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Impaired Fasting Glucose, High Glyco, Sarcoidosis

I have had Impaired Fasting Glucose levels for at least 5 years, which I have not been actively trying to address until recently.  A fasting glucose of 123, and glyco reading (from tests I requested.  I know the 3-mo average glyco test is normally to monitor diabetic control, but my doctor 5 years ago used them also as a diagnostic tool.  This made sense to me so I have continued her practice.) of 6.3 shook me out of my complacency in Oct 2009.  I have been working to reduce my weight since (down 25 lbs, 25 to go) and adjusted my diet to eliminate as much sugar as I could conveniently manage to do.  Latest fasting glucose reading is 109 (this reading being more typical of the impaired fasting glucose levels of the past 5 years), glyco of 6.2 after 3 months of my revised diet.   I have doubt that losing the other 25 lbs will fix the problem, since I was experiencing high fasting glucose levels 5 years ago when I was at a normal weight.

In early 2007 I was diagnosed with Sarcoidosis, which in my case is severe, chronic, and debilitating.  I am unable to exercise, even in water, due to what this disease has done to my bones, tendons, and muscles.  Sarcoidosis can attack the pancreas, causing individuals to develop Type 2 Diabetes.  While I have NOT been diagnosed as having a diseased pancreas, I now have no way to sort out my on-going impaired fasting glucose problem from a Sarcoidosis-induced impaired fasting glucose level.  My current family practice doctor has so far decided to order fasting glucose tests every 3 months, and of course is encouraging my weight loss and diet change.  My question is two-fold:  Should I be seeing a specialist in Diabetes at this point?  For all intents and purposes, due to the longevity of this problem, should my doctor and I be managing this as Diabetes, rather than "pre-diabetes"?  I would appreciate any insight and advice you can give me.  Thank you!

This discussion is related to Fasting Glucose Levels.
5 Responses
Avatar universal
You don't use the standard terms, so I'm going to guess that by "glyco" test you mean HA1C, since you refer to it as a three month average. An A1C of 6.2 is considered diabetes, not pre-diabetes (anything over 6.0). Your fasting numbers are still within the range of pre-diabetes (100-125), but the A1C is now considered the best diagnostic tool. So given that, what should you do differently? You are on the right track with losing the extra weight. Cutting out sugar is also positive, however it is not just sugar that affects blood glucose, but carbs, so you might want to reduce your carbs as well. Check out Bloodsugar101.com (also available as a book) for some basic information about diabetes. If your number continues to rise despite weight loss and lowering of carb intake than it might be time to consider oral meds. As far as the doctor is concerned, if you feel comfortable with your doctor (some are not proactive enough imho) than great, if not, see an endo.
Avatar universal
Thanks very much for the thorough answer, especially considering that you are a member here and certainly not under any obligation to help me out. I appreciate you taking the time and energy to reply to me!  I am glad to see your comment about the A1C being the best diagnostic tool. I tried to tell my family practice doctor and his assistant that A1C is used for diagnostic purposes now,  They looked at me as if I have two heads.  I am curious about the 6.0 mark being the threshold for diabetes.  Is there some controversy or inconsistency about this?  I ask because some internet health sites list 6.5 as the threshold, and that is apparently what my Doc uses.  Is 6.0 a standard that MedHelp uses?  Thanks for the advice about carbs and about Bloodsugar101.  I'll get familiar with that site and educate myself so that I can incorporate this next set of adjustments to my diet. Any further feedback you could give me about my questions above, or other references or advice you think of, would definitely meet with action on my part.  Thanks again!
Avatar universal
I believe recently the ADA officially adopted A1C as the standard diagnostic tool, but you could google that to be sure; I also generally hear 6.0 but have occasionally heard some people use 6.5. Yes, there is lots of controversy and lots of inconsistency in diabetes management and your average PCP is woefully behind the times in their information. That's in part because the ADA is behind the times! The ADA still thinks 180 is a reasonable post prandial blood sugar even though all the studies show that damage begins with numbers above 140. I think the ADA being so far behind is purely political and financial, but that might be cynical. In general I have learned way more from other diabetics than doctors. MedHelp is most commonly a gateway site frequented by people who are newly diagnosed and seeking answers. (Which is why I try and help where I can.) The administration believes other websites are "competition" so I am going to send you a private message with a couple sites that get much more traffic from people with a lot more experience and knowledge than me.
1361527 tn?1277656851
i need the explication about this test...glyco (A1C) 6.5
and GLU TOLE 2 HRS___140.4,,,WHAT IS THAT? AND WBC____6-10
Avatar universal
I want to correct my previous statement; I'm sorry I was in error. An A1C of 5.7 to 6.4 is considered pre-diabetes and anything over 6.5 is diabetic.

Yomara, an A1C is a blood test that measures an average blood sugar for a period of 2-3 months. An A1C of 6,.5 is diabetes.  I'm uncertain what the other numbers you are referring to are. If by glu tole 2 hours 140.4 you mean you had an OGTT test where they gave you a sugary drink and after two hours your blood sugar was 140, that would only be in the pre-diabetes range. However the A1C or a fasting blood sugar are considered the diagnostics for diabetes. (Fasting-100-125 = pre-diabetes and 126 and over is diabetic)
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