High fasting blood glucose, normal OGTT, hypoglycemia
Patient :41 year old active female, NOT overweight ( 5'10, 130Ibs), on no medications, good BP & Cholesterol, no other medical problems, eat a very healthy diet with no processed foods and very little sugar, plenty of whole foods, veggies, nuts, seeds, lean meats, healthy grains.
Have had 2 high fasting blood glucose tests in the last month (101 mcg/dL, and 105 mcg/dL with normal range being 70-100), but a normal Oral Glucose Tolerance Test (GLU GTT-FAST: 99 mg/dL, GLU GTT - 2HR: 84 mg/dL). Also normal Insulin of 7.6 uIU/mL (range 2.6 - 24.9). Microsomal Antibodies
Symptoms: Undiagnosed hypoglycemia spells that have increased in frequency lately to several times per day (shaking, sweating, nausea, heart palpitations, light headed, resolves upon eating something with sugar). Also extreme fatigue, tingly/numb hands, restless at night, sometimes insomnia, multiple cataracts, retinal hemorrhages, spells of double vision, damaged blood vessels in eyes seen during dilated eye exam, floaters, dry eyes and nose, frequent infections, occasional headaches, frequent urination.
Thank you for writing to Ask The Doctor
I have gone through your query and I do not think that you have a problem with glucose. There is a chance that you have some disease or a pre-disease which can be controlled by certain steps. Hypoglycemia is common in people who do not consume long term release sugars. If you are not taking things like oats or rice which are released slowly to the body, then there is a chance of low sugar.
Based on your weight, I also think that you do not have excess fat or too much of glycogen stores. This can cause the hypoglycemia you had.
Coming to the increased level of glucose in the blood. The levels are raised by less than 5 mcg and this can happen if you did a sudden run to the test centre or if there was a release in adrenaline which caused the glucose levels to go up. Combined with the normal GTT, I do not think that this is anything to worry about.
I am worried about the fatigue that you are having. There is a chance that this is a migraine or there is a chance that you are more predisposed to blood clots. I recommend that you get checked for a HbA1c and a D-dimer assay. This can help get to the cause.
I also recommend that you see a Neurologist to check your double vision. There is a chance that this is just a migraine that is causing problems but I would want to confirm the cause.
All the best and do follow up after you get the reports. Wish you the best of health.
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