, 5 days after the original post[^] [v] #1,165,418
@1,165,398 (Kook !!rcSrAtaAC)
Yes. It feels like I need to pee when I don't. It has gone today though.
Yes. It feels like I need to pee when I don't. It has gone today though.
Roweena !!ESfYqv8Fq replied with this 3 years ago, 2 hours later, 5 days after the original post[^] [v] #1,165,432
Kook !!rcSrAtaAC replied with this 3 years ago, 18 hours later, 5 days after the original post[^] [v] #1,165,596
Anonymous I joined in and replied with this 3 years ago, 3 hours later, 6 days after the original post[^] [v] #1,165,602
Not gonna read the autism in this thread but Anon B and C are right and Anon D has bad opinions and should feel bad.
My employer for the past six years is the most advance blood sugar testing in the market. It’s a really complex calculation to map blood sugar measurements to estimated A1C. The self test finger pricks are not useful to diagnose the Type 2 disease. They can sure suggest it, but it’s not a slam dunk.
A1C blood tests are the current standard of care. (But, yes, finger pricks after fasting do reveal if you have some condition, but not which condition.) They are the coarse “yes/no” analysis. Then, our specific testing helps to determine the severity or specific ways your body does or does not handle carbs and sugars.
Anon D understands like 10 percent of the modern state of these diseases.
My employer for the past six years is the most advance blood sugar testing in the market. It’s a really complex calculation to map blood sugar measurements to estimated A1C. The self test finger pricks are not useful to diagnose the Type 2 disease. They can sure suggest it, but it’s not a slam dunk.
A1C blood tests are the current standard of care. (But, yes, finger pricks after fasting do reveal if you have some condition, but not which condition.) They are the coarse “yes/no” analysis. Then, our specific testing helps to determine the severity or specific ways your body does or does not handle carbs and sugars.
Anon D understands like 10 percent of the modern state of these diseases.
(Edited 14 minutes later.)
Anonymous I double-posted this 3 years ago, 6 minutes later, 6 days after the original post[^] [v] #1,165,603
@1,164,987 (B)
> Yes. A1C is used more as a measure of how well diabetes is controlled than a direct indicator of diabetes. Thanks.
True.
> Yes. A1C is used more as a measure of how well diabetes is controlled than a direct indicator of diabetes. Thanks.
True.
Anonymous I triple-posted this 3 years ago, 1 minute later, 6 days after the original post[^] [v] #1,165,604
Anonymous C replied with this 3 years ago, 16 minutes later, 6 days after the original post[^] [v] #1,165,606
@1,165,596 (Kook !!rcSrAtaAC)
What?? You mean someone with no medical training or knowledge whatsoever reading an article is not the same as being examined and tested by a doctor???
What?? You mean someone with no medical training or knowledge whatsoever reading an article is not the same as being examined and tested by a doctor???
Anonymous D replied with this 3 years ago, 10 minutes later, 6 days after the original post[^] [v] #1,165,610
@1,165,602 (I)
I've cited medical literature describing the diagnostic criteria used by the WHO and the ADA and you've cited?
I've cited medical literature describing the diagnostic criteria used by the WHO and the ADA and you've cited?
Anonymous D double-posted this 3 years ago, 43 seconds later, 6 days after the original post[^] [v] #1,165,611
Anonymous D triple-posted this 3 years ago, 3 minutes later, 6 days after the original post[^] [v] #1,165,612
Did Anon C ever pay back Anon I?
Anonymous B replied with this 3 years ago, 37 seconds later, 6 days after the original post[^] [v] #1,165,613
Anonymous D replied with this 3 years ago, 5 minutes later, 6 days after the original post[^] [v] #1,165,618
@previous (B)
Interest rate calculator tells me an amount like, provided I remember it roughly enough, ought to be worth nearly $1000 now with a standard interest rate. Almost enough to buy a full tank of gas these days lol!
Interest rate calculator tells me an amount like, provided I remember it roughly enough, ought to be worth nearly $1000 now with a standard interest rate. Almost enough to buy a full tank of gas these days lol!
