Am I at Risk for Diabetes or Prediabetes? Symptoms and Tests

Is it diabetes or prediabetes?

Hello, I would like to ask you about diabetes.
Here are my conditions/test results listed below:
[Two and a half years ago] Newborn health check showed fasting blood glucose of 75 mg/dL; liver, kidney, and other tests were normal.

[One and a half years ago] I started experiencing dry mouth symptoms, and I observed that the dry mouth led to increased water intake, which resulted in frequent urination, rather than frequent urination causing dry mouth.
This was accompanied by feelings of hunger, which improved after a while.

[One year ago] During military service health check (summer military), my blood glucose was tested 1-2 hours after a meal, but the report did not indicate blood glucose levels; other tests were normal.

[One month ago] I experienced dry mouth again, accompanied by feelings of hunger, especially before meals.
I consulted a gastroenterologist who suggested this might resemble ulcer symptoms (similar to two and a half years ago, when I was quite certain I had a gastrointestinal ulcer).
At that time, I self-diagnosed with diabetes and felt quite distressed, so I visited a family medicine doctor.
The next day, he tested my fasting blood glucose (along with liver and kidney tests and urinalysis).
That day, I weighed 2 kg more compared to six months ago.
Four days later, my fasting blood glucose was 99 mg/dL, liver and kidney tests were normal, and urinalysis was normal.
The doctor, noticing my concerns, asked if I had eaten, and I mentioned I had consumed 350 mL of unsweetened Quaker oatmeal an hour prior.
He said that was acceptable for testing.
However, I later realized it had only been about 40 minutes since I ate, and the result was 104 mg/dL, which he said was normal (I was a bit worried about the 20-minute discrepancy).
When I reviewed the report, the printed results were not yet available, and I was unsure if he had tested my glycated hemoglobin (HbA1c).
He only mentioned that all my test results were normal, except for slightly elevated bad cholesterol, which was 1 point above the standard (though I had emphasized wanting to check for diabetes during my first visit).
In summary: No family history of diabetes, age 20, height 183 cm, weight 65 kg, non-smoker, non-drinker.
The dry mouth symptoms and gastrointestinal ulcer symptoms appear and disappear simultaneously; I am uncertain if there is a correlation (though I found no similar symptoms in my research on gastrointestinal ulcers, only in traditional Chinese medicine).
The dry mouth is somewhat noticeable after meals (10 minutes later) but sometimes does not occur after eating.
I have been paying attention to my bladder due to frequent urination, and sometimes I go to bed late (around 2 or 3 AM).
My hygiene habits are poor.
Am I experiencing prediabetes? Is my dry mouth a symptom of diabetes? I feel exhausted living in constant worry, which is why I am asking.
Thank you for your response.

dàxuéshēng, 20~29 year old female. Ask Date: 2020/04/29

Dr. Ye Qianyu reply Family Medicine

Hello! Based on the information you provided, there is currently no risk of diabetes, and it is recommended that you follow up in six months.
The symptom of dry mouth is quite nonspecific; staying up late and insufficient hydration can both cause dry mouth.
It is advisable to adequately hydrate and monitor your urine output and color.
A low volume or dark color indicates dehydration.
Please aim to drink water daily and consider increasing your intake by 500-1000 cc based on your condition.
Additionally, developing a regular exercise routine can help reduce feelings of tension and anxiety.

Reply Date: 2020/04/29

More Info

Based on your detailed description of your health history and recent test results, it seems you are understandably concerned about the possibility of being at risk for diabetes or prediabetes. Let's break down your situation and clarify some important points regarding diabetes risk assessment, symptoms, and necessary tests.

Understanding Diabetes and Prediabetes
Diabetes is a chronic condition characterized by high blood sugar levels due to the body's inability to produce or effectively use insulin. Prediabetes is a state where blood sugar levels are higher than normal but not yet high enough to be classified as diabetes. The American Diabetes Association (ADA) defines the following criteria for diagnosing diabetes and prediabetes:
1. Fasting Plasma Glucose (FPG):
- Normal: Less than 100 mg/dL
- Prediabetes: 100-125 mg/dL
- Diabetes: 126 mg/dL or higher
2. Hemoglobin A1c (HbA1c):
- Normal: Less than 5.7%
- Prediabetes: 5.7% to 6.4%
- Diabetes: 6.5% or higher
3. Oral Glucose Tolerance Test (OGTT):
- Normal: Less than 140 mg/dL
- Prediabetes: 140-199 mg/dL
- Diabetes: 200 mg/dL or higher

Your Test Results
From your recent tests, you mentioned a fasting blood sugar of 99 mg/dL and a postprandial (after meal) blood sugar of 104 mg/dL. Both of these values are within the normal range, but they are close to the threshold for prediabetes. Your concern about the slight discrepancy in timing for the postprandial test is valid; however, the values still fall within the normal limits.

Symptoms and Concerns
You also reported experiencing symptoms such as dry mouth and increased thirst, which can indeed be associated with diabetes. However, these symptoms can also arise from other conditions, such as dehydration, certain medications, or gastrointestinal issues like ulcers, which you mentioned. The fact that you have a history of gastrointestinal problems could suggest that your symptoms may not be directly related to blood sugar levels.

Recommendations
1. Regular Monitoring: Given your concerns and the slight elevation in your blood sugar levels, it would be prudent to monitor your blood sugar regularly. Consider getting an HbA1c test done to provide a broader view of your blood sugar control over the past few months.

2. Consult a Specialist: If your symptoms persist or worsen, it may be beneficial to consult an endocrinologist or a diabetes specialist. They can provide a more comprehensive evaluation and may suggest further testing, such as an OGTT or continuous glucose monitoring.

3. Lifestyle Modifications: Regardless of your current status, maintaining a healthy lifestyle is crucial. This includes a balanced diet, regular physical activity, and weight management. Since you mentioned being underweight, ensure that your diet is nutritious and sufficient to meet your energy needs.

4. Manage Stress and Anxiety: Living in constant worry about your health can be exhausting. Consider speaking with a mental health professional or a counselor who can help you manage anxiety and provide coping strategies.

5. Stay Informed: Educate yourself about diabetes and its risk factors. Understanding the condition can help alleviate some of your fears and empower you to take proactive steps in managing your health.

Conclusion
While your current test results do not indicate diabetes or prediabetes, your symptoms warrant further investigation. Regular monitoring and consultations with healthcare professionals will help you stay informed about your health status. Remember, early detection and lifestyle changes can significantly reduce the risk of developing diabetes in the future.

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