What Type Of Diabetes Do I Have?
When you were diagnosed, you were probably told you had either Type 1 or Type 2 diabetes. Clear-cut and tidy. Since diabetes typically occurs in two types, you have to fit into one of them. Many people fit clearly into one of these categories, but others do not. And those who clearly fit one type when diagnosed may find these clear lines begin to smudge over time. Are there really only two types? Are you really the type you were told you were? Could you have more than one type of diabetes? Is your original diagnosis still correct after all these years? A Short History Of Types Described and treated since ancient times, diabetes has certain characteristics that have long been recognized. Before the discovery of insulin, people found to have sugar in their urine under the age of 20 usually died in their youth, while those diagnosed when over the age of 40 could live for many years with this condition. Beginning in the mid 1920s, those who got diabetes when young (juvenile onset) were put on insulin, and those who got it when older (adult onset) often were not. However, the mechanisms that led to this difference in treatment were unknown. The only marker that differentiated the two types at that time was the presence in the urine of moderate or large levels of ketones when blood sugars were high. When significant ketones were present because the person could no longer make Tenough insulin, injected insulin was needed to control the glucose and they were called insulin-dependent. Differences In The Three Major Types Of Diabetes Type 1 Type 1.5/LADA Type 2 Avg. age at start 12 35 60 Typical age at start 3-40* 20-70* 35-80* % of all diabetes 10% (25%**) 15% 75% Insulin problem absence deficiency resistance Antibodies ICA, IA2, GAD65, IAA mostly GAD65 none Early treatment insu Continue reading >>
Test Center
Test Guide Laboratory Testing for Diabetes Diagnosis and Management This Test Guide discusses the use of laboratory tests (Table 1) for diagnosing diabetes mellitus and monitoring glycemic control in individuals with diabetes. Diagnosis Tools for diagnosing diabetes mellitus include fasting plasma glucose (FPG) measurement, oral glucose tolerance tests (OGTT), and standardized hemoglobin A1c (HbA1c) assays (Table 2). FPG and OGTT tests are sensitive but measure glucose levels only in the short term, require fasting or glucose loading, and give variable results during stress and illness.1 In contrast, HbA1c assays reliably estimate average glucose levels over a longer term (2 to 3 months), do not require fasting or glucose loading, and have less variability during stress and illness.1,2 In addition, HbA1c assays are more specific for identifying individuals at increased risk for diabetes.1 Clinically significant glucose and HbA1c levels are shown in Table 2.1 The American Diabetes Association® (ADA) recommends using these values for diagnosing diabetes and increased diabetes risk (prediabetes). Management Following a diagnosis of diabetes, a combination of laboratory and clinical tests can be used to monitor blood glucose control, detect onset and progression of diabetic complications, and predict treatment response. Table 3 shows the recommended testing frequency and target results for these tests. Different laboratory tests are available for monitoring blood glucose control over the short, long, and intermediate term to help evaluate the effectiveness of a management plan.1 Self-monitoring of blood glucose (SMBG) is useful for tracking short-term treatment responses in insulin-treated patients, but its usefulness is less clear in non–insulin-treated patients.1 By co Continue reading >>
Home Blood Glucose Test: How To Test For Diabetes At Home
Home blood glucose testing is a safe and affordable way to detect diabetes before it becomes a health issue. Diabetes, especially in the early stages, does not always cause symptoms. Almost half of people with the disease don't know they have it. For people already diagnosed with diabetes, a simple diabetes home test is vital in the management of blood sugar levels. It could even be lifesaving. How to test for diabetes at home Home blood glucose monitoring is designed to offer a picture of how the body is processing glucose. A doctor might recommend testing at three different times, and often over the course of several days: Morning fasting reading: This provides information about blood glucose levels before eating or drinking anything. Morning blood glucose readings give a baseline number that offers clues about how the body processes glucose during the day. Before a meal: Blood glucose before a meal tends to be low, so high blood glucose readings suggest difficulties managing blood sugar. After a meal: Post meal testing gives a good idea about how your body reacts to food, and if sugar is able to efficiently get into the cells for use. Blood glucose readings after a meal can help diagnose gestational diabetes, which happens during pregnancy. Most doctors recommend testing about 2 hours after a meal. For the most accurate testing, people should log the food they eat, and notice trends in their blood glucose readings. Whether you consume a high or low carbohydrate meal, if your blood sugar reading is higher than normal afterwards, this suggests the body is having difficulty managing meals and lowering blood glucose. After consulting a doctor about the right testing schedule and frequency, people should take the following steps: Read the manual for the blood glucose moni Continue reading >>
