Patient: My fasting blood sugar is 158 first thing in the morning, but it is 104 two hours after dinner. Am I diabetic? I have a Dr appointment in two weeks to get blood work and a diagnosis, but I am curious now about what might be going on. I am 27, a male, 6 ft tall and weigh 307 pounds. I have been counting carbs and exercising for three weeks and have lost 11 pounds.
Doctor: Hello. Welcome to Ask The Doctor. We are here to help you.So if your fasting blood sugar is high it raises suspicion t hat you might have Diabetes. Post dinner blood sugar has no significance in diagnosing Diabetes.To diagnose Diabetes we consider Fasting and 2 hours post prandial (after Fasting) blood sugar readings significant.If your Fasting is more then 126 mg/dl then you have Diabetes. You may however repeat the readings to nullify any errors.Now, the best test to diagnose Diabetes is Glycosylated Hemoglobin (HbA1c). It gives you an average blood sugar level of last 3 months and is not effected by your prior meals. So it is considered as gold standard test for diagnosing Diabetes. The results will give you clear cut value and will tell that you have Diabetes or not. And it also helps in monitoring the follow up.So in your case i would advise you to get :1. Fasting and Post Prandial blood sugar.2. HbA1c.3. Urine for microalbumin.4. Fasting lipid profile.5. Kidney function tests.6. ECG.7. Fundus examination to rule out Early Diabetic retinopathy.This long list of tests I have mentioned are important to rule out Diabetes and also to rule out its complications.So, get investigated and I would like to discuss with you on the treatment part once you have your reports as the treatment would be based on the HbA1c levels.I hope I am able to help you. If you have any further query, please ask me.Stay Healthy.