How do I know if I have diabetes?

I was driving in to work the other day and I was listening to Sirius satellite radio.  They have a station called 'Doctor Radio' which is run by the doctors at NYU medical center.  Generally, they have great topics and help teach people what to do to get the best healthcare. 

There was one man who called in to this show yesterday and wasn't sure if he had diabetes.  He had an LDL of 121 and a fasting blood sugar of 129.  He also had a waist circumfrence of 40 and peripheral neuropathy.  He wasn't on any medications for diabetes at the time and wasn't testing his blood sugars. 

The doctor on the show told him that he just needed to get his waist size down to a 36 and everything would improve.  I was a little angry at that comment because although weight loss is extremely important, this man already had complications starting from diabetes and didn't even know it. 

SO, what does this all mean?  For one, everyone should know what their numbers mean.  The diagnosis of diabetes is very clear.  You must have 2 fasting blood sugars of greater than 126, or a random blood test (anytime of the day) that is greater than 200.   Some doctors will have their patients do a 2 hour glucose tolerance test to diagnose them that way.  A fasting blood sugar of 100-126 is considered prediabetes (used to be called 'borderline diabetes'). 

If your blood sugar is between 100-126, this is the ONLY time you can prevent or delay this from turning into full blown diabetes.  This is an extremely important time to get help with your health.

One test that many doctors do is called a hemoglobin A1c.  This is a 2-3 month average of what your blood sugars have been.  If your a1c is between 4-6 this is considered normal.  Greater than 6 generally means that your blood sugars have been running in a range consistent with diabetes.  HOWEVER, an A1C is not a diagnostic test.  Diabetes is not able to be diagnosed simply with an A1c.  You must have the other tests completed for a diagnosis.  If one does have an A1c of greater than 6, most generally that person would have high blood sugars on a glucose tolerance test and could be diagnosed that way. 

There are many doctors who do diagnose based on an A1c.  I certainly don't disagree that someone with an a1c over 6 has diabetes, however, for insurance purposes, they do require the other tests. 

When your doctor does your labs, discuss the results with him/her.  There are many things that you can do to prevent diabetes or to keep it under control.

It is believed that diabetes could be coming on for years before diagnosis.  It's important to know your numbers and talk to your doctor.