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Nonfasting exam not a reliable guage for diabetes

Dear Dr. Gott: My recent nonfasting glucose was 102, and A1C was 6.21. My physician wants to repeat the A1C in three months and, if it is still elevated, will recommend oral diabetic medication. What is your opinion? I am 82.

Dear reader: Your blood tests do not unequivocally indicate diabetes. Even if these numbers were based on a fasting glucose and A1C, I would not recommend medication.

Nonfasting blood tests for diabetes, cholesterol and other disorders are not reliable enough to form the basis for a diagnosis. The tests measure not only what your body is making and storing, but also whatever fats, sugar, etc., were in the food you ate in the last six to 12 hours. This is why most physicians order blood work when a person has not eaten anything since dinner the night before the testing.

I urge you to request a retest after fasting to provide a more accurate result. If your numbers are similar, you do not need medication. I believe your numbers will be even lower in the normal range. If your numbers are abnormal, don't take any medication before trying nonmedical treatments, such as getting more exercise, losing weight if you are stout, and cutting back on sugar and sweets.

Given your age and the normal blood test results, I'd follow up with blood-sugar testing once or twice a year.

— Dr. Peter Gott is a columnist for Newspaper Enterprise Association. Questions may be sent to him in care of United Media Services, 200 Madison Ave., 4th Floor, New York, NY 10016. Questions of general interest will be answered in future columns.

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