Question on pre-diabetes

I had scheduled a walk in my development for World Diabetes Day and one of my neighbors came because she wanted to get her BS tested. She was 119 both before and after walking. I know all about the 20% meter crap and I used the Aviva - it is one of the highest rated ones and is always only a couple points when I test it against the lab so please don't say there is a 20% margin of error because that is not the case with this meter.

I think 119 was a little high. She told me that her father was diabetic but didn't know what type when I asked. Her one daughter also had gestational diabetes two of the three times she was pregnant (it was the first one she didn't have it with). She said she has problems with what feels like hypoglycemia when she misses meals. She is not working & doesn't have insurance so can't afford to go to a doctor. I told her to lay off the carbs - I know she eats a lot of carby stuff.

I suggested she let me test her sometime two hours after she eats. Should I tell her to eat a high carb meal to do that?

Well, most people as they get older (like me) will tend to have their blood sugar control degrade. It doesn't mean they are diabetic or even pre-diabetic, but it will mean that after high carb meals it is more likely to be higher than a normal 70-140 mg/dl. A 119 mg/dl fasting, and particularly after a 20-30 minute walk suggests that your friend may have some issues. Walgreens is offering free blood sugar testing this year for diabetes awareness month, but not an A1c. But your friend is lucky, she has you.

I have always felt that the most sensitive test is a glucose tolerance test. But you should control it. Ingest 75 g of fast acting carbs and then take a test 2hrs after you eat. The hard part is measuring 75g of carbs and then timing it. Since few non-diabetics have any clue what 75g of carbs look like, it would be most accurate if you measured and served it to her. If she is > 200 mg/dl, the she has outright diabetes. If she is > 140 mg/dl, then it is impaired glucose tolerance and she would be considered pre-diabetic. Most people that get T2 have impaired glucose tolerance and over time it gets worse and worse until eventually they have an impaired fasting glucose.

Just to clarify BSC, the 119 wasn't fasting. I scheduled the walk for 2.

I will have to come up with 75 grams worth of carbs then. I know that she has no clue about the carb stuff. I doubt she would have a scale to weigh things.

Thanks BSC!

I don't think you can tell much from one random test. You would need to know the context i.e how long since the last meal, reading before the meal and carb count of the meal.

bsc'a idea of a makeshift GTT is the best, but coming up with 75 grams of pure glucose is somewhat problematic.You can buy pure dextrose (another name for glucose) just Google it, but it may be more trouble than your neighbor wants to go to. I think a carby meal which minimizes fat and protein and maximizes fast acting carbs would do in a pinch. If she goes over 140 further investigation, perhaps a real GTT would certainly be in order.

Thanks Badmoon. I know one reading doesn't tell the story, but I do think she has a problem. Unfortunately, I don't think I can convince her she needs a real GTT when she can't afford it. I am glad you mentioned the fat & protein because I didn't think of that. I might fill her up with juice!

Hi Kelly. This is almost silly, but well, there's an article on the MSNBC website called 'Muffin Test' Could Help Diagnose Diabetes. I personally like muffins better than juice...

Thanks Trudy. I think I would rather have a muffin than juice also. I am not a big juice person.

Since many fruits contain both glucose and fructose and fructose won't raise blood sugar, it would be important to choose a fruit with minimal fructose. I believe the carbs in grapes are almost pure glucose so unsweetened grape juice might be a good choice. Be sure to read the label as the artificial sweetener will most probably be High Fructose Corn Syrup, which would dilute the glucose content.

2 cups of unsweetened grape juice would be almost exactly 75g

Trudy's muffin test would also work just fine, the threshold that would cause concern would just be lower.

Since you can provide the meter and poker there's really no reason not to do a fast and dirty test.

Thanks Badmoon. I will have to look for some unsweetened grape juice.