ANSWER: I take night sweats seriously. Tuberculosis is the classic cause of night sweats, which is of immense concern in a nursing facility, where most people are tested for TB yearly. But other chronic infections, high thyroid levels and even blood and marrow diseases like lymphoma can show up with night sweats. Most of the time, a chest X-ray and blood tests, along with a careful exam, can make the diagnosis. Other times, it’s harder to find. More often, it goes away as mysteriously as it came. But it is worth another look.
DEAR DR. ROACH: From a blood test, how can I tell if I am an insulin-dependent Type 2 diabetic? For instance, what would my insulin or glucose readings have to be?
Secondly, at what point would I have to start taking medications? — E.
ANSWER: Diabetes is diagnosed with any of the following: hemoglobin A1c of 6.5 percent or higher; fasting blood sugar of 126 or higher; blood sugar during a glucose tolerance test of 200 or greater at two hours; or random glucose of 200 or greater in someone with classic symptoms. In Type 1 diabetes, insulin levels are very low, while in Type 2 they are normal or high.
Not everybody with diabetes needs medication. Many people can be well-controlled just with dietary modification and often weight loss, and almost everybody can improve with a better diet.