PCOS Messages for December, 2001: Re: PCOS and no IR?

Re: PCOS and no IR?

From: Belle (anonymous@obgyn.net)
Mon, 31 Dec 2001 13:23:48 -0600 (CST)

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In reply to: anonymous: "Re: PCOS and no IR?"

It is great that you are so concerned about your clients however the actual 2001 standards diagnosing diabetes for the ADA are listed on this site. http://www.diabetes.org/clinicalrecommendations/Supplement101/S21.htm

The specific portion of the diagnostic requirements that pertain to this issue are pasted below:

Nondiabetic individuals with an FPG >110 mg/dl (6.1 mmol/l) but <126 mg/dl (7.0 mmol/l) are considered to have IFG, and those with 2-h values in the OGTT >140 mg/dl (7.8 mmol/l) but <200 mg/dl (11.1 mmol/l) are defined as having IGT. Both IFG and IGT are risk factors for future diabetes. Normoglycemia is defined as plasma glucose levels <110 mg/dl (6.1 mmol/l) in the FPG test and a 2-h postload value <140 mg/dl (7.8 mmol/l) in the OGTT.

(This information is located just below Table 2)

As you can see 140 mg/dl - 200 mg/dl are defined as Impaired Glucose Tolerance.

I think that part of the difference here is that the original poster was discussing *fasting* levels and listed a number up to 199 mg/dl as being normal, which may be what her lab uses but which is far too high for a normal value according to every reference that I can access. The numbers that I gave are the diagnostic numbers. These are the ones that the doctors would be using when trying to diagnose diabetes.

I *think* that the numbers you are refering to are not post-prandial, nor are the after an 8 to 12 hour fast. These are more like maintainance numbers. The result of a random test that could be taken at anytime through the day.

Also, you could possibly be thinking of the post treatment levels. If I had a client come in who was on diabetic treatment yet came in with glucose of 180 mg/dl, it would indeed be concerning. But, while diabetic plans are individualized, I have seen many plans which use a goal of 65 mg/dl to 180 mg/dl as the maintence level for diabetics under the care of specialist.

Obviously the lower a diabetic keeps their bloodsugar, the better (within normal ranges), especially when in refence to impaired wound healing.

I hope this clears some things up. It can be very confusing.

The ADA website is http://www.diabetes.org

At Mon, 31 Dec 2001, anonymous wrote: >
>Actually the cut-off for diabetes is much lower than what you stated.
>The
>current ADA (American Diabetes Assoc.) levels are 126 for a fasting, and
>140-something (I forget the exact number) for a random (anytime in the
>day).
>
>My wound program is part of a diabetes program, and I help work the
>screening
>events. These are the numbers on the ADA forms. If someone came in
>with a
>sugar of 180, I wouldn't call them glucose intolerant. I'd call them
>diabetic,
>definitely. And, if my diabetic patient told me that his sugar was 180,
>I'd
>consider that high, even for a diabetic.
>
>I just don't want anyone to not get treatment thinking they aren't
>diabetic
>when they may be, based on their blood sugar level.
>
>Renee
>
>Belle wrote:
>> Fasting
>> glucose means nothing. 199mg/dl is not normal. 200mg/dl is diabetic.
>> Between 140 and 199 mg/dl is considered Glucose Intolerant. Fasting
>> levels should be less than 120 mg/dl but ideally between 60 - 80mg/dl
>> for a 8 - 12 hour fast.
>
>--
>Renee Cordrey, MSPT, MPH, CWS
>
>---
>
>Don't follow in the footsteps of the masters. Seek what they sought.
> --Zen saying
>

-- Hope this helps,

Belle

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