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Diagnosis
Print Symptoms of type 1 diabetes often appear suddenly and are often the reason for checking blood sugar levels. Because symptoms of other types of diabetes and prediabetes come on more gradually or may not be evident, the American Diabetes Association (ADA) has recommended screening guidelines. The ADA recommends that the following people be screened for diabetes: Anyone with a body mass index higher than 25, regardless of age, who has additional risk factors, such as high blood pressure, a sedentary lifestyle, a history of polycystic ovary syndrome, having delivered a baby who weighed more than 9 pounds, a history of diabetes in pregnancy, high cholesterol levels, a history of heart disease, and having a close relative with diabetes. Anyone older than age 45 is advised to receive an initial blood sugar screening, and then, if the results are normal, to be screened every three years thereafter. Tests for type 1 and type 2 diabetes and prediabetes Glycated hemoglobin (A1C) test. This blood test 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 6.5 percent or higher on two separate tests indicates that you have diabetes. An A1C between 5.7 and 6.4 percent indicates prediabetes. Below 5.7 is considered normal. If the A1C test results aren't consistent, the test isn't available, or if you have certain conditions that can make the A1C test inaccurate — such as if you're pregnant or have an uncommon form of hemoglobin (known as a hemoglobin variant) — your doctor may use the following tests to diagnose diabetes: Random blood sugar Continue reading >>
How Does A Doctor Test For Diabetes?
ANSWER Getting diagnosed for diabetes begins with one of three tests. in most cases, your doctor will want to repeat a test that is high in order to confirm the diagnosis. Tests include: Your doctor may also suggest a zinc transporter 8 autoantibody test. This blood test -- along with other information and test results -- can help determine if a person has type 1 diabetes instead of another type. The goal of having this blood test is a prompt and accurate diagnosis, one that can lead to timely treatment. A fasting glucose test is a test of your blood sugar levels taken in the morning before you have eaten. A level of 126 mg/dL or higher may mean that you have diabetes. An oral glucose tolerance test entails drinking a beverage containing glucose and then having your blood glucose levels checked every 30 to 60 minutes for up to three hours. If the glucose level is 200 mg/dL or higher at two hours, then you might have diabetes. The A1c test is a simple blood test that shows your average blood sugar levels for the past two to three months. An A1c level of 6.5% or higher may mean you have diabetes. Continue reading >>
How Useful Is A Urine Test In The Diagnosis Of Diabetes?
Question: How useful is a urine test in the diagnosis of diabetes? Answer: Urine tests, that was the way we measured glucose in the past, and, you know, urine tests may be the only thing available in some populations, but most people now use blood glucose testing, because it tells you what's happening that minute. So if you have diabetes, you want to know what's happening now. Urine collects overtime, so lets say for example, you tested in the morning and you tested your urine, well you might have sugar in your urine, but that might be sugar in your urine from midnight, because you held your urine in your bladder all night long. The blood test tells you exactly what's happening when you test at 8 o'clock in the morning. Urine glucose doesn't show up until blood glucose is about, we call it the renal threshold or the 'spilling point,' is up to about 180. Now that number's a little different in everyone, but you don't spill sugar in your urine until your blood glucose is pretty high, so it's not really a good gauge of how well you're doing. Next: What Are The Most Important Nutritional Principles For Someone With Type 1 Diabetes? Previous: What Is A Hemoglobin A1c Test And When Is It Done? Continue reading >>
Diabetes Symptoms, Diagnosis, & Testing
