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Diabetes - Juvenile Community
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Blood glucose tests help
by robertin75, Oct 07, 2004 12:00AM
I'm 29 years old, male and just received the following 2 blood tests:
Fasting glucose 80
HBA1C 7.0%
Fructosamine 0.8mmol/l (ranges 1.50-2.70)
Does the low fructosamine value means that I could be suffering from hypoglycemia?
Does the HBA1C is within range?
I'm currently taking Elavil and don't know if this drug can affect the values from the blood tests.
Help is greatly appreciated.
Fasting glucose 80
HBA1C 7.0%
Fructosamine 0.8mmol/l (ranges 1.50-2.70)
Does the low fructosamine value means that I could be suffering from hypoglycemia?
Does the HBA1C is within range?
I'm currently taking Elavil and don't know if this drug can affect the values from the blood tests.
Help is greatly appreciated.
Doctor's Answer
by JDRF-Team-sgg, Oct 07, 2004 12:00AM
The following web site offers a good explanation in layman's terms of the tests and what they show:
http://www.diabetesmonitor.com/ghb.htm
It appears that you may have been slightly hypoglycemic for the past 3 weeks, the period of time tested by the fructosamine test. However, your a1c level is slightly higher than the ideal, although still not "bad." Most endocrinologists nowadays like to see a1c levels close to 6 or even in the upper 5's, but generally are happy if the a1c number is under 7. Your number at exactly 7 is on the upper range of the usual goal. So it appears that your recent (last 3 weeks) glucose levels have been lower than they perhaps were at the beginning of the time that the a1c tests for (about 2-3 months ago). Your fasting number is perfect. If you are not finding hypoglycemia when you do your glucose tests, I would not worry about lows, for they will show up in routine glucose tests if you test several times a day.
As for the possibility that the drug Elavil may be affecting your blood sugar levels, read the side effects listed on this web site:
http://www.healthsquare.com/newrx/ELA1155.htm
It appears that this drug CAN cause glucose levels to go high or low. You may want to discuss this with your doctor, especially if you notice changes in how your glucose tests read since you began taking this medication. I would advise you to perhaps do more frequent glucose tests than usual (perhaps every 3 hours or so), write down the readings and then if you notice abnormalities, call your doctor and discuss this with him or her. There may be a drug other than Elavil that will treat your symptoms just as well without affecting your glucose levels if this indeed is happening to you.
http://www.diabetesmonitor.com/ghb.htm
It appears that you may have been slightly hypoglycemic for the past 3 weeks, the period of time tested by the fructosamine test. However, your a1c level is slightly higher than the ideal, although still not "bad." Most endocrinologists nowadays like to see a1c levels close to 6 or even in the upper 5's, but generally are happy if the a1c number is under 7. Your number at exactly 7 is on the upper range of the usual goal. So it appears that your recent (last 3 weeks) glucose levels have been lower than they perhaps were at the beginning of the time that the a1c tests for (about 2-3 months ago). Your fasting number is perfect. If you are not finding hypoglycemia when you do your glucose tests, I would not worry about lows, for they will show up in routine glucose tests if you test several times a day.
As for the possibility that the drug Elavil may be affecting your blood sugar levels, read the side effects listed on this web site:
http://www.healthsquare.com/newrx/ELA1155.htm
It appears that this drug CAN cause glucose levels to go high or low. You may want to discuss this with your doctor, especially if you notice changes in how your glucose tests read since you began taking this medication. I would advise you to perhaps do more frequent glucose tests than usual (perhaps every 3 hours or so), write down the readings and then if you notice abnormalities, call your doctor and discuss this with him or her. There may be a drug other than Elavil that will treat your symptoms just as well without affecting your glucose levels if this indeed is happening to you.
Do you have any symptoms? Shakiness, weakness, hungeer, loss of concentration, etc?
