DEAR DR. DONOHUE: I have enclosed the results of my diabetes tests. I’ve gotten two different opinions on them. One says I am headed for diabetes. What does that mean? The other says my results are normal. How about a third opinion? Isn’t the urine test for diabetes done anymore? If not, why not? — D.T.

ANSWER: Professional diabetes organizations that set the criteria for diagnosing diabetes regularly change the values they use to denote diabetes. They make the changes as more scientific information on diabetes develops.

The fasting blood sugar — FBS, more correctly called fasting plasma glucose — is a standard test for diabetes. “Fasting” means taking no calories for the eight hours preceding the time when blood is drawn. A normal test is one in which the glucose value is less than 100 mg/dL (5.6 mmol/L). A value of 126 (7.0 mmol) or greater is considered diabetes. A second test usually is required before the diagnosis becomes firm.

Your value is 110 (6.1). This is in the bracket of 100 or greater, but is less than 126. That range of values isn’t diabetes. It’s called impaired glucose tolerance. Being in that range puts you at a higher risk of developing diabetes, or “headed for diabetes,” in the words of one of your consultants. You have to do everything you can to lower your blood sugar. One of the best ways of getting that done is through weight loss, and the weight loss doesn’t have to be monumental.

A second, now commonly used test for diabetes is the HbA1C, hemoglobin A1C test. Hemoglobin is a giant protein inside all red blood cells. It’s the magnet that draws oxygen into the blood for delivery bodywide. If blood sugar is higher than normal, sugar coats hemoglobin. It turns a percentage of the hemoglobin into a glazed donut. Hemoglobin A1C has a distinctive advantage. It paints a picture of what your blood sugars have been for the preceding three months. A value of 6.5 percent is diabetes. Values between 5.7 and 6.4 are in the impaired blood sugar range. Again, your HbA1C value of 5.8 indicates that’s where you are on this test.

Urine tests for diabetes aren’t reliable and aren’t routinely used these days.

TO READERS: The booklet on heart attacks, America’s No. 1 killer, explains what happens, how they are treated and how they are avoided. Readers can order a copy by writing: Dr. Donohue — No. 102, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: For five years, doctors have tried to track down the reason why my liver enzymes are high. I don’t smoke, do drugs or drink alcohol. I’ve been checked for hepatitis twice. I had a liver scan that was normal. What do you think of this? — L.C.

ANSWER: I don’t know how high your liver enzymes are. If they’re not fantastically high, you might be one of those people who have tests outside the norm but have no illness. Some time ago, the Air Force checked 20,000 enlistees and found abnormal liver enzymes in 99. Only 12 out of the 99 had a true liver problem.

I believe you have been tested to the full. You have no symptoms. No signs of illness have appeared in five years. It’s most unlikely they ever will.

DEAR DR. DONOHUE: On the report for my last chest X-ray, it said: Old, calcified granulomas are seen in the right lung. A few calcified nodes are also seen. No active disease is identified.” Does this mean anything bad? — B.L.

ANSWER: Granulomas are heaps of dead cells that died in service to your body. They were fighting off an invader, like a bacterium or fungus. The body coated them with calcium as a fitting resting place. The TB germ is a bacterium that often leads to granuloma formation.

You do not have TB. You are not coming down with TB. You can forget the report.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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