Thanks.
Can a single blood sugar prick done at a hospital emergency department definitely rule out diabetes?
IANAD, but my understanding is that a single prick done at a hospital ED shows is if blood sugar is within expected ranges.
With diabetics, they cannot control their blood sugar, so it is not within expected ranges. They may have diabetes, just not having a diabetic attack at the time of the prick, and the results will show normal.
What the prick at the ED does tell is there nothing the ED can do as an emergency measure to improve the patients situation. In many cases, diabetes is controlled by diet, and if the diet is controlled, the blood sugar is within expected ranges.
You should contact your primary healthcare provider for [del]more[/del] better information.
A single prick, regardless of any context, is fairly meaningless.
What you’d need to have done is an A1C test, which requires a bit more blood and a lab test. A1C gives you an average of your blood sugar from the past few months and a high enough average will put you in the “diabetic” category.
You need to be tested in a variety of situations and different times of day. Before and after meals.
A single finger lance will just show what your glucose level is at that time.
More info is needed for a diagnosis.
Keep in mind, IANAD.
Interesting. Both the nurse who did the test and the doctor insisted “I was good” and the test showed I’m not diabetic.
The Doctor is looking for Horses not Zebras.
It matters what you were being seen about.
I watch some of the many fly-on-the-wall documentaries we have here which follow paramedics around. If a patient is collapsed or appears to be drunk or concussed, the first thing they do is to test blood sugar. Severe hypoglycaemia symptoms include confusion, unusual behaviour, slurred speech or clumsiness (like being drunk), feeling sleepy, fits (seizures), collapsing or passing out.
I think that you misunderstood and what they meant was that you blood sugar at that time was “good” - which is very different from saying you aren’t diabetic.
A finger stick, coupled with detailed information about what, and what time, you had most recently eaten, can provide a lot of information. If you are showing symptoms that could be diabetic ketoacidosis, or could be something else, they’ll do a finger stick to decide whether to do a blood draw, and then decide to treat you for ketoacidosis, or move on to looking for something else.
It’s possible you were told you didn’t have diabetic ketoacidosis, and you heard that as “you don’t have diabetes.” Those aren’t the same thing. It’s quite possible to be diabetic and not be in ketoacidosis-- in fact, one would hope that is the case.
It’s also possible that if you told the doctor the most recent thing you ate was a large ice cream sundae with three kinds of syrup, and hour ago, and your blood sugar level was 90, which is a low reading for a non-diabetic who recently consumed a very large amount of sugar, the doctor that it was pretty reasonable to presume you were not diabetic.
However, mistakes do happen.
I had one happen (apparently) when I had my gestational diabetes screening. I normally have low blood sugar. It can get really low, and I have developed such a tolerance for it, that I have been documented walking and talking normally with a blood sugar of 25 (most people would have passed out around 40). Anyway, my reading for the screening was 178.
It was probably either an error, or a typo. I wonder if it was really 78. They made me come back for the long version of the glucose tolerance test, and my numbers were all very low-- normal for me.
I don’t know why they stuck you, but as someone else said, your A1C is really the best way to check for diabetes. If it’s high, you will probably be sent for a glucose tolerance test.
But whatever the fingerstick told them, it sounds like the doctor isn’t concerned.
You can ask why the fingerstick was done in the first place. Did you pass out? A lot of hospitals do them automatically for anyone who passes out. Are you overweight? Some hospitals are staring to do them for overweight patients now. If it was for passing out, and they found the cause, or just for being overweight, I wouldn’t worry, but if it was for specific symptoms, and the didn’t find a definitive cause, you might want to make an appointment with your GP.
Both low (hypoglycemia) and high (hyperglycemia) blood sugar can present with patients exhibiting unusual behavior. I answered MANY MANY 9-1-1 calls with patients described as seeming drunk, babbling incoherently, confused, etc… Diabetes was what we were supposed to presume, absent a bottle of alcohol in the patient’s hand.
