pre-diabetesNew day, new patient. Fasting glucose is 124 mg/dL. Triglycerides are 560, HDLs 28. Patient is 50 pounds overweight. Does she or doesn’t she? Is it or isn’t it? The difference between having NO diabetes, pre-diabetes and diabetes can be so minor, a fine-line.

Fasting blood glucose between 65 mg/dL and 99 is “normal”, while 100-125 is pre-diabetes, and 126 and higher (measured on two different occasions) is considered diabetes. Other numbers need to be looked at as well.

The typical profile for a person with diabetes is high triglycerides and low HDL (healthy cholesterol aka high density lipoproteins). This patient was diagnosed with pre-diabetes and yet wasn’t concerned because it was not a true, full-fledged, diabetes diagnosis.

Looking at the other numbers (triglycerides and HDLs) I suggested another glucose test and HbA1c (3-month blood sugar average). Many cases of diabetes are missed and therefore, over the years, the guidelines have been changed.  We should request an “A1c” – especially if we are over the age of 45.

Marci Sloane

Marci Sloane, MS, RD, LD/N, CDE, is a registered and licensed dietitian/nutritionist and certified diabetes educator. She grew up in NYC where she graduated with a degree in Nutrition and Physiology from Teachers College at Columbia University.