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What Is The Best Test For Diagnosing Diabetes?

Tests For Diagnosing Diabetes Mellitus Glucose Tolerance Test Is Most Sensitive

Tests For Diagnosing Diabetes Mellitus Glucose Tolerance Test Is Most Sensitive

EDITOR, - David R McCance and colleagues state that the two hour plasma glucose, glycated haemoglobin, and fasting plasma glucose concentrations are equivalent predictors of the development of retinopathy and nephropathy.1 They therefore consider all three glycaemic variables to be equivalent for diagnosing diabetes. This conclusion should be viewed with caution. With regard to the sensitivity and specificity of glycaemic variables used, their roles in predicting microangiopathy and diagnosing diabetes need to be clearly distinguished. On the basis of data presented in tables I and II in the authors' paper (table), the oral glucose tolerance test has the highest sensitivity in diagnosing diabetes. It would be important to know whether all three glycaemic variables in an individual subject had identical centile positions in the distributions of the variables used. This requirement will be fulfilled if there is a positive linear correlation between the two hour glucose and glycated haemoglobin concentrations in an individual. No evidence can be found about this in McCance and colleagues' paper. This correlation is more likely in patients with poor metabolic control than in those with strict control. If the centile positions of the three glycaemic variables for an individual subject differ this means that the prediction of microangiopathy varies as a function of the glycaemic variables used. The Diabetes Control and Complications Trial Research Group has documented that better glycaemic control can delay the onset and slow the progression of microangiopathy in patients with insulin dependent diabetes mellitus.2 Better control implies early diagnosis and treatment of diabetes. Since the oral glucose tolerance test has the highest sensitivity in detecting patients with impai Continue reading >>

What Is Diabetes?

What Is Diabetes?

How are diabetes and pre-diabetes diagnosed? The following tests are used for diagnosis: A fasting plasma glucose test measures your blood glucose after you have gone at least 8 hours without eating. This test is used to detect diabetes or pre-diabetes. An oral glucose tolerance test measures your blood glucose after you have gone at least 8 hours without eating and 2 hours after you drink a glucose-containing beverage. This test can be used to diagnose diabetes or pre-diabetes. In a random plasma glucose test, your doctor checks your blood glucose without regard to when you ate your last meal. This test, along with an assessment of symptoms, is used to diagnose diabetes but not pre-diabetes. Positive test results should be confirmed by repeating the fasting plasma glucose test or the oral glucose tolerance test on a different day. Fasting Plasma Glucose (FPG) Test The FPG is the preferred test for diagnosing diabetes due to convenience and is most reliable when done in the morning. Results and their meaning are shown in table 1. If your fasting glucose level is 100 to 125 mg/dL, you have a form of pre-diabetes called impaired fasting glucose (IFG), meaning that you are more likely to develop type 2 diabetes but do not have it yet. A level of 126 mg/dL or above, confirmed by repeating the test on another day, means that you have diabetes. Table 1. Fasting Plasma Glucose Test *Confirmed by repeating the test on a different day. Oral Glucose Tolerance Test (OGTT) Research has shown that the OGTT is more sensitive than the FPG test for diagnosing pre-diabetes, but it is less convenient to administer. The OGTT requires you to fast for at least 8 hours before the test. Your plasma glucose is measured immediately before and 2 hours after you drink a liquid containing 75 grams Continue reading >>

