Experts recommend routine testing for type 2 diabetes if you. Medicare covers the cost of diabetes tests for people with certain risk factors for diabetes. If you have Medicare, find out if you qualify for coverage. If you have different insurance, ask your insurance company if it covers diabetes tests.
Though type 2 diabetes most often develops in adults, children also can develop type 2 diabetes. Experts recommend testing children between the ages of 10 and 18 who are overweight or obese and have at least two other risk factors for developing diabetes. All pregnant women who do not have a prior diabetes diagnosis should be tested for gestational diabetes. If you are pregnant, you will take a glucose challenge test between 24 and 28 weeks of pregnancy.
Health care professionals most often use the fasting plasma glucose FPG test or the A1C test to diagnose diabetes. In some cases, they may use a random plasma glucose RPG test. The FPG blood test measures your blood glucose level at a single point in time.
For the most reliable results, it is best to have this test in the morning, after you fast for at least 8 hours. Fasting means having nothing to eat or drink except sips of water. The A1C test is a blood test that provides your average levels of blood glucose over the past 3 months.
You can eat and drink before this test. When it comes to using the A1C to diagnose diabetes, your doctor will consider factors such as your age and whether you have anemia or another problem with your blood. Your health care professional may need to order a different type of A1C test. Your health care professional will report your A1C test result as a percentage, such as an A1C of 7 percent.
The higher the percentage, the higher your average blood glucose levels. The ADA recommends that the following people be screened for diabetes:. Glycated hemoglobin A1C test. This blood test, which doesn't require fasting, indicates your average blood sugar level for the past two to three months. It measures the percentage of blood sugar attached to hemoglobin, the oxygen-carrying protein in red blood cells. The higher your blood sugar levels, the more hemoglobin you'll have with sugar attached.
An A1C level of 6. An A1C between 5. Below 5. If the A1C test results aren't consistent, the test isn't available, or you have certain conditions that can make the A1C test inaccurate — such as if you are pregnant or have an uncommon form of hemoglobin known as a hemoglobin variant — your doctor may use the following tests to diagnose diabetes:. Oral glucose tolerance test.
For this test, you fast overnight, and the fasting blood sugar level is measured. Then you drink a sugary liquid, and blood sugar levels are tested periodically for the next two hours. If type 1 diabetes is suspected, your urine will be tested to look for the presence of a byproduct produced when muscle and fat tissue are used for energy because the body doesn't have enough insulin to use the available glucose ketones.
Your doctor will also likely run a test to see if you have the destructive immune system cells associated with type 1 diabetes called autoantibodies. Your doctor will likely evaluate your risk factors for gestational diabetes early in your pregnancy:.
Initial glucose challenge test. You'll begin the glucose challenge test by drinking a syrupy glucose solution. One hour later, you'll have a blood test to measure your blood sugar level. If your blood sugar level is higher than normal, it only means you have a higher risk of gestational diabetes.
Your doctor will order a follow-up test to determine if you have gestational diabetes. Follow-up glucose tolerance testing. For the follow-up test, you'll be asked to fast overnight and then have your fasting blood sugar level measured. Then you'll drink another sweet solution — this one containing a higher concentration of glucose — and your blood sugar level will be checked every hour for a period of three hours.
If at least two of the blood sugar readings are higher than the normal values established for each of the three hours of the test, you'll be diagnosed with gestational diabetes. Our caring team of Mayo Clinic experts can help you with your diabetes-related health concerns Start Here.
Depending on what type of diabetes you have, blood sugar monitoring, insulin and oral medications may play a role in your treatment. Eating a healthy diet, maintaining a healthy weight and participating in regular activity also are important factors in managing diabetes. An important part of managing diabetes — as well as your overall health — is maintaining a healthy weight through a healthy diet and exercise plan:.
Healthy eating. Contrary to popular perception, there's no specific diabetes diet. You'll need to center your diet on more fruits, vegetables, lean proteins and whole grains — foods that are high in nutrition and fiber and low in fat and calories — and cut down on saturated fats, refined carbohydrates and sweets.
In fact, it's the best eating plan for the entire family. Sugary foods are OK once in a while, as long as they're counted as part of your meal plan. Yet, understanding what and how much to eat can be a challenge.
A registered dietitian can help you create a meal plan that fits your health goals, food preferences and lifestyle. This will likely include carbohydrate counting, especially if you have type 1 diabetes or use insulin as part of your treatment.
Physical activity. Everyone needs regular aerobic exercise, and people who have diabetes are no exception. Exercise lowers your blood sugar level by moving sugar into your cells, where it's used for energy.
Exercise also increases your sensitivity to insulin, which means your body needs less insulin to transport sugar to your cells. Get your doctor's OK to exercise. Then choose activities you enjoy, such as walking, swimming or biking. What's most important is making physical activity part of your daily routine. Aim for at least 30 minutes or more of aerobic exercise most days of the week, or at least minutes of moderate physical activity a week.
Bouts of activity can be as brief as 10 minutes, three times a day. If you haven't been active for a while, start slowly and build up gradually. It's also a good idea to avoid sitting for too long — aim to get up and move if you've been sitting for more than 30 minutes. Treatment for type 1 diabetes involves insulin injections or the use of an insulin pump, frequent blood sugar checks, and carbohydrate counting.
Treatment of type 2 diabetes primarily involves lifestyle changes, monitoring of your blood sugar, along with diabetes medications, insulin or both. Monitoring your blood sugar. Depending on your treatment plan, you may check and record your blood sugar as many as four times a day or more often if you're taking insulin.
