Our Health Care professional can diagnose diabetes, prediabetes, and gestational diabetes through blood tests. This is called Diabetes Diagnosis. The blood tests show if our blood glucose, also called blood sugar, is too high.
Testing also allows health care professionals to find prediabetes. Making lifestyle changes to lose a modest amount of weight if we are overweight may help us delay or prevent type 2 diabetes.
- are age of 45 or older
- are between the ages of 19 and 44, are overweight or obese, and have one or more other diabetes risk factors
- are a woman who had gestational diabetes
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.
- low birth-weight
- a mother who had diabetes while pregnant
- any risk factor mentioned in Risk Factors for Type 2 Diabetes
§ Fasting Plasma Glucose (FPG) Test
The FPG blood test measures our 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 we fast for at least 8 hours. Fasting means having nothing to eat or drink except sips of water.
§ A1C Test
The A1C test is a blood test that provides our average levels of blood glucose over the past 3 months. Other names for the A1C test are hemoglobin A1C, HbA1C, glycated hemoglobin, and glycosylated hemoglobin test. We can eat and drink before this test. When it comes to using the A1C for diabetes diagnosis, our doctor will consider factors such as our age and whether we have anemia or another problem with our blood. The A1C test is not accurate in people with anemia.
Our health care professional will report our A1C test result as a percentage, such as an A1C of 7 percent. The higher the percentage, the higher our average blood glucose levels.
People with diabetes also use information from the A1C test to help manage their diabetes.
§ Random Plasma Glucose (RPG) Test
Sometimes health care professionals use the RPG test for diabetes diagnosis when diabetes symptoms are present and they do not want to wait until we have fasted. We do not need to fast overnight for the RPG test. We may have this blood test at any time.
o Glucose Challenge Test
If we are pregnant and a health care professional is checking us for gestational diabetes, we may first receive the glucose challenge test. Another name for this test is the glucose screening test. In this test, a health care professional will draw our blood 1 hour after we drink a sweet liquid containing glucose. We do not need to fast for this test. If our blood glucose is too high—135 to 140 or more—we may need to return for an oral glucose tolerance test while fasting.
o Oral Glucose Tolerance Test (OGTT)
The OGTT measures blood glucose after we fast for at least 8 hours. First, a health care professional will draw our blood. Then we will drink the liquid containing glucose. For gestational diabetes diagnosis, we will need our blood drawn every hour for 2 to 3 hours.
High blood glucose levels at any two or more blood test times during the OGTT—fasting, 1 hour, 2 hours, or 3 hours—means we have gestational diabetes. Our health care team will explain what our OGTT results means.
Health care professionals can also use the OGTT to diagnose type 2 diabetes and prediabetes in people who are not pregnant. The OGTT helps health care professionals detect type 2 diabetes and prediabetes better than the FPG test. However, the OGTT is a more expensive test and is not as easy to give. To diagnose type 2 diabetes and prediabetes, a health care professional will need to draw our blood 1 hour after we drink the liquid containing glucose and again after 2 hours.
- Fasting plasma glucose level ≥ 7.0 mmol/l (126 mg/dl)
- Plasma glucose ≥ 11.1 mmol/l (200 mg/dl) two hours after a 75 gram oral glucose load as in a glucose tolerance test (OGTT)
- Symptoms of high blood sugar and casual plasma glucose ≥ 11.1 mmol/l (200 mg/dl)
- Glycated hemoglobin (HbA1C) ≥ 48 mmol/mol (≥ 6.5 DCCT %).
A positive result, in the absence of unequivocal high blood sugar, should be confirmed by a repeat of any of the above methods on a different day. It is preferable to measure a fasting glucose level because of the ease of measurement and the considerable time commitment of formal glucose tolerance testing, which takes two hours to complete and offers no prognostic advantage over the fasting test. According to the current definition, two fasting glucose measurements above 7.0 mmol/l (126 mg/dl) is considered diagnostic for diabetes.
