Diabetes Testing: How to know if you have Diabetes

Generally speaking if you experience some of the following symptoms; being very thirsty, frequent urination, increased hunger, irritability, blurry vision, tingling or numbness in the hands or feet, unexplained weight loss, wounds that don’t heal, frequent gum, skin or bladder infections it might be wise for you to visit your doctor and be checked for diabetes.

In this regard, there are several tests that you may be required to take. To diagnose type 1 diabetes your doctor will normally require you to take any of the following; the Glaciated Hemoglobin (also known as glycosylated hemoglobin, A1C, hemoglobin A1C and HbA1c) test.  The test works by measuring your average sugar level for the previous two to three months. That is to say, it assesses what percentage of your hemoglobin (the oxygen carrying agent in red blood cells) sugar has attached to it. This is what is meant by glaciated and the rule of thumb is that an A1C score or level of 6.5 percent or higher on two separate tests- the initial and confirmatory test, indicates the presence of diabetes.

Under certain conditions however (unavailability of the A1C test, pregnancy, where the subject has a hemoglobin variant), other tests may be used to diagnose diabetes (in general). That is to say check for diabetes without recourse to type. These are;

The Fasting blood Sugar test. Here a blood sample is taken in order to measure your blood sugar level after having gone without eating for at least the past 8 hours. This is where the "Fasting" part of the test gets its name from.

Now for people who do not have diabetes, the normal fasting blood sugar is between 70 and 100 milligrams per deciliter or mg/dL. A reading of between 100 to 125 mg/dL (5.6 to 6.9 mmol/L) means prediabetes, whereas 126 mg/dL (7 mmol/L) or greater on two separate tests means diabetes. 

This test is the preferred choice for diagnosing diabetes because according to the American Diabetes Association it is not only convenient, easy to do but also less expensive than other tests.

Another test often taken to diagnose diabetes is the Random (or Casual) blood Sugar test. Under this, a blood sample is taken at a random time. With this test, irrespective of when you ate your last meal, a result of 200mg/dL (11.1 mmol/L) or higher is a strong indication of diabetes, particularly when found in tandem with any of the signs asymptomatic of the disease, namely extreme thirst and frequent urination. 

One should note that under this test, a reference value (200mg) higher than that for the Fasting Glucose Test of between 100mg to 125mg is used because being random, it assumes the consumption of a recent meal and due to that, the presence of more glucose in the blood.

To distinguish which type of diabetes is present, your doctor may then check your blood for auto antibodies, prevalent in type one cases. Further, a urinal analysis showing the presence of ketones-a by-product of the breakdown of fat, is normally a sign of Type 1 rather than Type 2 diabetes.

For Type two Diabetes too, the relevant test is the Fasting Sugar test/Fasting Plasma Glucose test. As explained earlier, a Fasting glucose level greater than or equal to 126mg/dL found on two separate tests means diabetes. Where normal fasting blood sugar levels are normal, yet the individual exhibits symptoms of or possesses risk factors for diabetes, a glucose tolerance test may be prescribed to make sure that the individual does not actually have diabetes.

So what is the Oral Glucose Tolerance Test?

The oral glucose test is normally prescribed to check for diabetes in people with a fasting blood glucose level that is high but not enough (above 125mg/dL) to meet the regular diagnosis for diabetes. It is regarded as the Gold standard for making the diagnosis of type 2 diabetes, although it is also used for the diagnosis of gestational diabetes.

Under this method, for three days before the test, the individual is not to eat a high carbohydrate diet. That means his carbohydrate intake should fall between 150-200 grams. In addition he must have fasted for between 8 to 16 hours immediately prior to the administration of the fasting plasma glucose test. Before the test begins, a blood sample will be taken. The individual would then be required to drink a 75mg oral glucose solution which taste can be likened to drinking very sweet soda. Blood will then be taken again every 30 to 60 minutes. As such as much as five times measure of blood glucose level may be taken over a period of three hours. 

For the blood stream of a person without diabetes, glucose levels rise and fall quickly. In someone with diabetes however, the reverse is the case, with glucose levels rising higher than normal and also failing to fall back down as fast.

For a person with normal blood sugar as earlier stated, normalcy of fasting glucose is regarded as being between 60 to 100 mg/dL, before the oral test. An hour after taking the oral solution however, any figure less than 200 mg/dL, and 2 hours after taking the test, less than 140 mg/dL.

A glucose level higher than 140 mg/dL but less than 200 mg/dL is called impaired glucose tolerance (IGT) or what is also called prediabetes. This is not in itself diabetes but as the name suggests could be an indication that the individual may develop diabetes later if some life style changes are not made. 

Since stress to the body either from stroke, trauma, heart attack or surgery is another culprit in diabetes cases, lifestyle changes, among them- weight loss, regular exercise and dietary adjustments can actually help fend off the onset of diabetes and return glucose levels to normal. Medications are available which also help to combat the condition. One of such is metformin (Glucophage). Nevertheless as in all drug cases, a doctor’s advice and prescription should be sought before use.