Diagnosing Diabetes

Diagnosing Diabetes

Protocol for diagnosing diabetes According to the National Institute of Diabetes and Digestive and Kidney Diseases: People over age 45 should be tested for prediabetes or diabetes. If the first blood glucose test is normal, they should be retested every 3 years. People under age 45 should consider getting tested for prediabetes or diabetes if they have a body mass index (BMI) of greater than or equal to 25 kg/m2 and have 1 or more of the following risk factors: Having a first-degree relative with diabetes (mother, father, or sibling) Being a member of a high-risk ethnic group (African American, Hispanic, Asian, Pacific Islander, or Native American) Delivering a baby weighing more than 9 pounds, or having diabetes during pregnancy Having blood pressure at or above 140/90 mm/Hg Having abnormal blood fat levels, such as high-density lipoproteins (HDL) less than or equal to 35 mg/dL, or triglycerides greater than or equal to 250 mg/dL (mg/dL = milligrams of glucose per deciliter of blood) Having an inactive lifestyle Having impaired glucose tolerance when previously tested for diabetes Having polycystic ovarian syndrome People who have already been identified as having prediabetes to find out if they have since developed diabetes A diagnosis of diabetes A1C greater than or equal to 6.5% Fasting plasma glucose of greater than or equal to 126 mg/dL Casual plasma glucose (taken at any time of the day) of greater than or equal to 200 mg/dL with the symptoms of hyperglycemia or hyperglycemic crisis Oral glucose tolerance test (OGTT) value of greater than or equal to 200 mg/dL. The OGTT is obtained 2 hours after a drink containing glucose has been consumed. This happens after fasting for at least 8 hours. A diagnosis of gestational diabetes Gestational diabetes may be diagnosed w Continue reading >>

5 Important Tests For Type 2 Diabetes

5 Important Tests For Type 2 Diabetes

It takes more than just one abnormal blood test to diagnose diabetes.Istockphoto For centuries, diabetes testing mostly consisted of a physician dipping his pinkie into a urine sample and tasting it to pick up on abnormally high sugar. Thankfully, testing for type 2 diabetes is lot easier now—at least for doctors. Urine tests can still pick up diabetes. However, sugar levels need to be quite high (and diabetes more advanced) to be detected on a urine test, so this is not the test of choice for type 2 diabetes. Blood tests Almost all diabetes tests are now conducted on blood samples, which are collected in a visit to your physician or obstetrician (if you're pregnant). More about type 2 diabetes If you have an abnormal resultmeaning blood sugar is too high—on any of these tests, you'll need to have more testing. Many things can affect blood sugar (such as certain medications, illness, or stress). A diabetes diagnosis requires more than just one abnormal blood sugar result. The main types of diabetes blood tests include: Oral glucose-tolerance test. This test is most commonly performed during pregnancy. You typically have your blood drawn once, then drink a syrupy glucose solution and have your blood drawn at 30 to 60 minute intervals for up to three hours to see how your body is handling the glut of sugar. Normal result: Depends on how many grams of glucose are in the solution, which can vary. Fasting blood sugar. This is a common test because it's easy to perform. After fasting overnight, you have your blood drawn at an early morning doctor's visit and tested to see if your blood sugar is in the normal range. Normal result: 70-99 milligrams per deciliter (mg/dl) or less than 5.5 mmol/L Two-hour postprandial test. This blood test is done two hours after you have eate Continue reading >>

Diabetes: Diagnosing Type 2 Diabetes

Diabetes: Diagnosing Type 2 Diabetes

What do the results mean? If you experience symptoms of severe increased thirst, frequent urination, unexplained weight loss, increased hunger, tingling of your hands or feet -- your doctor may suspect diabetes. To confirm the diagnosis, a fasting plasma glucose test or a casual plasma glucose test will be performed. The fasting plasma glucose test (FPG) is the preferred method of diagnosing diabetes because it is easy to do, convenient and less expensive than other tests, according to the American Diabetes Association. How Do I Prepare for the Test? You will not be allowed to eat anything for 10-12 hours before the FPG test. Blood will be drawn and sent to the lab for analysis. Normal fasting blood glucose is between 70 and 100 milligrams per deciliter or mg/dL for people who do not have diabetes. The standard diagnosis of diabetes is made when two separate blood tests show that your fasting blood glucose level is greater than or equal to 126 mg/dL. However, if you have normal fasting blood glucose, but you have risk factors for diabetes or symptoms of diabetes and your fasting blood glucose is normal, your doctor may decide to do a glucose tolerance test (see below) to be sure that you do not have diabetes. Some people have a normal fasting blood glucose reading, but their blood glucose rapidly rises as they eat. These people may have glucose intolerance. If their blood glucose levels are high enough, they may be diagnosed with diabetes. The casual plasma glucose test is another method of diagnosing diabetes. During the test, blood glucose is tested without regard to the time since the person's last meal. You are not required to abstain from eating prior to the test. A glucose level greater than 200 mg/dL may indicate diabetes, especially if the test is repeated at a Continue reading >>

Could Your Child Have Diabetes?

