The criteria for the diagnosis of type 2 diabetes have recently been changed. The new criteria use lower levels as a threshold in making the diagnosis because we now know that significant complications begin at these lower levels. Type 2 diabetes occurs in approximately 4-12 percent of the U.S. adult population and many of these patients are undiagnosed, or are identified only after several years of the disease. These patients are at increased risk for retinopathy, neuropathy, nephropathy with renal failure, coronary artery disease and myocardial infarction, stroke, peripheral vascular disease, hypertension, hyperlipidemia, and obesity.
There are three ways to make a diagnosis of diabetes:
1. If you have the symptoms of diabetes [polyuria (passing lots of urine), polydipsia (drinking lots of water), unexplained weight loss] and you test your glucose level (blood sugar) and it is greater than 200 you have diabetes. We call this a random or casual glucose level because it can be tested at any time of day without regard to the last meal.
or
2. If you have a fasting glucose level greater than 126 you have diabetes. A fasting level is when it has been at least 8 hours since you have eaten anything.
or
3. A third way that a diagnosis may be confirmed is with a glucose tolerance test.After fasting they give you a drink of glucose (75g) and then test your glucose level after 2 hours. If it is greater than 200 you have diabetes.
HbA1c is not used for diagnostic screening because of variability in the methodology and the lack of universal standards for the assay. In addition to being simpler, the revised criteria will increase the number of patients recognized and diagnosed with diabetes mellitus, allowing appropriate lifestyle and therapeutic interventions.
Do I Have Pre-Diabetes?
Pre-diabetes is a type of high blood sugar that predisposes to heart disease and often leads to full-blown diabetes. most people with pre-diabetes will go on to develop type 2 diabetes over the next decade unless they take measures to prevent it. Research shows that diet and exercise are the most effective way to prevent pre-diabetes from turning into diabetes. People with pre-diabetes are at a 50% greater risk of having a heart attack or stroke.
There are two ways to make a diagnosis of pre-diabetes.
1. If you have a fasting glucose level between 110 and 125, you have pre-diabetes. A fasting level is when it has been at least 8 hours since you have eaten anything.
or
2. A glucose tolerance test is when after fasting they give you a drink of glucose (75g) and then test your glucose level 2 hours later. If it is between 140 and 199 you have pre-diabetes.
How can I get my sugar level tested?
See your doctor or the nearest health clinic, they can order the test for you. Who should be tested? If you are over 45 you should be tested every 3 years. But if you are at an increased risk to develop diabetes you should be tested younger and more frequently. Who is at increased risk? You are at an increased risk if you are: obese, or have a first degree relative with diabetes, or are African American, Hispanic, or native American, or if you delivered a baby greater than 9 lbs., or if you have had gestational diabetes, or if you are hypertensive (have high blood pressure), have an HDL level less than 35, or a triglyceride level greater than 250, or if your previous glucose testing was borderline.