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Do I have diabetes or is it just glucose intolerance?

Q: I am of Asian descent, 6.1 feet tall, weigh 250 pounds. I got recently tested for glucose levels and was having levels of 226 after 2 hrs of my heavy breakfast. Afterwards I made too many lifestyle changes like: No Alcohol, No castor powdered sugar in any form, taking complex carbohydrates mainly. I am on low fat diet. My brisk walking plan also seems to be working as the pain in the legs have gone away gradually. My Glucose levels are like this: 105-110 in the morning (fasting), after 2 hrs breakfast of whole grain cereal, low fat yogurt and one egg omelette, it goes up to 200/210 or 180 or 190. Then immediately before lunch it comes down to 125 or even less. And if I go for 8 hrs fasting after taking lunch, it is well within the normal range (< 110) in the evenings. I wonder what kind of diabetes I am suffering from? Is it Insulin Resistance or Diabetes in its real form?

A:To be sure whether you have diabetes or only impaired glucose intolerance (IGT) you need to undergo OGTT i.e., fasting and 2-hour post 100 gm glucose. If either fasting is >126 mg or post glucose >200 mg/dl then you have diabetes mellitus and if fasting is normal and post glucose is >140 and <200 mg/dl then you have IGT. In addition also get your lipid profile done. Insulin resistance is contributing factor in both. Treatment is lifestyle modification which you have already started and insulin sensitizers i.e., Metformin 500 mg twice a day after meals.


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