Why Are American Lab Range Values So Narrow?

Brief Answer:
Please find XXXXXXX diabetes association recommendations given below

Detailed Answer:
Hi XXXXX,
Thanks for writing back to us.

I have read through your query in detail.
Please find my observations below.

1. We have various associations across the world who have done large population studies in different geographies and involving people of various races having particular lifestyles and diet.

2. Sometimes these associations and laboratories find it important to follow a strict guidelines.

The XXXXXXX Diabetes Association guidelines are as follows

(i) HbA1C

Normal less than 5.7%
Prediabetes 5.7% to 6.4%
Diabetes 6.5% or higher

(ii) Fasting blood glucose

Normal      less than 100 mg/dl
Prediabetes      100 mg/dl to 125 mg/dl
Diabetes      126 mg/dl or higher

(iii) Oral glucose tolerance test (test that checks your blood glucose levels 2 hours after glucose drink)

Normal      less than 140 mg/dl
Prediabetes      140 mg/dl to 199 mg/dl
Diabetes      200 mg/dl or higher

3. Going by the above guidelines,

(i) in April your HbA1C was in borderline diabetes and in XXXXXXX it is in the prediabetes group.
(ii) in April your fasting glucose was in prediabetes and in XXXXXXX it is normal.

Since diagnosis based on HbA1C is more reliable therefore I guess you might be in the prediabetic stage and this is not a serious concern. Please continue with the lifestyle changes which you are following since April.

Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

---

Brief Answer:
Please find possibilities of your urinary tract infection discussed below

Detailed Answer:
Hi XXXXX,
Thanks for writing back with an update.

1. Though the incidence of UTI at your age is low among males, the following might explain how you got the infection.

(i) At your age, some people might have an enlarged prostate that does not allow the urinary bladder to get emptied completely. This leaves residual urine in the urinary bladder and the bacteria multiples quickly giving rise to an infection.

(ii) Another possibility is using public toilets. There are times when you use public toilets and the doors and handles are contaminated with bacteria from another person. If you touch your genital then there is a small chance of bacteria being transferred and giving rise to urinary infection.

(iii) Contraction of infection from your wife who does not show any symptoms is less likely.

(iv) People with diabetes also have a higher chance of getting urinary tract infection.

(v) If your inner clothes were not washed and dried properly then that might have caused the urinary tract infection.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

---

Brief Answer:
Benign enlargement of prostate is assessed by doing ultrasound scan

Detailed Answer:
Hi XXXXX,
Thanks for writing back with an update.

1. The PSA level has more relevance with a malignancy of prostate. The PSA level does not provide specific information on benign enlargement of prostate.

2. We measure the prostate by doing ultrasound scan on a full bladder. It is a volume measurement obtained by measuring the size of prostate in three axis.

3. I agree that you do not have diabetes and any possible contamination from the use of public bathrooms by you would have made UTI a relative frequent occurrence in your case.

4. It will be important to know that the bacteria take no time in multiplying should there be an associated incontinence which gives a chance to the bacteria to thrive and reproduce. The urethra might be considered an open access in such a situation for the bacteria to enter and cause infection.

5. In conclusion, the ways in which you got the infection might still remain mysterious but I hope that now the infection is completely treated and you are enjoying good health.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

---

Brief Answer:
Please find details below

Detailed Answer:
Hi XXXXX,
Thanks for writing back with an update.

1. Great to know that you are cured from the infection.

2. The full bladder test need not be done on a completely distended bladder; the prostate might be measured at the time you start getting a full bladder sensation. I mean you really dont have to go through the torture of having to control your bladder and the scan can still be done with a 75 percent full bladder.

3. A physician checks the prostate manually and this is subjective and what we do on the ultrasound is an objective calculation of BPH. Since medicine is becoming evidence based therefore the ultrasound volume is a more acceptable solution and considered less invasive than a physician examining the prostate manually.

However, if your physician feels that your manual prostate examination is normal, then there is no concern as long you do not have any BPH symptoms and the PSA levels return back to normal when tested a month after you have been cured from the urinary tract infection. I hope you are keen on repeating the PSA level soon.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

---