As per the WHO, people with fasting glucose levels from 6.1 to 6.9 mmol/l (110 to 125 mg/dl) are considered to have impaired fasting glucose. People with plasma glucose at or above 7.8 mmol/l (140 mg/dl), but not over 11.1 mmol/l (200 mg/dl), two hours after a 75 gram oral glucose load are considered to have impaired glucose tolerance. Of these two prediabetic states, the latter in particular is a major risk factor for progression to full-blown diabetes mellitus, as well as cardiovascular disease.
The American Diabetes Association (ADA) since 2003 uses a slightly different range for impaired fasting glucose of 5.6 to 6.9 mmol/l (100 to 125 mg/dl).
Glycated hemoglobin is better than fasting glucose for determining risks of cardiovascular disease and death from any cause.
Each
test to detect diabetes and prediabetes uses a different measurement. Usually,
the same test method needs to be repeated on a second day to diagnose diabetes.
Our doctor may also use a second test method to confirm that we have diabetes.
The following table helps us understand what our test numbers mean if we are not pregnant.
[a]: Glucose values
are in milligrams per deciliter, or mg/dL.
[b]: At 2 hours after drinking 75 grams of glucose. To diagnose gestational diabetes, health care professionals give more glucose to drink and use different numbers as cutoffs.
To find out if our diabetes is type 1, our health care professional may look for certain auto-antibodies. Auto-antibodies are antibodies that mistakenly attack our healthy tissues and cells. The presence of one or more of several types of auto-antibodies specific to diabetes is common in type 1 diabetes, but not in type 2 or monogenic diabetes. A health care professional will have to draw our blood for this test.
If we had diabetes while we were pregnant, we should get tested no later than 12 weeks after our baby is born to see if we have type 2 diabetes.
Who Should be TESTED for Diabetes?
Anyone who has symptoms of diabetes should be tested for the disease. Some people will not have any symptoms but may have risk factors for diabetes and need to be tested. Testing allows health care professionals to find diabetes sooner and work with their patients to manage diabetes and prevent complications.Testing also allows health care professionals to find prediabetes. Making lifestyle changes to lose a modest amount of weight if we are overweight may help us delay or prevent type 2 diabetes.
- Type 1 Diabetes
- Type 2 Diabetes
- are age of 45 or older
- are between the ages of 19 and 44, are overweight or obese, and have one or more other diabetes risk factors
- are a woman who had gestational diabetes
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.
- low birth-weight
- a mother who had diabetes while pregnant
- any risk factor mentioned in Risk Factors for Type 2 Diabetes
- Gestational Diabetes
What Tests are Used for Diabetes Diagnosis and Prediabetes?
Health care professionals most often use the fasting plasma glucose (FPG) test or the A1C test for diabetes diagnosis. In some cases, they may use a random plasma glucose (RPG) test.§ Fasting Plasma Glucose (FPG) Test
The FPG blood test measures our 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 we fast for at least 8 hours. Fasting means having nothing to eat or drink except sips of water.
§ A1C Test
The A1C test is a blood test that provides our average levels of blood glucose over the past 3 months. Other names for the A1C test are hemoglobin A1C, HbA1C, glycated hemoglobin, and glycosylated hemoglobin test. We can eat and drink before this test. When it comes to using the A1C for diabetes diagnosis, our doctor will consider factors such as our age and whether we have anemia or another problem with our blood. The A1C test is not accurate in people with anemia.
Our health care professional will report our A1C test result as a percentage, such as an A1C of 7 percent. The higher the percentage, the higher our average blood glucose levels.
People with diabetes also use information from the A1C test to help manage their diabetes.
§ Random Plasma Glucose (RPG) Test
Sometimes health care professionals use the RPG test for diabetes diagnosis when diabetes symptoms are present and they do not want to wait until we have fasted. We do not need to fast overnight for the RPG test. We may have this blood test at any time.
What Tests are Used to DIAGNOSE Gestational Diabetes?
Pregnant women may have the glucose challenge test, the oral glucose tolerance test, or both. These tests show how well our body handles glucose.o Glucose Challenge Test
If we are pregnant and a health care professional is checking us for gestational diabetes, we may first receive the glucose challenge test. Another name for this test is the glucose screening test. In this test, a health care professional will draw our blood 1 hour after we drink a sweet liquid containing glucose. We do not need to fast for this test. If our blood glucose is too high—135 to 140 or more—we may need to return for an oral glucose tolerance test while fasting.
o Oral Glucose Tolerance Test (OGTT)
The OGTT measures blood glucose after we fast for at least 8 hours. First, a health care professional will draw our blood. Then we will drink the liquid containing glucose. For gestational diabetes diagnosis, we will need our blood drawn every hour for 2 to 3 hours.