Thanks to the way diabetes is dramatized on television and in movies, many associate it with its more dramatic symptoms. Many think of the weakness and confusion that comes with a hypoglycemic episode, or the disabilities, like vision and circulation problems, associated with uncontrolled blood sugar. Some may even associate obesity with Type II diabetes. Not everyone with diabetes knows they have it, however. In fact, according to the Centers for Disease Control (CDC), more than a quarter of people with diabetes are undiagnosed. If you suspect you have diabetes, or are worried that someone in your life may have the illness, you should certainly watch out for symptoms, and if you see persistent signs of diabetes, you should seek a definitive diagnosis. The greatest threat diabetes poses is the damage that high blood sugar does to a person’s health over time, and the best treatment seeks to keep blood sugar at a healthy level. Left undiagnosed, high blood sugar will gradually degrade a person’s health. But once it’s diagnosed, a diabetic can begin to safeguard their lives against the disease. Symptoms of Diabetes How do people know if they have diabetes? Many of them don’t know, and they’re walking around with an undetected and untreated health problem. Even if you don’t have any diabetes symptoms, it’s important for you to have your blood sugar tested with your yearly checkup, just to be sure your blood sugar numbers are still in a good range. If you do see the following symptoms—in yourself, or in one of your loved ones—you should see a doctor as soon as possible. All of these symptoms can have causes besides diabetes, but no matter what, it’s important to find out what the cause is so it can be treated appropriately. Because everyone is different, Continue reading >>
Nondiabetic Hypoglycemia
What is non-diabetic hypoglycemia? Hypoglycemia is the condition when your blood glucose (sugar) levels are too low. It happens to people with diabetes when they have a mismatch of medicine, food, and/or exercise. Non-diabetic hypoglycemia, a rare condition, is low blood glucose in people who do not have diabetes. There are two kinds of non-diabetic hypoglycemia: Reactive hypoglycemia, which happens within a few hours of eating a meal Fasting hypoglycemia, which may be related to a disease Glucose is the main source of energy for your body and brain. It comes from what we eat and drink. Insulin, a hormone, helps keep blood glucose at normal levels so your body can work properly. Insulin’s job is to help glucose enter your cells where it’s used for energy. If your glucose level is too low, you might not feel well. What causes non-diabetic hypoglycemia? The two kinds of non-diabetic hypoglycemia have different causes. Researchers are still studying the causes of reactive hypoglycemia. They know, however, that it comes from having too much insulin in the blood, leading to low blood glucose levels. Types of nondiabetic hypoglycemia Reactive hypoglycemia Having pre-diabetes or being at risk for diabetes, which can lead to trouble making the right amount of insulin Stomach surgery, which can make food pass too quickly into your small intestine Rare enzyme deficiencies that make it hard for your body to break down food Fasting hypoglycemia Medicines, such as salicylates (such as aspirin), sulfa drugs (an antibiotic), pentamidine (to treat a serious kind of pneumonia), quinine (to treat malaria) Alcohol, especially with binge drinking Serious illnesses, such as those affecting the liver, heart, or kidneys Low levels of certain hormones, such as cortisol, growth hormone, glu Continue reading >>
Testing
There are a range of tests which will need to be done to monitor your health and your diabetes. Some of these, such as your blood glucose levels, you will be able to do yourself. Others will be done by healthcare professionals. Self-monitoring of blood glucose can be a beneficial part of diabetes management. As part of the day-to-day routine it can help with necessary lifestyle and treatment choices as well as help to monitor for symptoms of hypo- or hyperglycaemia. Monitoring can also help you and your healthcare team to alter treatment which in turn can help prevent any long-term complications from developing. Some people with diabetes (but not all) will test their blood glucose levels at home. Home blood glucose testing gives an accurate picture of your blood glucose level at the time of the test. It involves pricking the side of your finger (as opposed to the pad) with a finger-pricking device and putting a drop of blood on a testing strip. Some people can't see the point of testing as they think they know by the way they feel, but the way you feel is not always a good or accurate guide to what is happening. Blood glucose targets It is important that the blood glucose levels being aimed for are as near normal as possible (that is in the range of those of a person who does not have diabetes). These are: 3.5–5.5mmol/l* before meals less than 8mmol/l, two hours after meals. There are many different opinions about the ideal range to aim for. As this is so individual to each person, the target levels must be agreed between the person and their diabetes team. The target blood glucose ranges below are indicated as a guide. Children with Type 1 diabetes (NICE 2015) on waking and before meals: 4–7mmol/l after meals: 5–9mmol/l.after meals: 5–9mmol/l. Adults with Type Continue reading >>
Urine Tests During Pregnancy