Could Your Child Have Diabetes?

More than 15,000 children are diagnosed with type 1 every year. Make sure you know the telltale signs -- they're all too easy to dismiss. When Chloe Powell started begging for one more drink of water every night, her father, Charles, thought his then 7-year-old was using a common bedtime stall tactic. "I was irritated that she wouldn't go to sleep," admits Dr. Powell, who's a family physician in Dallas. With all she was drinking, he wasn't surprised when she began wetting the bed. But when Chloe couldn't make it through a conversation without having to use the bathroom, he became concerned. "I figured she had a urinary-tract infection, and she'd take some antibiotics and feel better," says Dr. Powell. He wasn't at all prepared for what his daughter's urine test showed: a dangerously high level of sugar that was a clear indicator of type 1 diabetes. In an instant, Chloe, now 10, went from being a kid who never thought twice about the foods she ate or the energy she burned to one who'd face a lifetime of carbohydrate counting, finger pricks, and insulin injections. A Disease on the Rise Type 1 diabetes is an autoimmune disorder that causes the body's immune system to mistakenly destroy healthy cells in the pancreas that produce the hormone insulin. (Type 2, on the other hand, occurs when the body doesn't respond to the insulin that's being made.) Insulin ensures that sugar (glucose) in the bloodstream gets into the body's cells where it's needed for energy; without insulin, sugar builds up in the blood, which can be deadly. It's important to begin insulin therapy as soon as possible because high blood-sugar levels can cause permanent vision and nerve problems as well as damage to blood vessels, increasing the risk of heart attack, stroke, and kidney disease. Since the 198 Continue reading >>

Diagnosis Of Type 2 Diabetes Mellitus

Diagnosis Of Type 2 Diabetes Mellitus

There is a continuum of risk for poor patient outcomes as glucose tolerance progresses from normal to overt type 2 diabetes. AACE-defined glucose tolerance categories are listed in Table 1.1 Table 1. Glucose Testing and Interpretation1 Normal High Risk for Diabetes Diabetes FPG < 100 mg/dL IFG FPG ≥100-125 mg/dL FPG ≥126 mg/dL 2-hour PG <140 mg/dL (measured with an OGTT performed 2 hours after 75 g oral glucose load taken after 8-hour fast) IGT 2-hour PG ≥140-199 mg/dL 2-hour PG ≥200 mg/dL Random PG ≥200 mg/dL plus symptoms of diabetes (polyurea, polydipsia, or polyphagia) A1C < 5.5% 5.5% to 6.4% For screening of prediabetesa ≥6.5% Secondaryb Abbreviations: A1C = hemoglobin A1C; FPG = fasting plasma glucose; IFG = impaired fasting glucose; IGT = impaired glucose tolerance; PG = plasma glucose. a A1C should be used only for screening prediabetes. The diagnosis of prediabetes, which may manifest as either IFG or IGT, should be confirmed with glucose testing. b Glucose criteria are preferred for the diagnosis of DM. In all cases, the diagnosis should be confirmed on a separate day by repeating glucose or A1C testing. When A1C is used for diagnosis, follow-up glucose testing should be done when possible to help manage diabetes. The diagnostic cut points recommended by the American Diabetes Association (ADA) differ slightly from the AACE recommendations; please see the ADA Standards of Medical Care in Diabetes for details.2 In addition to glucose criteria, type 1 diabetes (T1D) is diagnosed according to the presence of autoantibodies to glutamic acid decarboxylase, pancreatic islet (beta) cells, or insulin.1,2 Type 2 diabetes (T2D) accounts for 90% of diabetes cases and is usually identified in individuals 30 years or older who are overweight or obese and/or have Continue reading >>

