Should I see an endocrinologist for a second opinion?

For some reason I’ve been having some weird blood work. A little about me: I’m in my early 20s, 5’6 and 155 lbs. Went to do some routine blood work after some other irregular blood test results and doc wanted me to fast for this one (last one I wasn’t fasted).

Results came back as:

Glucose: 123 mg/dL (prior blood test 3 months ago glucose was 100, non-fasted, although I hadn’t had a lot of food that day)

Triglycerides: 73 mg/dL

HDL: 53 mg/dL

LDL: 133 mg/dL

Total Cholesterol: 199 mg/dL

Doc couldn’t get A1C added on, so about 4 weeks later I went back in to get the A1C. I did try to cut out sugar as I was eating candy nearly everyday, but didn’t do low carb. Not sure how much 4 weeks of less sugar impacted A1C.

Hemoglobin A1C came back at 4.7%

I am very lost. I’m wondering if eating that much candy gave me temporary prediabetes (although I read it’s a myth that eating sugar gives you diabetes or pre).

A1C says my body can handle blood sugars just fine, glucose says I need to start eating low carb. My dad was prediabetic, although he was actually overweight and got it in his mid 40s.

The only thing that I think of that would have influenced my fasting glucose is that I’m extremely terrified of blood tests and heard cortisol can raise blood sugars. My blood pressure was 160 in the doctors office. Normally it sits between 117-132. Although my PCP said that stress is unlikely to cause acute glucose elevation.

Obviously either way I want to cut out candy and only in moderation, but I never got a clear answer from my PCP of why my fasting was 123 but he said I wasn’t prediabetic or diabetic. I mean there’s obviously more to this right? It’s not normal to have 123 mg/dL and right now I’m trying to put on muscle mass so I’m eating a good amount of chicken, brown rice, and veggies, but if carbs will make me turn into diabetic I want to know whether this is a fluke or I really need to go low carb.

I just want answers and it’s frustrating that it’s not like a clear you are positive or you are negative. Should I seek an endocrinologist?

123 is not crazy high. If you aren’t fasting, it’s meaningless.
An a1c of 4.7 is also normal.
Candy is not good for anyone, not just diabetics.
So maybe meet up with a nutritionist.
Sugar can be addictive and we build up tolerance.
So eating sweets makes us want more sweets and sweeter sweets.
it’s a tough thing to eat healthy and break habits, but maybe just make small changes, if diabetes is in your family, you could hold off developing it with healthier food

There is a percentage of error in any lab test. Plus certain medications can elevate levels. With diabetics outright stress can raise blood sugar levels, I’m not sure about “normal” people.

When you get unusual results, usually they retest, which is what was done and it’s normal.

However a slight warning here, diabetes runs in families. Type 2 is definitely something that when a parent has it, your odds go way up. It sounds like you are eating healthy right now, I see no reason for you to go low carb, but a I see a huge reason to watch your sugar eating. Exercise is also one of the best things you can do for your health too!

So don’t worry so much as just stay on the right path of healthier eating!

The lab test was just a snapshot and might not represent your day to day. You can buy a finger stick blood glucose meter at any drug store without a prescription. They are pretty cheap, it’s the test strips that are relatively expensive. Contour Next is a reliable meter. With some finger stick tests maybe you can set your mind at ease by seeing what your range is…fasting, before a meal vs 1 hr after meal, 2 hr after meal etc.

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It is generally not the candy that will do you in as it is quick into your bloodstream and quick out, of course in moderation. You can eat candy and sugar, even as a diabetic. It is the white stuff that will get you and you need to watch as those nasty carbs linger in your body for days. Bread, pasta, rice and other wheat products. Get a good cheap glucose meter and strips and test your blood after various foods and you will know the effect on your blood sugar.

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I don’t think this is or the other content about diet in your comment is true. Can you provide any reliable sources for this or that somehow bread/pasta etc is worse than candy? Processed white carbs include processed sugar, i.e. candy. None of it is good except in small amounts for someone with a significant family history of T2D (or for anyone really).

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Also to the OP, if you are concerned, you can ask for fasting insulin levels (rather than blood glucose) with your next regular blood work. That’s now seen as an even more sensitive measure for early prediabetes, since insulin levels go up prior to blood glucose regulation impairment. But I agree with the folks who suggest continuing to consider dietary stuff given the family history and maybe a consult with a nutritionist if that feels helpful, but to otherwise not worry.

