Diabetes: Symptoms, Diagnosis, and When to Medicate

Q: Diabetes: Symptoms, Diagnosis, and When to Medicate

Hello Ms. <br>Huang： You likely have early-stage diabetes, and you need to manage your diet, engage in regular exercise, and attend follow-up appointments for monitoring.

Diabetes mellitus

Hello, three years ago during a health check, I was informed that my blood glucose was on the borderline of diabetes, with a fasting blood glucose level of 108 mg/dL after fasting for 8 hours.
Now, my self-monitored fasting blood glucose levels range between 103 and 125 mg/dL.
Over the past month, I have recorded levels of 126 mg/dL and 131 mg/dL (averaging once a week).
Does this mean I have diabetes? I consulted a doctor, but the explanation was unclear.
They ordered a blood test for my glucose levels and advised me to pay attention to my diet and exercise.
Do I need medication? Under what circumstances would I need medication? I have symptoms of thirst, frequent urination, dizziness, occasional sudden weakness in my arms and legs, and numbness in my hands and feet.
Is the diagnosis of diabetes solely based on blood glucose levels? Thank you.

Ms. Huang, 30~39 year old female. Ask Date: 2008/09/04

Dr. Chen Qingbin reply Internal Medicine

Hello Ms.
Huang: You likely have early-stage diabetes, and you need to manage your diet, engage in regular exercise, and attend follow-up appointments for monitoring.

Reply Date: 2008/09/04

More Info

Understanding diabetes, particularly its symptoms, diagnosis, and treatment options, is crucial for managing this chronic condition effectively. Based on your situation, it appears that you are experiencing fluctuations in your fasting blood glucose levels, which have ranged from 103 to 131 mg/dL. This range indicates that you are likely in the prediabetic stage, as normal fasting blood glucose levels are typically below 100 mg/dL, while levels between 100 and 125 mg/dL are classified as prediabetes. A fasting blood glucose level of 126 mg/dL or higher on two separate tests is required for a diabetes diagnosis.

Your symptoms of increased thirst, frequent urination, dizziness, and episodes of weakness or numbness in your limbs are concerning and may indicate that your blood sugar levels are not well controlled. These symptoms, often referred to as the "three P's" of diabetes—polydipsia (excessive thirst), polyuria (excessive urination), and polyphagia (excessive hunger)—are classic indicators of diabetes. However, they can also occur in prediabetes or even in other conditions, so it is essential to consider the entire clinical picture.

Regarding your question about medication, the decision to start pharmacotherapy for diabetes is typically based on several factors, including:
1. Blood Glucose Levels: If your fasting blood glucose consistently exceeds 126 mg/dL or if your HbA1c (a measure of average blood glucose over the past 2-3 months) is 6.5% or higher, medication may be warranted. Since you mentioned that your doctor has advised you to monitor your blood glucose and adjust your diet and exercise, it suggests that they are considering lifestyle modifications as the first line of treatment.

2. Symptoms: The presence of significant symptoms, such as those you described, may also prompt your healthcare provider to consider medication sooner rather than later, especially if lifestyle changes alone do not lead to adequate control of your blood sugar levels.

3. Risk Factors: Other risk factors, such as family history of diabetes, obesity, hypertension, or dyslipidemia, may influence the decision to initiate medication.

4. Response to Lifestyle Changes: If you are actively working on improving your diet and increasing physical activity but still see little improvement in your blood glucose levels, medication may be necessary to help achieve better control.

In terms of monitoring, it is essential to continue regular blood glucose checks and to have periodic HbA1c tests as recommended by your healthcare provider. This will help you and your doctor assess how well your management plan is working.

In conclusion, while your current blood glucose levels suggest you are in the prediabetic range, the presence of symptoms and the fluctuations in your readings indicate that you should remain vigilant. It is crucial to maintain open communication with your healthcare provider about your symptoms and any changes in your condition. If your symptoms worsen or if your blood glucose levels remain elevated, it may be time to discuss the possibility of starting medication to help manage your diabetes effectively. Remember, early intervention can significantly reduce the risk of developing complications associated with diabetes.

Similar Q&A

Understanding Diabetes Symptoms: When to Seek Medical Advice

Hello Doctor: On April 30th, my fasting blood glucose was 98, and my hemoglobin A1c was 4.8. On May 15th, my fasting blood glucose was 91, and my hemoglobin A1c was 4.7. However, on August 14th, my fasting blood glucose was 102, and on August 27th, it was 104, but I did not have ...

Dr. Li Jian reply Internal Medicine
The diagnostic criteria for diabetes are a fasting blood glucose level of 126 mg/dL or higher, or a hemoglobin A1c level of 6.5% or higher. Symptoms such as tingling, fatigue, blurred vision, and frequent urination cannot currently be interpreted as indicative of diabetes.

Understanding the Four Key Symptoms of Diabetes: Thirst, Hunger, Urination, and Weight Loss

The "three polys and one less" symptoms of diabetes refer to: 1. Polyuria: Increased urination. 2. Polydipsia: Increased thirst. 3. Polyphagia: Increased hunger. 4. Weight loss: Unintentional weight loss.

Dr. Xiao Yongxun reply Internal Medicine
Hello: In response to your question, the common clinical symptoms of diabetes include polyuria (excessive urination), polydipsia (excessive thirst), polyphagia (excessive eating), and weight loss. If any random plasma glucose level is greater than or equal to 200 mg/dL, it may in...

Understanding Diabetes: Key Questions on Symptoms and Treatment

Hello, doctor. I am a university student majoring in biomedical sciences, and I am currently working on a paper discussion topic. My report is about the use of Ephedra to treat hyperglycemia and oxidative stress caused by diabetes. Initially, I noticed some symptoms of diabetes, ...

Dr. Liu Hongxiang reply Family Medicine
Hello, university student: If you are currently experiencing any symptoms of diabetes, the best solution is to visit a hospital for testing, as you may receive results on the same day. Streptozotocin is used in medical research to establish animal models for Type 1 diabetes, whil...

Should You Rely on Medication for Diabetes Management?

Hello, doctor. At the end of May and the beginning of June, my blood sugar was checked at 127, and my hemoglobin A1c was 7.2. The doctor said I have diabetes and prescribed medication for me. A friend mentioned that my levels are not too high and that I shouldn't take medica...

Dr. Lin Zhebin reply Family Medicine
Hello: Since you have just been diagnosed with diabetes, I would recommend that you manage your blood sugar through a combination of medication, diet, and exercise. Although your fasting blood sugar in the morning is only slightly elevated, your postprandial blood sugar may be hi...