Diagnosing Type 2 Diabetes in a lean young adult.

Patient: 20 y/o male, I am experiencing all the symptoms of type 2 diabetes. I am of normal BMI but have a “beer gut”,have lived an extremely sedentary lifestyle and my maternal great-grandmother died of Diabetes in her forties.I began to experience the outlined symptoms below while travelling abroad, initially a sudden onset of constant urination and inexplicable drowsiness. I immediately thought of diabetes, being well aware of the disease, having studied it extensively in my previous college year. I continued on my vacation but started limiting my carbs, just until I could get home to see a doctor. I eventually got a HBA1C which came back within normal parameters, and yet my symptoms continued and more emerged.I purchased a BG meter and began to exercise intensively daily and eat a an extremely healthy diet, limiting carb intake to only 150 grams a day. Milk and cereal (60g of carbs) resulted in an unacceptable 1 and 2 hour postprandial BG of 166 and 156.6 respectively. Following my new diet and exercise regime my BG levels remain in the euglycemic range of a non diabetic almost all the time. However, the symptoms still remain (with vision abnormalities, paresthesia in feet, still slightly elevated urination), despite “acceptable” HBA1C’s and a OGTT that is at the highest possible result for a non-diabetic. The ophthalmologist I saw regarding my eyes detected “macular” changes in both eyes, but because of the blood results, cannot consider T2DM.Are there any other more definitive tests regarding diabetes I can request or convince my own doctor to order to get these symptoms diagnosed?

Symptoms: Unexplained tiredness, insatiable hunger, hourly urination, tingling/numbness in feet/legs (esp. after eating), flashers/dark floaters constant in eyes, impaired night vision, slow healing cuts on hands, knees and feet, inability to gain weight. Also yellowed fingernails.

Doctor: