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NetWellness provides the highest quality health information and education services created and evaluated by faculty of our partner universities.
Sunday, September 7, 2008
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NetWellness provides the highest quality health information and education services created and evaluated by faculty of our partner universities.
Sunday, September 7, 2008
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Many people have diabetes for years before it is ever diagnosed. In fact, nearly 1/3 of diabetics are undiagnosed.
Warning signs that indicate a doctor's visit is necessary include:
It is good to keep in mind that simply having one or more of these symptoms doesn’t automatically indicate a diabetes diagnosis. To evaluate your risk, the American Diabetes Association has a Diabetes Risk Test that you can take online.
If your physician suspects the possibility that you have diabetes, he or she may give you some of the following tests.
Fasting Blood Glucose Test
Diabetes is diagnosed by measuring the amount of glucose in the blood. When the glucose level is higher than that of a normal person, the patient is diagnosed with diabetes. Because eating food raises the blood glucose level, a fasting (not eating for a period of time) test is used to compare the glucose levels between different people. Typically the fast will be for 12 hours before the test.
After fasting for 12 hours, the glucose level in a healthy person stays below 126 milligrams/deciliter (mg/dL). In a diabetic, the level may be higher than 126 mg/dL. The fasting blood glucose test tends to be the preferred test because it is very easy to perform. Test results that are above 126 mg/dL mean there is an elevated sugar level and will likely lead to more tests. Values even above 100 mg/dL are considered abnormal and should indicate a pre-diabetes state called Impaired Glucose Tolerance.
Glucose Tolerance Test (Oral Glucose Test)
After fasting from food and drink for at least eight hours, the patient will be given a drink containing a measured amount of glucose. Blood samples are drawn continuously for two hours and the levels of glucose are measured and recorded. A reading over 200 mg/dL indicates diabetes. A reading between 150 and 200 mg/dL is a grey area where a patient may be determined to be at risk for developing diabetes or "pre-diabetic." Blood glucose levels in a diabetic will rise faster and stay higher longer than in a healthy person. This test is the most accurate way to determine a diagnosis.
Random Blood Glucose Test
Blood glucose levels can be tested at any time with a finger prick and a glucose monitor. As food and drink can have a drastic effect on the glucose levels, this test is usually administered by a health professional after a meal. If the levels look suspiciously high, a fasting test is likely to be ordered.
Monitoring Blood Glucose Levels for Diabetics
As glucose levels can fluctuate quite dramatically, diabetics need to measure glucose levels several times a day to keep a close watch on the levels. If there is too much sugar in the blood, either too many sugars or carbohydrates were eaten, or not enough insulin was taken. At low blood sugar levels, the opposite is true. Either not enough sugars or carbohydrates were consumed, or too much insulin or oral medication was taken. However, many diabetics are able to manage their blood sugar levels without taking insulin, but by careful control of their diet and exercise habits. There are some ways to monitor how well a diabetic is controlling his or her blood sugar.
Hemoglobin A1 C Test
Taken to monitor long term trends, this test can give accurate readings without being affected by current glucose levels. Glucose tends to attach itself to a protein in the blood called hemoglobin (the iron-containing protein that carries oxygen and colors the blood red). Glucose combined with hemoglobin results in a new compound called glycohemoglobin. This test measures the percentage of hemoglobin in the body that is made of up this new compound, glycohemoglobin.
Healthy people usually have less than 7% of the hemoglobin in their body made up of glycohemoglibin (meaning that less than 7% of the hemoglobin in the body has glucose attached to it). Readings above this 7% marker mean that sugar levels are not being controlled very well over the last several months. Doing this test regularly over a period of time shows how well a diabetic is controlling overall glucose levels, instead of how it’s being controlled at that moment.
This article is a NetWellness exclusive. 
Last Reviewed: Sep 08, 2006
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Robert M. Cohen, MD Associate Professor Division of Endocrinology and Metabolism Department of Internal Medicine College of Medicine University of Cincinnati |
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Laurie Sadler, MD Medical Director and Assistant Professor Center for Vascular Health St. Vincent Charity Hospital School of Medicine Case Western Reserve University |
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