Anonymous I replied with this 3 years ago, 2 minutes later, 6 days after the original post[^] [v] #1,165,619
Anonymous I double-posted this 3 years ago, 3 minutes later, 6 days after the original post[^] [v] #1,165,621
@1,165,610 (D)
I am trained on diagnostics and regularly work with Joslin and the authors and principle investigators for GMI and AGP reports 😎
I am trained on diagnostics and regularly work with Joslin and the authors and principle investigators for GMI and AGP reports 😎
(Edited 22 minutes later.)
Anonymous D replied with this 3 years ago, 30 seconds later, 6 days after the original post[^] [v] #1,165,622
@1,165,619 (I)
As far as I remember, the claim was that green couldn't be diagnosed with a blood glucose reading. This is and remains untrue and I gave direct citations saying this. How could anything be more straightforward?
As far as I remember, the claim was that green couldn't be diagnosed with a blood glucose reading. This is and remains untrue and I gave direct citations saying this. How could anything be more straightforward?
Anonymous D double-posted this 3 years ago, 23 seconds later, 6 days after the original post[^] [v] #1,165,623
Anonymous I replied with this 3 years ago, 2 minutes later, 6 days after the original post[^] [v] #1,165,625
@1,165,622 (D)
You started with something like “syringes cure cancer” and then moved to copypasta of the entire method to administer multiple rounds of chemotherapy via IV
You started with something like “syringes cure cancer” and then moved to copypasta of the entire method to administer multiple rounds of chemotherapy via IV
Anonymous C replied with this 3 years ago, 13 minutes later, 6 days after the original post[^] [v] #1,165,626
Anonymous I replied with this 3 years ago, 5 minutes later, 6 days after the original post[^] [v] #1,165,627
Anonymous I double-posted this 3 years ago, 8 minutes later, 6 days after the original post[^] [v] #1,165,628
@1,165,626 (C)
Wait you thought I was joking? I last had a call with Dr. Flo Brown March 24 and just yesterday sent her the final patient data set for her upcoming pregnancy publication.
Wait you thought I was joking? I last had a call with Dr. Flo Brown March 24 and just yesterday sent her the final patient data set for her upcoming pregnancy publication.
Anonymous D replied with this 3 years ago, 9 minutes later, 6 days after the original post[^] [v] #1,165,630
@1,165,625 (I)
What? I feel like I'm missing a meme or reference to something because what you're saying isn't making any sense.
What? I feel like I'm missing a meme or reference to something because what you're saying isn't making any sense.
Anonymous C replied with this 3 years ago, 3 minutes later, 6 days after the original post[^] [v] #1,165,631
Anonymous I replied with this 3 years ago, 7 minutes later, 6 days after the original post[^] [v] #1,165,632
Anonymous C replied with this 3 years ago, 1 hour later, 6 days after the original post[^] [v] #1,165,639
Anonymous I replied with this 3 years ago, 1 hour later, 6 days after the original post[^] [v] #1,165,649
@previous (C)
You have the most pathetically insecure tell of not believing anybody could be more skilled, knowledgeable, or accomplished than you :’)
You have the most pathetically insecure tell of not believing anybody could be more skilled, knowledgeable, or accomplished than you :’)
Green !StaYqkzUPc (OP) replied with this 3 years ago, 31 minutes later, 6 days after the original post[^] [v] #1,165,656
@1,165,596 (Kook !!rcSrAtaAC)
It feels a lot better since I've stopped doing such intense kegels. May have strained something. Now I do light rep kegels.
It feels a lot better since I've stopped doing such intense kegels. May have strained something. Now I do light rep kegels.
Green !StaYqkzUPc (OP) double-posted this 3 years ago, 1 day later, 1 week after the original post[^] [v] #1,165,965
I think I'm going to listen to Anonymous C and book a full blood count with the doctor on Monday. This Chinese blood glucose monitor is wildly inaccurate. Yesterday was 2.7mmol/l today was 6.0mmol/l and I tested a few minutes later and it was 9.0mmol/l. Best see a doctor and get some proper results.