Unconsciousness can also result on either the high or low end of blood sugar, though low is more immediately a danger. Avoiding a loss of consciousness due to low sugar was such a priority such that patients who were conscious were to be given more sugar if they could drink the juice without assistance. Once the medics arrived they could assess further and treat as appropriate if the sugar was actually too high.
No.
You’re welcome. 
mmm
If taken together with an unremarkable physical exam and lack of risk factors, a normal fasting glucose makes it unlikely that the person has diabetes, but does not rule it out.
Reported for political sniping.
*kidding, kidding.
I had tingling and burning sensations in my feet. I’m pretty good with them words and that logic thing, so I asked them precisely “does the negative result of the blood sugar test mean I’m not diabetic?” They both answered “Yes”. Either they were idiots or decided to treat me like one.
Was this meant literally, or as a shorthand for “absent some specific, articulable reason to suspect drunkenness”? Like, if the call came in “My buddy was at a frat party, and got into some stupid drinking contest, and now he’s really messed up”, would your default presumption still have to be diabetes?
EDIT: greenpurple, just because you’re good with that words thing, doesn’t mean that the doctors were. Even though you asked a simple, clear, direct question, doesn’t mean that’s the question they were asking. The question they were concerned with was “Are the symptoms the patient is displaying right now the result of diabetes?”, to which the blood-prick gives the answer of “no”, and they might have assumed that that was the question you were asking.
And yes, it also annoys me greatly when I ask someone a simple, direct question, and they answer a different question, just like it also annoys me when someone else asks me a question that isn’t actually what they mean to ask. I’ve gotten into the habit of trying to answer both questions: In this case, that would be something like “We can’t rule out the possibility that you have diabetes, but it’s not the cause of the problems you’re having right now”.
I had tingling and burning sensations in my feet. I’m pretty good with them words and that logic thing, so I asked them precisely “does the negative result of the blood sugar test mean I’m not diabetic?” They both answered “Yes”. Either they were idiots or decided to treat me like one.
I assume the procedure these days still includes a glucose challenge (tolerance test), and an a1C. You can also ask to be prescribed a glucometer and test strips and you can check your fasting and postprandial blood sugar over time. I think you can just buy a glucometer without a prescription, but the test strips aren’t cheap.
If the medical folks said it wasn’t diabetes, what was their explanation for the neuropathy? I intermittently have a bit of neuropathy in my toes from diabetes, but it felt distinctly different from the mild neuropathy caused by chemotherapy (for which L-glutamine was helpful).
Wishing you the best of luck, and I’d pursue a better work-up if it were me.
I can get as high as 569 or as low as 38 [my check on waking this morning] and show nothing, not feeling or acting funky [which is why I adore my Freestyle Libra - I don’t need to fingerstick, but when I feel the need, I have test strips for it]
Now if a single stick pings at 300 or so, they should be really worried … and do more checking.
[I wear dogtags and have tattooed body tags specifying I am insulin control diabetic]
greenpurple, please tell us the complete details on why you were in a hospital emergency room. Was it only because you felt these “tingling and burning sensations” in your feet, which caused you to immediately go to the E/R? Did the people in the E/R do any other tests, and what did they say about those results?
In any case, you should schedule an appointment with your family doctor. (You do have a family doctor, don’t you?) Ask them to do all the standard things they would do for a periodic check-up for someone of your age, sex, medical history, etc. Do you get regular check-ups from your family doctor (every few months or every year or whatever)? Suggest that they should include an A1C in the tests they do on you during the next check-up. Tell the doctor about the symptoms that caused you to go to the E/R. If for some reason you can’t get a doctor’s appointment, it is possible to buy a blood sugar testing kit at a pharmacy or order it online. It will probably come with some test strips and lancets, or it may be necessary to buy those in addition. Test yourself each day after you wake up in the morning before eating breakfast. You can look up what readings you should expect to see. In any case, you should be discussing all this with your doctor as soon as you can schedule an appointment.