There are lots of ways to diagnose diabetes but they are not all the same. Some of them can miss diabetes completely

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In type 1 diabetes, the symptoms normally appear more suddenly, leading to blood glucose levels being checked. Since the symptoms of prediabetes and other types of diabetes appear more gradually, the American Diabetes Association (ADA) has recommended some screening guidelines. These guidelines are based on which groups of people are most at risk of developing diabetes. The ADA recommends people in the following groups be checked for diabetes:

How will my doctor know what type of diabetes I have?

Testing for prediabetes, and type 1 and type 2 diabetes can use a couple of different methods for diagnosis. The doctor will also look at your previous medical history, as well as conduct some blood tests.

The HbA1c test blood test

The HbA1c test, or the glycated haemoglobin A1c test, is a blood test that can be taken at any time. You don’t need to fast before taking the test! It indicates what your average blood glucose levels are over the past three months, by measuring the percentage of blood glucose that has attached to haemoglobin. Haemoglobin is the oxygen carrying protein found in red blood cells.

In people with diabetes, the higher the blood glucose levels are, the more glucose you have attached to haemoglobin. A HbA1c level of 6.5% or higher, on two separate tests, can indicate that you have diabetes. Whereas a HbA1c level between 5.7 and 6.4% can indicate prediabetes. Levels below 5.7% are considered normal.

The HbA1c test should not be used alone to test for diabetes. It should be used in combination with other blood glucose tests.

Random blood glucose test

In this test, a blood sample is taken at any random time, regardless of when you last ate. A random blood glucose level of 11.1mmol/L (200mg/dL) or higher can indicate diabetes.

Fasting blood glucose test

A blood sample is taken after an overnight fast. A fast is when you refrain from eating for a period of time. Fasting blood glucose levels less than 5.6mmol/L (100mg/dL) is considered normal. A fasting blood glucose level of 5.6-6.9mmol/L (100-125mg/dL) is considered to be prediabetes, while 7mmol/L (126mg/dL) or higher on two separate tests, is considered diabetes.

Oral glucose tolerance test

This test is similar to a fasting blood glucose test. In an oral glucose tolerance test, you fast overnight and then a fasting blood sugar level is measured. You then proceed to drink a sugary liquid, and your blood glucose levels are tested periodically for the next two hours.

A blood glucose level less than 7.8 mmol/L (140 mg/dL) is considered normal. A reading of more than 11.1 mmol/L (200 mg/dL) after two hours indicates diabetes, whereas a reading between 7.8 mmol/L and 11.0 mmol/L (140 and 199 mg/dL) indicates prediabetes.

Urine test

If the doctor suspects that you have type 1 diabetes, they may test your urine to check for the presence of by-products of muscle and fat tissue breakdown. In people with type 1 diabetes, muscle and fat are often broken down as a source of energy, since there is no insulin produced to assist glucose to move from the blood and into the cells, where it can be used for energy. This is why rapid and unintentional weight loss occurs in people with type 1.

What if I’m pregnant? – Testing for gestational diabetes

All women should be tested for gestational diabetes (internal link to ‘what causes diabetes’) at weeks 24-28 gestation, which is during your second trimester. You are at a high risk of gestational diabetes if you are obese at the beginning of your pregnancy; have previously had gestational diabetes; or a close family member (i.e. mother, father, or sibling) has diabetes. If you are at a higher risk, your doctor may screen you earlier for gestational diabetes.

There are two tests your doctor may use to test for gestational diabetes:

Initial glucose challenge test

The test begins with drinking a syrupy glucose solution, and then your blood glucose levels are tested an hour later through a blood test. Typically, a blood glucose reading below 7.8mmol/L (140mg/dL) is considered to be normal. If your blood glucose levels are higher than normal, it indicates that you have a higher risk of gestational diabetes, where you will need to do a follow up test.

Follow up glucose tolerance test

In the follow up test, you will be required to fast overnight and then have you blood glucose levels measured. You drink another syrupy glucose drink, except this one has a higher concentration of glucose, and then your glucose levels are checked every hour for three hours.

You will be diagnosed with gestational diabetes, if at least two of the blood glucose readings are higher than the normal values.

When to speak to your doctor?

If you experience any signs and symptoms of diabetes, it is important to get tested for diabetes as soon as possible. Some people are at higher risk and need regular testing if you are 45 years or older or have other risk factors for diabetes. By diagnosing and treating the condition early, it means you can decrease the risk of developing any further health complications, for example nerve damage, blindness, and heart disease.

If you have already been diagnosed with diabetes and would like to know more about how best to manage the condition, you can join our personalised

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