Urine tests provide your doctor or midwife with important information about diseases or conditions that could potentially affect you or your growing baby. That's why at each prenatal visit, you'll be asked to give a urine sample as part of your regular exam. This sample is used to help determine if you have diabetes, kidney disease, or a bladder infection by measuring the levels of sugar, protein, bacteria, or other substances in your urine. The test is routine and painless and could prevent a lot of trouble down the road. What does a urine test involve? Urine can be collected any time of day. You will most likely be given a sterile cup to collect a sample before your exam. Before urinating, use a sterile towelette to wipe your genitals from front to back, and then release a small amount of urine into the toilet -- this prevents the sample from being contaminated with bacteria or other secretions that may invalidate the results. Put the container in your urine stream, and collect at least one to two ounces. This sample is then checked with chemically treated testing strips or sticks, and the results are usually available right away. If more analysis is necessary, your urine may be sent to a lab for additional assessment. What can a urine test detect? Sugar Typically, there is very little or no sugar (glucose) in urine during pregnancy. But when blood sugar levels in the body are too high, excess sugar can end up in the urine. This can be seen with gestational diabetes, a form of diabetes that only develops during pregnancy. It occurs when pregnancy hormones disrupt the body's ability to use insulin, a chemical that turns blood sugar into energy. A doctor often orders a blood test for diabetes early in your pregnancy if he or she knows you have other risk factors, like a Continue reading >>
Diagnosis
It's important for diabetes to be diagnosed early so treatment can be started as soon as possible. If you experience the symptoms of diabetes, visit your GP as soon as possible. They'll ask about your symptoms and may request blood and urine tests. Your urine sample will be tested for glucose. Urine doesn't normally contain glucose, but glucose can pass from the kidneys into your urine if you have diabetes. If your urine contains glucose, a specialised blood test known as glycated haemoglobin (HbA1c) can be used to determine whether you have diabetes. Glycated haemoglobin (HbA1c) test The glycated haemoglobin (HbA1c) test can be used to diagnose diabetes. It can also be used to show how well diabetes is being controlled. The HbA1c test gives your average blood glucose level over the previous two to three months. The results can indicate whether the measures you're taking to control your diabetes are working, by meeting agreed personal targets. If you've been diagnosed with diabetes, it's recommended that you have your HbA1c measured at least twice a year. However, you may need to have your HbA1c measured more frequently if: you've recently been diagnosed with diabetes your blood glucose remains too high your treatment plan has been changed The HbA1c test can be carried out at any time of day and doesn't require any special preparation, such as fasting. However, it's less reliable in certain situations, such as during pregnancy. The advantages associated with the HbA1c test make it the preferred method of assessing how well blood glucose levels are being controlled in a person with diabetes. HbA1c is also increasingly being used as a diagnostic test for type 2 diabetes, and as a screening test for people at high risk of diabetes. Type 1 diabetes in children The majority Continue reading >>
Diabetes Urine Tests
Urine tests may be done in people with diabetes to evaluate severe hyperglycemia (severe high blood sugar) by looking for ketones in the urine. Ketones are a metabolic product produced when fat is metabolized. Ketones increase when there is insufficient insulin to use glucose for energy. Urine tests are also done to look for the presence of protein in the urine, which is a sign of kidney damage. Urine glucose measurements are less reliable than blood glucose measurements and are not used to diagnose diabetes or evaluate treatment for diabetes. They may be used for screening purposes. Testing for ketones is most common in people with type 1 diabetes. Type 1 Diabetes: What Are The Symptoms? This test detects the presence of ketones, which are byproducts of metabolism that form in the presence of severe hyperglycemia (elevated blood sugar). Ketones are formed from fat that is burned by the body when there is insufficient insulin to allow glucose to be used for fuel. When ketones build up to high levels, ketoacidosis (a serious and life-threatening condition) may occur. Ketone testing can be performed both at home and in the clinical laboratory. Ketones can be detected by dipping a test strip into a sample of urine. A color change on the test strip signals the presence of ketones in the urine. Ketones occur most commonly in people with type 1 diabetes, but uncommonly, people with type 2 diabetes may test positive for ketones. The microalbumin test detects microalbumin, a type of protein, in the urine. Protein is present in the urine when there is damage to the kidneys. Since the damage to blood vessels that occurs as a complication of diabetes can lead to kidney problems, the microalbumin test is done to check for damage to the kidneys over time. Can urine tests be used to Continue reading >>
4 Lab Tests For Diabetes
