Brief Answer:
Do another fasting blood glucose, review infection

Detailed Answer:
Hi and thanks for the query,

It is important to know if the reading 167mg/dl, I suppose was a fasting blood glucose measure or not. In case it was a fasting blood glucose, measured under standard conditions, I am afraid this should be diagnostic of diabetes and not prediabetes. In case the blood glucose was not under fasting conditions (going overnight without food for over 8 hours, we can talk of prediabetes or something). This is a basis that is important before any further analysis could be made.

Secondly, it is also important to note that persons tolerate raised glucose levels differently. It is not surprising to find persons with fasting blood glucose levels at 500mg/dl moving about normally, and presenting just no symptoms, and others presenting with classical symptoms of raised blood glucose at 150mg/dl.

It is however imperative to check for other conditions that could make you feel unwell. Infections in persons with altered glucose metabolism would not generally manifest themselves with classical signs and symptoms of inflammation. It is not therefore rare to find persons who will just have a general feeling of not being well, with normal body temperatures. A complete blood count, C reactive protein measures, Urine analysis coupled with a proper clinical review would be of utmost importance to exclude an infectious process. Any presence of general malaise, joint pain, swelling or feeling of not feeling well might warrant exclusion of other inflammatory diseases, autoimmune conditions and infections. This is on the basis however of a proper clinical review.

A repeat fasting blood sugar measurement should be done, under standard conditions, after a normal 8 hour fast to be sure that of diabetes or not. This is key in further clinical thinking and management. A recent history of a flu , if present or experienced lately, could sometimes explain some fatigue.

I strongly suggest a proper clinical review, carrying out of another fasting blood sugar for diabetes, checking for any infection possible and also for inflammatory and autoimmune diseases. Initial exams like simple Erythrocyte sedimentation rates (ESR) and complete blood counts are initial guiding tests.

Thanks and kind regards as I wish you just the best of health. Please, do feel free asking any follow up questions in case you do have any specific concerns. kind regards.

Dr Bain

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