New Test For Diagnosis Of Diabetes And Pre-diabetes

New Test For Diagnosis Of Diabetes And Pre-diabetes

The ADA and other organizations will be announcing the guidelines on how to use the A1c test to diagnose diabetes. The test that has been used by most doctors is the fasting blood glucose test. The problem with the fasting blood glucose is that you have to be fasting, but it can still give you a false reading. Now the A1c test which is a 90 day average of your blood sugars will be used, which means fasting will not be required. Leading diabetes organizations in the U.S., as the American Diabetes Association and others will come out with the guidelines within the next couple of months. They will contain information explaining how to use the A1c test as a diagnostic tool for type 2 diabetes. This change is coming at a time when the diagnosis of diabetes has increased over 90% among U.S. adults in the past 10 years. From 4.8 cases per 1,000 population during 1995-97, the number climbed up to 9.1 per 1,000 people in 2005-07 in 33 states. Right now most doctors use the fasting blood sugar result to diagnose diabetes and prediabetes. But we know that you can have a normal fasting blood sugar but still have undiagnosed diabetes. This change will allow us to catch more people with diabetes and they will not have to fast for the test. The glycated hemoglobin test (HbA1c) or the A1c test has been around for more than 30 years. It provides average blood glucose over the previous 90 days. It has become the gold standard test in diabetes care. But, it has not been used as a way to diagnose a person with diabetes because it was not a standardized test. Meaning that a 6% in one lab could be an 8% in another lab. Or that a 6% in one lab is 126mg/dL and a 6% in another lab would be 154mg/dL. It has only been used to find out how a person with diabetes is doing over the last 90 -120 days Continue reading >>

Diagnosis Of Diabetes

Diagnosis Of Diabetes

The following tests are used for the diagnosis of diabetes: A fasting plasma glucose test measures your blood glucose after you have gone at least 8 hours without eating. This test is used to detect diabetes or prediabetes. An oral glucose tolerance test measures your blood sugar after you have gone at least eight hours without eating and two hours after you drink a glucose-containing beverage. This test can be used to diagnose diabetes or prediabetes. In a random plasma glucose test, your doctor checks your blood sugar without regard to when you ate your last meal. This test, along with an assessment of symptoms, is used to diagnose diabetes, but not prediabetes. Positive test results should be confirmed by repeating the fasting plasma glucose test or the oral glucose tolerance test on a different day. When first diagnosed with diabetes, your doctor may suggest a zinc transporter 8 autoantibody (ZnT8Ab) test. This blood test -- along with other information and test results -- can help determine if a person has type 1 diabetes and not another type. The goal of having the ZnT8Ab test is a prompt and accurate diagnosis and that can lead to timely treatment. The FPG is most reliable when done in the morning. Results and their meaning are shown in table 1. If your fasting glucose level is 100 to 125 mg/dL, you have a form of prediabetes called impaired fasting glucose (IFG), meaning that you are more likely to develop type 2 diabetes but do not have it yet. A level of 126 mg/dL or above, confirmed by repeating the test on another day, means that you have diabetes. Table 1. Fasting Plasma Glucose Test Plasma Glucose Result (mg/dL) Diagnosis 99 and below Normal 100 to 125 Prediabetes (impaired fasting glucose) 126 and above Diabetes* *Confirmed by repeating the test on a diff Continue reading >>

