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Many people view diabetes as hardly more serious than having an allergy or some minor health problem. Yet diabetes is a devastating force to be reckoned with, a life-threatening disease with frighteningly dangerous consequences to peoples’ health…as well as to their life span.
From hearing, vision, sleep, and sexual functioning, to mental health and wellness, diabetes affects every part of the body. The disease is responsible for 80,000 plus amputations each year in the United States alone.1 The leading cause of chronic kidney disease and failure,2 diabetes is also the frontrunner for new cases of adult blindness each year. Adult diabetics have heart disease death rates two to four times higher than those without,3 and the death risk from stroke is 2.8 times higher among diabetics.4
So it’s important to know whether or not you’re at risk for diabetes and its complications. While there are no hard and fast guidelines as to who should be tested, by what method, or when, testing may enable you to protect yourself from becoming yet another diabetes health statistic.
Who Ought to Be Tested for Diabetes, and When?
The general consensus among experts is that everyone over forty-five years of age ought to be screened.
Younger adults with some of the following factors in their lives ought to undergo regular testing:
- A history or presence of heart disease, peripheral artery disease, or stroke
- Abnormal cholesterol levels
- Being in a high-risk ethnic group (African-American, Hispanic-American, or Native American)
- For women, having a history of gestational diabetes, polycystic ovary disease, or having delivered a baby weighing over nine pounds
- Having a close relative with diabetes (mother, father, or siblings)
- High blood pressure
- Impaired glucose intolerance
- Low activity level
- Poor diet (high-sugar foods)
- Weighing twenty-percent more than the ideal body weight
Children over ten years of age ought to be screened for type 2 diabetes if they’re overweight, and have some of the other risk factors, above.
What Diabetes Testing Methods Are Used?
Glycated hemoglobin (A1C) blood test
Glycated (or glycosylated) hemoglobin refers to hemoglobin that has bound with glucose. If you have diabetes, or aren’t managing the disease effectively, the glycated hemoglobin levels in your blood will increase.
Measuring the percentage of blood sugar bound to hemoglobin illustrates your average blood sugar level for the past two or three months (the lifespan of the hemoglobin cell). Those with high blood sugar levels have more hemoglobin with sugar attached to it. Two different tests showing an A1C level of 6.5 percent or higher is an indication of diabetes.
This test would not be used during pregnancy, or for those with an uncommon form of hemoglobin. It’s often used to screen for pre-diabetes.
Random blood glucose test (RBG) (also known as a random plasma glucose test and a casual plasma glucose test)
Administered during the drawing of blood for other tests, this test can also be carried out without the aid of a health care provider via finger prick and glucose meter. A small amount of fingertip blood is placed on a test strip, and then inserted into the glucose meter (a medical device that calculates blood glucose levels). RBG testing is carried out randomly, regardless of when you last ate.
When multiple, random RBG tests indicate blood sugar levels higher than 200 mg/dL, you may have diabetes. This testing method isn’t as accurate as a laboratory test, so RBG tests ought to be followed up with testing administered by a health care provider for an accurate diagnosis. This test cannot be used to diagnose pre-diabetes.
Fasting plasma glucose test (FPG)
An easy, inexpensive, quick, and therefore preferred method for diabetes testing, the FPG test measures blood sugar levels in a person who hasn’t eaten for eight hours or more. The FPG test is most reliable when performed after an overnight fast.
- A blood glucose level between 100 mg/dL and 125 mg/dL indicates impaired fasting glucose (IFG), a form of pre-diabetes. If left untreated, IFG can develop into type 2 diabetes).
- A blood glucose level of 126 mg/dL or greater indicates type 1 or type 2 diabetes. Further testing is required to make a type 1 or type 2 diagnosis.
Though convenient and cost-effective, the FBG will not catch some forms of diabetes or pre-diabetes, such as gestational diabetes.
Oral glucose tolerance test (OGTT)
Similar to, but more sensitive than the FPG test for diagnosing pre-diabetes and all other forms of diabetes, the OGTT is not as convenient to administer. Fasting for a minimum of eight hours prior to testing is necessary. Immediately before drinking a liquid comprised of glucose dissolved in water, and two hours afterwards, plasma glucose levels are measured.
- When blood sugar levels are between 140 and 199 mg/dL two hours after consuming the liquid, impaired glucose tolerance (IGT) is indicated. This is a form of pre-diabetes that puts patients at increased risk of developing type 2 diabetes.
- When blood sugar levels are at 00 mg/dL or above2 two hours after consuming the liquid – and this is confirmed by a repeat test on another day – diabetes is indicated. Further testing is required to make a type 1 or type 2 diagnosis.
C-peptide tests are performed when a diabetes diagnosis has been made, and clarification as to whether it’s type 1 or type 2 diabetes is required. Carried out as a typical blood test, C-peptide tests measure the level of C-peptide in the blood. C-peptide is generally found in amounts equal to insulin because insulin and C-peptide are linked when initially produced by the pancreas. If the body does not manufacture enough insulin, it won’t produce a lot of C-peptide either.
Urine sugar test
Also known as the urine glucose or glucosuria test, this procedure measures the amount of sugar in a urine sample. A health care provider measures the sugar content by immersing a color- and chemically-sensitive dipstick into the sample. The health care provider can determine the amount of glucose in the urine by the change in color to the dipstick. Since sugar is not normally present in urine, if it is found, further testing will be required.
Prior to testing, it may be necessary to refrain from taking certain drugs that are known to increase urine glucose content.
Carried out as a typical blood test, liver function tests (LFTs) are routinely used to screen for liver disease, or to monitor the progression of a disease or effect of drugs that may be toxic to the liver. People with type 2 diabetes show abnormalities in liver function tests far more frequently than individuals who don’t have the disease. For example, chronic mild elevations of liver enzymes that help in metabolizing protein and amino acids (transaminases) are frequently discovered in diabetes type 2 patients.5