How Is Diabetes Diagnosed?
||This article covers the diagnosis of type 1 and 2 diabetes. The diagnosis of gestational diabetes is dealt with separately.
Initially your doctor may perform a urine analysis to check for signs of high blood sugar. To do this, you will need to provide a urine sample, into which the doctor will stick a specially coated strip or dipstick. The dipstick changes color according to the level of blood sugar present. The results are instantaneous. However, this test alone is not enough to make a diabetes diagnosis. For a clinical diagnosis, one or more of the following tests must be carried out:
Fasting Plasma Glucose (FPG) Test: This is a blood test which measures your blood glucose levels after you have fasted for at least 8 hours. It is used to detect diabetes and pre-diabetes. Results will show:
Oral Glucose Tolerance Test (OGTT): Yet another blood test that measures glucose levels - but with this one first you need to fast for 8 hours, then drink a glucose beverage and wait for a further 2 hours before being tested. This test might be performed if the fasting or random test is not conclusive.
The standard definition of diabetes is too much, or excessive glucose in a blood sample. But over the years doctors and authorities have disagreed about what is considered 'excessive'. In 1997 they lowered the blood-glucose levels necessary to be diagnosed with diabetes because too many people were suffering diabetic complications, even though there were not diagnosed with the disease under the then-current standards. In 2003 the threshold was lowered again. Subsequently the World Health Organization (WHO) and the American Diabetes Association have agreed the following standard criteria:
This is a newer test to the market, which only requires a pin-prick of blood to test for signs of diabetes (and no fasting is required). Also called the hemoglobin A1c test and HbA1 test, it can check a person's average blood sugar levels over the previous 3 months. Although some doctors still prefer to use the traditional tests outlined above, since 2009, a panel of international experts agreed that the A1C test is accurate enough to help diagnose both type 1 diabetes and type 2 diabetes (but not gestational diabetes). It is hoped that the convenience of the test will help more people check for prediabetes. Additionally the American Diabetes Association recommends that people who are receiving diabetes treatment should have an A1C test twice a year to check that they are managing their blood glucose levels correctly (see diabetes tests). Tests are sold for this purpose over the counter in pharmacies; brand names include A1C Now Self-Check by Bayer which costs around $30.
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