How Diabetes Is Diagnosed

How Diabetes Is Diagnosed

Fasting Blood Glucose Test What it is: After you fast for at least 8 hours, you'll undergo a simple blood test that measures the amount of sugar in your bloodstream. Pro: It's widely available (it'll probably be included in your standard physical) and not too expensive. The results are also pretty reliable, assuming you complete the required fast. Con: If you eat when you're supposed to be fasting, the test could give false positives or negatives. For example, coffee is often allowed during the fast, but just adding a dash of cream to your cup can throw off test results. Oral Glucose Tolerance Test What it is: After fasting for at least 8 hours, you drink a sugary solution akin to super-concentrated soda (without the fizz). Frequent blood tests measure your glucose levels over the next 2 or more hours. Pro: It's the most accurate diagnostic test. Con: Frankly, who wants to sit in the doctor's office all day? Random (Non-Fasting) Blood Glucose Test What it is: Similar to the fasting glucose test, but, of course, without the fasting. Pro: It's convenient. Con: It's not actually sanctioned as a diagnostic test for diabetes, so it's likely that you'll be asked to make a return visit for a second test to validate the results. A1C Test What it is: A blood test that measures blood glucose levels in your red blood cells, which live in your bloodstream for about 3 months. Pro: It's the most comprehensive test to diagnose diabetes. Each red blood cell can reveal how much blood glucose was attached to it over its 3-month lifespan, serving as a calendar of your average blood glucose levels. Con: It's not technically considered a diagnostic test—yet. But in April 2009, an expert panel comprised of representatives from the American Diabetes Association, the International Diabetes F Continue reading >>

Glucose Tolerance: Diabetes Mellitus

Glucose Tolerance: Diabetes Mellitus

Rationale: The American Diabetes Association (ADA) 2011 Standards of Medical Care provide the following recommendations regarding the diagnosis of diabetes.1,2 Criteria for the diagnosis of diabetes:1 A1c ≥6.5%.* This test should be performed in a laboratory using a method that is NGSP certified and standardized to the DCCT assay, or Fasting blood glucose ≥126 mg/dL.* Fasting is defined as no caloric intake for at least eight hours, or Two-hour plasma glucose ≥200 mg/dL during an oral glucose tolerance test.* This test should be performed as described by the World Health Organization (WHO) using a glucose load containing the equivalent of 75 g anhydrous glucose dissolved in water. The LabCorp test number for the WHO glucose tolerance test is 101200, or In a patient with classic symptoms of hyperglycemia or hyperglycemic crisis, a random plasma glucose ≥200 mg/dL. *In the absence of unequivocal hyperglycemia, the result should be confirmed by repeat testing. There is an intermediate group of subjects whose glucose levels, although not meeting criteria for diabetes, are nevertheless too high to be considered normal. These individuals have been referred to as having prediabetes, indicating the relative high risk for the future development of diabetes. Categories of increased risk for diabetes include impaired fasting glucose, impaired glucose tolerance, and elevated A1c. Fasting plasma glucose of 100−125 mg/dL = impaired fasting glucose, or Two-hour plasma glucose in the 75 g OGTT 140−199 mg/dL = impaired glucose tolerance, or A1c of 5.7% to 6.4% *For all of these tests, risk is continuous, extending below the lower limit of the range and becoming disproportionately greater at higher ends of the range. ADA guidelines refer to only two oral glucose tolerance tes Continue reading >>