Four blood tests are available to diagnose prediabetes and diabetes: • Fasting plasma glucose (FPG) • Oral glucose tolerance test (OGTT) • Hemoglobin A1c (A1c) test • Random plasma (blood) glucose To make a diagnosis, the results of each test must be confirmed by repeat testing on a different day, unless you have obvious symptoms of elevated blood glucose (hyperglycemia). If diabetes is diagnosed, you’ll need periodic A1c tests to monitor your blood glucose control. 1. Fasting plasma glucose (FPG) test The fasting plasma glucose test is the preferred method for diagnosing diabetes in children, men, and nonpregnant women. The test measures blood glucose levels after an overnight fast (no food intake for at least eight hours). A diagnosis of diabetes is made when the fasting blood glucose level is 126 mg/dL or higher on at least two tests. Values of 100 to 125 mg/dL indicate prediabetes. A normal fasting blood glucose level is less than 100 mg/dL. 2. Oral glucose tolerance test (OGTT) This test is done when diabetes is suspected, but you have normal results on a fasting plasma glucose test. For the test, you’ll have to fast overnight and then drink a very sweet solution containing 75 g of glucose. A sample of your blood will be drawn two hours later. Normal glucose levels are less than 140 mg/dL at two hours. The criterion for a diagnosis of diabetes with this test is a two-hour blood glucose level of 200 mg/dL or higher. Prediabetes is diagnosed if the blood glucose level at two hours is 140 to 199 mg/dL. 3. Hemoglobin A1c (A1c) test This blood test measures the amount of glucose attached to hemoglobin—the oxygen-carrying protein in red blood cells that gives blood its color. The A1c test was originally used to monitor glucose levels in people already diagn Continue reading >>
Type 1 Diabetes In Children
What is type 1 diabetes? Type 1 diabetes is an autoimmune disease that causes an unhealthy amount of a simple sugar (glucose) to build up in a person's blood. Someone with type 1 diabetes can't produce enough insulin, a hormone that moves glucose from the bloodstream into cells throughout the body, where it supplies energy and fuels growth. Normally, a child's immune system protects her body from diseases by destroying unhealthy cells and germs. But when a child has type 1 diabetes, her body also mistakenly attacks the healthy insulin-producing cells of the pancreas (a gland behind the stomach). Without these cells, her pancreas produces very little or no insulin, which leads to an abnormally high amount of sugar in her blood. Without proper care, type 1 diabetes can cause serious, wide-ranging health problems that can damage organs throughout the body over the long-term. If your child has been diagnosed with type 1 diabetes, it's understandable that you might worry. But diabetes can be kept under control by carefully monitoring your child's blood sugar and following her treatment plan. A team of doctors, nurses, and nutritionists can help your child be as healthy as possible and teach her to manage the condition so she stays that way. What are the symptoms of type 1 diabetes in children? Symptoms of type 1 diabetes include: Extreme thirst Peeing more than usual (You might notice more wet diapers if your child is very young, or "accidents" if your child is potty trained.) Extreme hunger Weight loss Unusual tiredness Crankiness Yeast infection or diaper rash If your child has one or more of these symptoms, call his doctor right away. Type 1 diabetes symptoms can start quickly and become very serious without treatment. Get medical care immediately if your child has any of Continue reading >>
Diabetes Diagnosis
It is important for diabetes to be diagnosed early so treatment can be started as soon as possible. Diabetes is diagnosed by a blood test. Most people with type 1 diabetes and many with type 2 diabetes will present with symptoms of diabetes such as increased thirst, urination and tiredness. Some people will also have signs of slow healing of wounds or persistent infections. However, many people with type 2 diabetes have no symptoms at all. A blood test is taken from a vein and sent to a pathology lab. The test may be either: a fasting sugar (glucose) test - fasting is required for at least eight hours, such as eating or drinking overnight a random glucose test taken anytime during the day an oral glucose tolerance test (OGTT) - where a patient who has fasted drinks a sugary drink and then has a blood test done 1 and then 2 hours later. The patient needs to eat and drink adequate (150 grams a day) of carbohydrates (starchy foods) for 3 days before the glucose tolerance test. Another blood test that can diagnose diabetes is the HbA1c test, which measures the percentage of haemoglobin molecules (the molecules that makes red blood cells red) in the blood that have a sugar molecule attached to them. Diabetes is diagnosed when: The fasting sugar level is >7mmol/L (on 2 separate occasions) The glucose tolerance test is >11mmol/L 2 hours after the sugary drink (on 2 separate occasions) The HbA1c level is >6.5% (on 2 separate occasions) Can diabetes be diagnosed with a blood glucose meter or urine test? A diagnosis of diabetes should not be made only by using a blood glucose meter and finger prick, or by urine glucose test. Although your doctor may take a blood test with a finger prick in the consulting room, you will still need a further blood test sent to pathology to confirm Continue reading >>