Careful monitoring is the only way to make sure that your blood sugar level remains within your target range. People with type 2 diabetes who aren't taking insulin generally check their blood sugar much less frequently. People who receive insulin therapy also may choose to monitor their blood sugar levels with a continuous glucose monitor. Although this technology hasn't yet completely replaced the glucose meter, it can significantly reduce the number of fingersticks necessary to check blood sugar and provide important information about trends in blood sugar levels.
Even with careful management, blood sugar levels can sometimes change unpredictably. With help from your diabetes treatment team, you'll learn how your blood sugar level changes in response to food, physical activity, medications, illness, alcohol, stress — and for women, fluctuations in hormone levels. In addition to daily blood sugar monitoring, your doctor will likely recommend regular A1C testing to measure your average blood sugar level for the past two to three months.
Antibody testing is limited by availability, cost, and predictive value, especially in black and Asian patients. Prevalence of any antibody in white patients with type 1 diabetes is 85 to 90 percent, 5 whereas the prevalence in similar black or Hispanic patients is lower 19 percent in both groups in one study.
As with any condition, a rationale for screening should first be established. Diabetes is a common disease that is associated with significant morbidity and mortality.
It has an asymptomatic stage that may be present for up to seven years before diagnosis. The disease is treatable, and testing is acceptable and accessible to patients. Early treatment of diabetes that was identified primarily by symptoms improves microvascular outcomes. Table 4 presents screening guidelines from several organizations. All persons 30 years or older who are at risk of having or developing type 2 diabetes should be screened annually. Testing to detect type 2 diabetes should be considered in asymptomatic adults with a BMI of 25 kg per m 2 or greater and one or more additional risk factors for diabetes.
Additional risk factors include physical inactivity; hypertension; HDL cholesterol level of less than 35 mg per dL 0. If test results are normal, repeat testing should be performed at least every three years. There is fair evidence to recommend screening patients with hypertension or hyperlipidemia for type 2 diabetes to reduce the incidence of CV events and CV mortality.
Current evidence is insufficient to assess balance of benefits and harms of routine screening for type 2 diabetes in asymptomatic, normotensive patients.
In all pregnant women, fasting glucose should be measured at the first prenatal visit no later than 20 weeks' gestation. All pregnant women should be screened through history, clinical risk factors, or laboratory testing.
Low-risk criteria include age younger than 25 years, BMI of 25 kg per m 2 or less, no history of abnormal OGTT result, no history of adverse obstetric outcomes usually associated with gestational diabetes, no first-degree relative with diabetes, not a member of a high-risk ethnic group.
Women with gestational diabetes should be screened six to 12 weeks postpartum and should receive subsequent screening for the development of diabetes. Women with clinical characteristics consistent with a high risk of gestational diabetes e. If glucose test results are negative, retesting should be performed at 24 to 28 weeks' gestation. Testing may be excluded in low-risk women see ACOG criteria above. Women with gestational diabetes should be screened for diabetes six to 12 weeks postpartum and should receive subsequent screening for the development of diabetes.
There is poor evidence to recommend for or against screening using Glucola testing in the periodic health examination of pregnant women. Evidence is insufficient to assess the balance of benefits and harms of screening for gestational diabetes, either before or after 24 weeks' gestation. Physicians should discuss screening with patients and make case-by-case decisions.
Preventive Services Task Force. Information from references 1 , 8 , and 32 through Screening for type 1 diabetes is not recommended because there is no accepted treatment for patients who are diagnosed in the asymptomatic phase. The Diabetes Prevention Trial identified a group of high-risk patients based on family history and positivity to islet cell antibodies.
However, treatment did not prevent progression to type 1 diabetes in these patients. Medications and lifestyle interventions may reduce the risk of diabetes, although 20 to 30 percent of patients with type 2 diabetes already have complications at the time of presentation.
Guidelines differ regarding who should be screened for type 2 diabetes. The U. There are several questionnaires to predict a patient's risk of diabetes. The Diabetes Risk Calculator was developed using data from the National Health and Nutrition Examination Survey III and incorporates age, height, weight, waist circumference, ethnicity, blood pressure, exercise, history of gestational diabetes, and family history.
The tool is most valuable in helping define which patients are very unlikely to have diabetes. Whether patients should be screened for gestational diabetes is unclear.
An abnormal Glucola test result i. Whether screening and subsequent treatment of gestational diabetes alter clinically important perinatal outcomes is unclear. Untreated gestational diabetes is associated with a higher incidence of macrosomia and shoulder dystocia.
Treatment did not reduce risk of cesarean delivery or admission to the neonatal intensive care unit, however. Patients may initially present with diabetic ketoacidosis or hyperglycemic hyperosmolar state Table 5 , 45 both of which are initially managed with insulin because they are essentially insulin deficiency states. Both groups of patients may present with polyuria, polydipsia, and signs of dehydration.
Diagnostic criteria of diabetic ketoacidosis include a blood glucose level greater than mg per dL However, significant ketosis has also been shown to occur in up to one third of patients with hyperglycemic hyperosmolar state.
Diabetic ketoacidosis and hyperglycemic hyperosmolar syndrome. Diabetes Spectrum. Although diabetic ketoacidosis typically occurs in persons with type 1 diabetes, more than one half of newly diagnosed black patients with unprovoked diabetic ketoacidosis are obese and many display classic features of type 2 diabetes—most importantly with a measurable insulin reserve.
Presence of antibodies, particularly glutamic acid decarboxylase antibody, predicts a higher likelihood of lifelong insulin requirement. There is, however, an overlap of presence of antibodies in type 1 and type 2 diabetes, and among patients with type 2 diabetes who may not require insulin.
A Swedish population-based study showed that among the 9. It should be noted that among patients who were negative for antibodies, 51 percent also needed insulin within three years. Already a member or subscriber? Log in. Author: Healthwise Staff. Medical Review: E. This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use.
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