Testing And Diagnosing Diabetes And Prediabetes

Testing And Diagnosing Diabetes And Prediabetes

Your goal: Do your level best One of the main goals of treating diabetes is to control the blood sugar level by maintaining it as close to normal as possible. Follow the blood sugar goals recommended by your doctor. The American Diabetes Association 2014 recommends the following blood sugar goals for people with diabetes: Note: These guidelines apply to many people, but not to everyone. Your best "level" may be higher or lower than these guidelines. Your doctor will help you set the blood sugar target range that is right for you. How to compare the results of your daily blood sugar test to HbA1c test: This chart shows the average blood sugar that corresponds to the HbA1c test result. Note that an HbA1c of 6.5% results when blood sugar averages about 135 mg/dL. Always consult your doctor to gain the right information on your HbA1c. The chart below only depicts the averages. Blood Sugar ( mg / dL ) HbA1c ( % ) 135 6% 170 7% 205 8% 240 9% 275 10% 310 11% 345 12% When to test the blood sugar? Testing patterns are individualized and depend on the type of diabetes and treatment plan of the patient. Your doctor sets these patterns for you. Some of the standard times to test include: First thing in the morning (Fasting) Before meals 2 hours after meals (Post Prandial) At bed time During the night (2-3 a.m.) Low Blood Sugar (What is Hypoglycemia?) When your blood sugar falls below 70mg/dL (3-9mmol/L), you may have low blood sugar (hypoglycemia). When this happens, most people experience unpleasant symptoms that can be both physical and emotional. These symptoms can come on quite suddenly. Hypoglycemia is usually easy to treat. However, if it is not dealt with quickly, serious reactions may result, including passing out or having convulsions. Talk with your doctor about what step Continue reading >>

Diabetes Tests

Diabetes Tests

Diabetes is a condition that affects the body’s ability to either produce or use insulin. Insulin helps the body utilize blood sugar for energy. Diabetes results in blood sugar, or blood glucose, that rises to abnormally high levels. Over time, diabetes results in damage to blood vessels and nerves, causing a variety of symptoms, including: difficulty seeing tingling and numbness in the hands and feet increased risk for a heart attack or stroke An early diagnosis means you can start treatment and take steps toward a healthier lifestyle. In its early stages, diabetes may or may not cause many symptoms. You should get tested if you experience any of the early symptoms that do sometimes occur, including: extreme thirst feeling tired all the time feeling very hungry, even after eating blurry vision urinating more often than usual have sores or cuts that won’t heal Some people should be tested for diabetes even if they aren’t experiencing symptoms. The American Diabetes Association (ADA) recommends you undergo diabetes testing if you’re overweight (body mass index greater than 25) and fall into any of the following categories: you’re a high risk ethnicity (African American, Latino, Native American, Pacific Islander, Asian American) you have high blood pressure, high triglycerides, low HDL cholesterol, or heart disease you have a family history of diabetes you have a personal history of abnormal blood sugar levels or signs of insulin resistance you don’t engage in regular physical activity you’re a woman with a history of polycystic ovary syndrome (PCOS) or gestational diabetes The ADA also recommends you undergo an initial blood sugar test if you are over the age of 45. This helps you establish a baseline for blood sugar levels. Because your risk for diabetes i Continue reading >>

What Is The Best Way To Treat Or Control Diabetes?

What Is The Best Way To Treat Or Control Diabetes?

MANAGING DIABETES People with diabetes can live long and healthy lives if their diabetes is detected and well-managed. Good management using a standardized protocol can potentially prevent complications and premature death from diabetes using: a small set of generic medicines; interventions to promote healthy lifestyles; patient education to facilitate self-care; regular screening for early detection and treatment of complications through a multidisciplinary team. The longer a person lives with undiagnosed and untreated diabetes, the worse their health outcomes are likely to be Blood glucose control is important in preventing and slowing the progression of complications CONTROLLING DIABETES 1. Life style changes are used to controlling diabetes and have several principles of good diabetes care: Monitor your diabetes regularly Prevent long term diabetes problems Get checked for long term problems and treat them 2. Exercise is important in helping to prevent diabetes and is having vital role of our treatment. Helps in losing weight Reduces blood glucose levels Exercise can reduce cholesterol and blood pressure Exercise helps reduce stress Exercise makes the tissues in your body more sensitive to the effects of insulin. 3. Diet places an emphasis on foods that are higher in fiber and low in fat. A high fiber, low fat diet can make body more sensitive to insulin. Diet may involve weight loss which can increase diabetic patient’s body sensitivity to the effects of insulin. There is a good website on healthcare, with some informative blogs on diabetes, you can check it here: Latest Health Care and News | DiscussMed Continue reading >>

Diabetes Diagnosis

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 >>

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