Diabetes is one of the most common chronic illnesses across the globe. It is a condition in which the sugar (glucose) level in the bloodstream is too high, as a result of the lack of production or utilisation of the pancreatic hormone, insulin.
Having ‘normal’ blood sugar is a deceptive statement that may hide underlying diabetic conditions.
Testing blood sugar levels is the most popular method to diagnose diabetes. However, there are different variations of the test that measure the blood sugar levels of an individual under various settings.
Taking to X (formerly known as Twitter) on March 20, Dr Sudhir Kumar, MD, DM, a neurologist at Apollo Hospitals in Hyderabad, explained why just one common test may not be enough to rule out diabetes in a patient, and the reason that “your sugar is normal” is “one of the most misleading statements in medicine.”
Case study of misdiagnosis
Dr Kumar shared a professional experience where he witnessed a person being wrongly diagnosed as not having diabetes.
The person in question was a 48-year-old who suffered from burning feet for six months. The condition apparently worsened at night. He had taken help from medical practitioners before Dr Kumar started his treatment.
As the physician explained, “A 48-year-old patient presented with burning feet for 6 months, which worsened during nights. He was evaluated by multiple doctors and given a diagnosis of ‘Idiopathic peripheral neuropathy.’ His Fasting glucose was 94 mg/dL, so diabetes was ‘ruled out.’ He was referred to me for further evaluation.”
Dr Kumar tested HbA1c, which measures the amount of glucose attached to haemoglobin in red blood cells and reveals the average blood sugar level for the last two to three months. The test showed that the HbA1c was 7.1 percent.
“So, the real diagnosis was diabetic neuropathy,” observed Dr Kumar.
The problem with relying on fasting sugar levels
According to Dr Kumar, the real problem lies in the over-reliance on fasting glucose levels to diagnose diabetes.
“Fasting glucose is the least sensitive test for early diabetes,” he stated. “By the time fasting sugar rises, the damage has often already begun.”
To determine if an individual has contracted diabetes, it is important to keep the following pointers in mind:
Fasting sugar is just a snapshot
Post-meal spikes do the early damage
HbA1c reveals what fasting sugar hides
“Many patients already have nerve damage and/or vascular damage while fasting sugar is still ‘normal,’” cautioned the physician.
Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.
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