Blood Sugar Issues: When to Seek Medical Advice

Q: Blood Sugar Issues: When to Seek Medical Advice

Dear Ms. Alice： 1. According to the diagnostic criteria for diabetes set by the American Diabetes Association： a. Fasting plasma glucose level ≥ 126 mg/dL after 8 hours of fasting, b. Plasma glucose level ≥ 200 mg/dL during a 2-hour oral glucose tolerance test,

Blood sugar issues?

The hospital's blood test report shows an AC of 89 and an HbA1c of 5.3.
Although these values are within the normal range and the lab technician mentioned that a single test may not be conclusive, during the Lunar New Year period, I experienced intermittent eating patterns.
After lunch, I felt a sharp pain in the outer side of my right thigh, similar to an electric shock along a line on the outer thigh.
I have had a similar sensation before, with sharp pain in the outer nerves of both thighs.
Could this be related to diabetes, or is it due to another cause? If I need to see a doctor, which specialty should I consult?

Alice, 30~39 year old female. Ask Date: 2016/04/22

Dr. Xiao Yongxun reply Internal Medicine

Dear Ms.
Alice:
1.
According to the diagnostic criteria for diabetes set by the American Diabetes Association: a.
Fasting plasma glucose level ≥ 126 mg/dL after 8 hours of fasting, b.
Plasma glucose level ≥ 200 mg/dL during a 2-hour oral glucose tolerance test, c.
HbA1c (glycated hemoglobin) ≥ 6.5% (this must be confirmed with a method that is certified by the National Glycohemoglobin Standardization Program (NGSP) and meets the standards of the Diabetes Control and Complications Trial (DCCT)).
The above criteria a, b, and c must be confirmed on two separate occasions.
d.
If there are clinical symptoms of diabetes (such as polydipsia, polyuria, polyphagia, weight loss, etc.), a single plasma glucose level ≥ 200 mg/dL is sufficient for diagnosis.

2.
Although the diagnosis of diabetes often requires two test results, it is likely that your test results do not indicate diabetes.
3.
Diabetic neuropathy primarily involves peripheral neuropathy (especially in the extremities) and autonomic neuropathy.
While it is possible to have a mononeuropathy, such cases are less common; moreover, there is currently no evidence of diabetes in your case.
4.
The pain in the outer thigh may be due to neuropathy, but it could also be related to muscle or ligament issues, or possibly spinal nerve root pathology.
Additionally, other causes such as medication, tumors, or inflammatory responses could also be contributing factors.
I recommend discussing this with your primary care physician or seeking evaluation from a neurologist.
Best regards.

Reply Date: 2016/04/22

More Info

When it comes to understanding blood sugar issues and when to seek medical advice, it's essential to consider several factors, including your blood test results, symptoms, and overall health history. Based on the information you provided, your blood test results show an AC (presumably A1C) of 89 and an HbA1C of 5.3, which are within the normal range for blood sugar levels. However, you mentioned experiencing pain in the outer side of your right thigh, described as a nerve-like pain, which raises some concerns.

Firstly, let's clarify the significance of your blood sugar levels. An HbA1C of 5.3% indicates good blood sugar control and suggests that you are not diabetic. The American Diabetes Association considers an HbA1C below 5.7% as normal, while levels between 5.7% and 6.4% indicate prediabetes, and 6.5% or higher is diagnostic for diabetes. Therefore, your HbA1C level suggests that you are not at risk for diabetes at this time.

However, the symptoms you are experiencing, particularly the nerve pain in your thigh, warrant further investigation. This type of pain could be attributed to various causes, including peripheral neuropathy, which can sometimes be associated with diabetes, but also other conditions such as sciatica, muscle strain, or even issues related to blood circulation. It is important to note that while your blood sugar levels are normal, other factors could be contributing to your symptoms.

Given that your symptoms are neurological in nature, it would be advisable to consult a healthcare professional who specializes in neurology. A neurologist can perform a thorough examination, possibly including nerve conduction studies or imaging tests, to determine the underlying cause of your pain. Additionally, if you have any concerns about your blood sugar levels or metabolic health, an endocrinologist would also be a suitable specialist to consult. They can provide insights into your overall metabolic health and help you understand if there are any risks or preventive measures you should consider.

In the meantime, it is crucial to monitor your symptoms closely. If the pain persists, worsens, or is accompanied by other symptoms such as numbness, tingling, weakness, or changes in bowel or bladder function, you should seek medical attention promptly. These could be signs of a more serious condition that requires immediate evaluation.

Moreover, lifestyle factors such as diet, exercise, and stress management play a significant role in maintaining healthy blood sugar levels and overall well-being. Engaging in regular physical activity, eating a balanced diet rich in whole foods, and managing stress can help support your metabolic health and potentially alleviate some of the symptoms you are experiencing.

In summary, while your blood sugar levels appear to be normal, the nerve pain you are experiencing should not be overlooked. Consulting with a neurologist is a prudent step to determine the cause of your symptoms. Additionally, maintaining a healthy lifestyle can contribute positively to your overall health. If you have any further questions or concerns, do not hesitate to reach out to a healthcare professional for personalized advice.

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