Kook !!rcSrAtaAC replied with this 3 years ago, 7 hours later, 1 week after the original post[^] [v] #1,165,990
Anonymous C replied with this 3 years ago, 2 hours later, 1 week after the original post[^] [v] #1,166,001
Anonymous I replied with this 3 years ago, 8 hours later, 1 week after the original post[^] [v] #1,166,121
Anonymous I double-posted this 3 years ago, 3 months later, 3 months after the original post[^] [v] #1,186,571
This month it’s Harvard again, but a different Associate Professor and it’s a pediatric endocrinology study
Anonymous B replied with this 3 years ago, 5 minutes later, 3 months after the original post[^] [v] #1,186,573
Wild in the streets**!
**The "streets" may actually refer to a single man's apartment, in which women's underwear are drying.
**The "streets" may actually refer to a single man's apartment, in which women's underwear are drying.
Anonymous C replied with this 3 years ago, 27 minutes later, 3 months after the original post[^] [v] #1,186,578
Green, did you get it checked out?
Green !StaYqkzUPc (OP) replied with this 3 years ago, 3 hours later, 3 months after the original post[^] [v] #1,186,607
@previous (C)
I got two devices form Amazon and did the prick thing for a few weeks and they were all normal levels. Also I started drinking more water and all my negative symptoms went away.
I got two devices form Amazon and did the prick thing for a few weeks and they were all normal levels. Also I started drinking more water and all my negative symptoms went away.
Anonymous C replied with this 3 years ago, 4 minutes later, 3 months after the original post[^] [v] #1,186,612
@previous (Green !StaYqkzUPc)
Ok good! But your A1C is the only real way to diagnose it. Daily readings fluctuate too much.
Ok good! But your A1C is the only real way to diagnose it. Daily readings fluctuate too much.
Green !StaYqkzUPc (OP) replied with this 3 years ago, 26 minutes later, 3 months after the original post[^] [v] #1,186,621
@previous (C)
I eat sweetener now and cut down on sugar. Also I am doing my kegels but not overexerting myself because I pulled a man muscle which made it feel like a pressure leading to incessant watering of the flowers.
I eat sweetener now and cut down on sugar. Also I am doing my kegels but not overexerting myself because I pulled a man muscle which made it feel like a pressure leading to incessant watering of the flowers.
Anonymous C replied with this 3 years ago, 19 minutes later, 3 months after the original post[^] [v] #1,186,627
Anonymous C double-posted this 3 years ago, 1 hour later, 3 months after the original post[^] [v] #1,186,646
@1,186,621 (Green !StaYqkzUPc)
I am just concerned about you. If your A1C ever goes above 7.0 (I think that is the number), then you are diabetic. Daily readings fluctuate. You should really get some bloodwork done and see a doctor. Only they can properly diagnose you. Since you have the NHS, why not? Takes ten minutes.
I am just concerned about you. If your A1C ever goes above 7.0 (I think that is the number), then you are diabetic. Daily readings fluctuate. You should really get some bloodwork done and see a doctor. Only they can properly diagnose you. Since you have the NHS, why not? Takes ten minutes.
Green !StaYqkzUPc (OP) replied with this 3 years ago, 8 minutes later, 3 months after the original post[^] [v] #1,186,648
@previous (C)
The trouble is getting a doctor's appointment. The receptionist likes to gatekeep and my line cut off while I was number 3 in the queue last time. My readings have only been as high as 6 (that was after I wiped the lancet with hand sanitizer though) and are usually around 5.4-5.7 daily.
The trouble is getting a doctor's appointment. The receptionist likes to gatekeep and my line cut off while I was number 3 in the queue last time. My readings have only been as high as 6 (that was after I wiped the lancet with hand sanitizer though) and are usually around 5.4-5.7 daily.
Anonymous C replied with this 3 years ago, 53 seconds later, 3 months after the original post[^] [v] #1,186,649
@previous (Green !StaYqkzUPc)
But again, daily does not mean everything. A1C average over months is what matters. Keep trying, son!!
But again, daily does not mean everything. A1C average over months is what matters. Keep trying, son!!