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Why he feels tired and fatigue with no weight loss or short of breath?

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Hi Doc

I am requesting your opinion on the attached test result. The results are of my uncle who wants to get a second opinion.

I can ask him to conduct more test if you require. He feels tired and fatigued lately. No wait loss or short of breath.

Category: Internal Medicine Specialist

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Dr. Deepu Sebin Sebastian is online now

Expert:  Dr. Deepu Sebin Sebastian replied 4 Days.


Thank you for your query at DoctorSpring.com.

I understand your concern.

Your uncle has a fasting glucose level of 124.2 mg/dL which is termed as an impaired fasting glucose level. A level >126 mg/dL will indicate overt Diabetes. Your uncle seems to have Pre-Diabetes or Impaired Glucose Tolerance(IGT).

His LDL cholesterol and Triglyceride values are also raised which need strict control of diet by avoidance of oily and fat containing foods.

He needs to make changes in lifestyle, including diet modification, weight loss, and exercise to slow progression of his IGT to overt Type 2 Diabetes. There is good evidence that lifestyle intervention (combined diet and exercise aimed at weight loss and increasing activity levels) can improve glucose tolerance and prevent progression from IGT to Type 2 Diabetes.

I have the following recommendations.

- He should follow strict diet control and avoid high sugar and fatty foods such as sweets, fried foods and snacks, red meat like beef and mutton. Instead he should take a diet with more vegetables, wholewheat cereals, fish or chicken cooked with very little or no oil. He should take 4-5 smaller meals instead of 3 large meals everyday. He should drink at least 2 litres of water everyday.

- If he is not overweight, he should reduce 7 % of his total body weight in one year. For eg., if he weighs 70 kg, he should reduce at least 5 Kg in the next one year. If he is overweight/obese, he needs to shed more weight and maintain his weight in the normal range.

- He should maintain an active lifestyle and exercise daily, like brisk walking for at least 30 minutes, everyday.

- His blood pressure should also be checked and maintained below 140/80 mm/Hg.

- He can re-check his blood glucose levels, triglyceride and cholesterol levels after 6 months of strictly following these measures. If at 6 months, they are still raised, he needs to be started on medications like Metformin to control glucose levels and Nicotinic acid/Fibrates for high triglyceride and impaired cholesterol levels.

If the diet changes, weight reduction and exercise are not followed strictly, there is a high chance that your uncle may develop Diabetes which if uncontrolled can result in damage to many organs including kidneys, eyes, nerves etc.

Please advice and encourage him to strictly follow these suggestions.

Let me know if I can assist you any further.

Thank you.

Dr. Deepu Sebin Sebastian
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MD, Internal Medicine - Stanley Medical School
Medical School - MBBS - Govt. Medical College, Kottyaam

Diagnostic Prediction - Stanford School of Medicine
Received Specialty training in Critical Care, Cardiology, Neurology, Gastroenterology, Nephrology from Stanley Medical College and in Endocrinology, Rheumatology.

Hematology and Geriatrics from Madras Medical College.
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