The 123 was a fasted result.

Also sorry, I just opened the forum. I know I’m responding late.

I’ll give the fasting insulin test a go.

I’m wondering if it’s a good idea to get the fasting glucose retested as well. Or maybe fasting insulin?

I have a OneTouch Ultra 2, but I can never get sufficient blood despite poking on the sides of my finger, warming it with water, and massaging. I even put on the biggest depth.

What actually are the odds? Like percentage wise. I assume it’s higher if more than 1 parent has T2, but are the odds so high that I’m very likely to get it? Only 1 of my parents has prediabetes (which is in remission now due to low carb eating)

@BBrandt247 Get a blood glucose meter. They aren’t expensive. Walmart has cheap meters and strips. Start testing, when you wake up, before meals and 2 hours after meals and before you go to bed for 3-5 days. It will give you a very accurate picture of what your blood sugars are doing.

As for an insulin test…it wouldn’t hurt but I would wait to find out with a blood glucose meter what you are testing at first before I would worry about it.

I know it is higher odds. It wouldn’t matter if it is controlled as your parent “got” it in the first place. Google it is the best bet. When I googled it just now it said your odds are fourfold. I don’t really know if that’s true. I just know you are at higher risk.

I have a meter (OneTouch Ultra 2). I just can never get enough blood despite warming it with water, poking at the sides, massaging the finger. I also have palmar hyperhidrosis (basically my fingers sweat uncontrollably) and so sometimes even if I wipe the sweat it comes back almost instantaneously and I assume this makes it very hard to get an accurate reading since salt can give an inaccurate reading. I have wasted so many test strips trying to get enough blood.

Otherwise if I could accurately get a blood reading, it would help put my mind to ease. But I can’t and it’s frustrating.

From what I understand, you can’t reverse prediabetes (even though Google wrongly says you can). If he went back to his normal diet it would come back. Hence why I said “controlled”. I just googled it and some sources say I have a 30% chance of developing type 2 diabetes.

Although my dad had excess weight. I don’t. But I understand that lean people can get T2. I also heard building muscle reduces the risk of T2 which is what I’m trying to do.

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Forgot to mention. Not sure if this is a symptom but sometimes when I eat candy or something sugary I get very light headed. I assume this is a symptom of hyperglycemia? (Too high blood sugar)

It would depend on the amount of sugar you ate. A piece of hard candy is usually only about 5 carbs, but a whole candy bar can be 25-50 carbs plus. Some people don’t feel good with high blood sugar but it might be the quick change in blood sugar levels causing more of an issue. Because if you increased enough to not feel good the odds are regular food sometimes would cause it too? If you have an issue.

Testing helps figure that out, but that’s not good you can’t test. The One Touch Verio definitely only takes a very small amount of blood to read. Much better than most. If you get really suspicious you could self fund and wear a Libre. They run about $37 each and you can use most smartphones now as a reader. They finally released their ap. You still need a script written for the sensor itself.

There is a genetic inherited issue. But the odds are a lot more in your favor of never getting it if you develop healthy habits in the first place.

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Try the Contour Next One I recommended for you above as it requires far less blood for the test strip than the One Touch Ultra 2 and even if you don’t get enough blood initially, it gives you sufficient time for a second finger stick elsewhere. It is also a more accurate meter. I have used both but once on Contour One Next, never went back to the One Touch.

Check out this March 2021 information from Virta Health.

Over 2 years, 97% of Virta prediabetes patients avoided progression to type 2 diabetes. Using the National Institutes of Health Diabetes Prevention Program (NIH DPP) trial as context¹, one way to frame this is that nearly 3x more people progress to T2D in the NIH DPP lifestyle intervention (approximately 5x more in the Metformin intervention), compared to Virta patients.

Here’s the full page link.

I’ll give that a try! Might help put my mind to ease if I notice that my fasting levels and post meal #s turn out to be normal

The 4.7 a1c is really a good number. I doubt you are going high for very long.
And I agree that prediabetes is not reversible. Because it’s really diabetes that’s not progressed yet.
Eating lower carbs or exercising will lower sugars to normal levels, but the insulin resistance still exists.
With type 2 it usually gets worse over time until the low carb and exercise just isn’t enough.

On top of the fact that eating fat will also make insulin resistance worse, and most low Carb diets are high in fat.

So, yea. It’s hard to thread that needle.