I also had a GTT (glucose tolerance test) with the following results:
basal glucose 92 mg/dl (ranges 65-110)
30 min 52 mg/dl (ranges 110-170) OUT OF RANGE
60 min 82 mg/dl (ranges <140)
120 min 63 mg/dl (ranges 70-120) OUT OF RANGE
180 min 101 mg/dl (no reference range)
It would be great if someone could give me their feedback regarding these GTT results.
Also, does the low fructosamine value doesn't mean that I could have hypoglycemia?
Thanks
The range of glucose levels that are considered "normal" are between 70-126 (give or take a few numbers, for doctors differ slightly on the ideal range). People who are neither diabetic nor hypoglycemic do find it normal for gluocse values to vary throughought the day as the body responds to the foods you eat. Most diabetics start to feel bad when glucose is dropping and begins to approach the 70 mark, so numbers below that are considered hypoglycemic. Below this number, your ability to think clearly, react quickly to stimuli of any sort, and function without fatique are impaired. So yes, you may be hypoglycemic. Your Glucose Tolerance Test shows that your body does respond to the high glucose in the syrup you drank by over-producing insulin at times. However, this test seems to show that your body works normally to level off the glucose levels when they do drop.
Some of your symptoms do sound perhaps like hypoglycemia, but this is a hard diagnosis for a doctor to make since he can only get readings from the GTT and has no way to see how you react in normal daily life to normal food and activity. You may find that it is wise to ask him about possible side effects of the Elavil and possibly to go to a diet that avoids caffeine and high-glucose foods that may trigger reactions if you tend to be a reactive hypoglycemic. An experiment with this kind of diet may be helpful to you and you can see if your energy levels return. You could also try treating fatigue with small amounts of juice (1/2 cup) and protein such as nuts or cheese to see if you feel better in about a half hour after nibbling when you feel fatigued. I am not a doctor, by the way, but am a type 1 diabetic of many years who has lots of relatives and friends who deal wtih hypoglycemia, so I have done lots of reading on the subject.
I have heard that people with reactive hypoglycemia should eat frequent small meals and cut sugars, but my main question is why am I having reactive hypoglycemia. There must be a cause why I am having this problem (if I have it) because I don't think that its normal in people without diabetes.
I got the following paragraphs from a reputable web site of a Harvard physician regarding hypoglycemia:
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When you feel exhausted and doctors can't find a cause, they often diagnose chronic fatigue syndrome. They used to diagnose hypoglycemia.
If your doctor tells you that you suffer from hypoglycemia, he must then tell you the cause because low blood sugar is the result of something going wrong in your body. It is not a cause. Your brain gets more than 98% of its energy from sugar in your bloodstream. There is only enough sugar in your bloodstream to last about three minutes, so your liver constantly releases sugar from its cells into your bloodstream. But your liver can store only enough sugar to last 12 hours at rest, so it must manufacture new sugar from protein and other energy stores.
When blood sugar levels drop, you may feel anxious, shaky, sweaty, hungry, a tingling in your skin or your heart may beat rapidly. More severe symptoms include confusion, a sensation of warmth, weakness or fatigue, loss of memory and in its extreme, seizures and passing out. As you suffer repeat attacks of low blood sugar, they affect you less and your symptoms lessen.
There are two types of low blood sugar. First when your blood sugar rises too high, causing your pancreas to release a large amount of insulin that drops your blood sugar too low, and second, a slow drop in blood sugar caused by your liver running out of stored sugar. Doctors used to think that insulin-induced hypoglycemia follows meals and that your liver running out of sugar doesn't follow meals, but they now know that both types can occur any time.
It is almost impossible to diagnose hypoglycemia by drawing blood after you suffer an attack of dizziness, weakness or fainting because your body produces adrenalin immediately and raises blood sugar levels to normal before your doctor can draw blood. It can be diagnosed by feeding you lots of sugar and measuring your blood sugar level every half hour for several hours. If you indeed suffer from hypoglycemia, your doctor then has to find a cause that includes a damaged liver, an inadequate amount or excess of many different hormones, tumors and glandular abnormalities.
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Thanks and help is greatly appreciated.
Roberto