High blood glucose levels at any two or more blood test times during the OGTT—fasting, 1 hour, 2 hours, or 3 hours—means we have gestational diabetes. Our health care team will explain what our OGTT results means.
Health care professionals can also use the OGTT to diagnose type 2 diabetes and prediabetes in people who are not pregnant. The OGTT helps health care professionals detect type 2 diabetes and prediabetes better than the FPG test. However, the OGTT is a more expensive test and is not as easy to give. To diagnose type 2 diabetes and prediabetes, a health care professional will need to draw our blood 1 hour after we drink the liquid containing glucose and again after 2 hours.
What TEST NUMBERS Tell Me if I Have Diabetes or Prediabetes?
Diabetes is characterized by recurrent or persistent high blood sugar, and is diagnosed by demonstrating any one of the following:- Fasting plasma glucose level ≥ 7.0 mmol/l (126 mg/dl)
- Plasma glucose ≥ 11.1 mmol/l (200 mg/dl) two hours after a 75 gram oral glucose load as in a glucose tolerance test (OGTT)
- Symptoms of high blood sugar and casual plasma glucose ≥ 11.1 mmol/l (200 mg/dl)
- Glycated hemoglobin (HbA1C) ≥ 48 mmol/mol (≥ 6.5 DCCT %).
A positive result, in the absence of unequivocal high blood sugar, should be confirmed by a repeat of any of the above methods on a different day. It is preferable to measure a fasting glucose level because of the ease of measurement and the considerable time commitment of formal glucose tolerance testing, which takes two hours to complete and offers no prognostic advantage over the fasting test. According to the current definition, two fasting glucose measurements above 7.0 mmol/l (126 mg/dl) is considered diagnostic for diabetes.
As per the WHO, people with fasting glucose levels from 6.1 to 6.9 mmol/l (110 to 125 mg/dl) are considered to have impaired fasting glucose. People with plasma glucose at or above 7.8 mmol/l (140 mg/dl), but not over 11.1 mmol/l (200 mg/dl), two hours after a 75 gram oral glucose load are considered to have impaired glucose tolerance. Of these two prediabetic states, the latter in particular is a major risk factor for progression to full-blown diabetes mellitus, as well as cardiovascular disease.
The American Diabetes Association (ADA) since 2003 uses a slightly different range for impaired fasting glucose of 5.6 to 6.9 mmol/l (100 to 125 mg/dl).
Glycated hemoglobin is better than fasting glucose for determining risks of cardiovascular disease and death from any cause.
| WHO diabetes diagnostic criteria | ||||
| Condition | 2-hour glucose | Fasting glucose | HbA1c | |
| Unit | mmol/l(mg/dl) | mmol/l(mg/dl) | mmol/mol | DCCT % |
| Normal | <7.8 (<140) | <6.1 (<110) | <42 | <6.0 |
| Impaired fasting glycaemia | <7.8 (<140) | ≥6.1(≥110) & <7.0(<126) | 42-46 | 6.0–6.4 |
| Impaired glucose tolerance | ≥7.8 (≥140) | <7.0 (<126) | 42-46 | 6.0–6.4 |
| Diabetes mellitus | ≥11.1 (≥200) | ≥7.0 (≥126) | ≥48 | ≥6.5 |
The following table helps us understand what our test numbers mean if we are not pregnant.
| Diagnosis | A1C (percent) | Fasting plasma glucose (FPG)[a] | Oral glucose tolerance test (OGTT)[a][b] | Random plasma glucose test (RPG)[a] |
| Normal | below 5.7 | 99 or below | 139 or below | |
| Prediabetes | 5.7 to 6.4 | 100 to 125 | 140 to 199 | |
| Diabetes | 6.5 or above | 126 or above | 200 or above | 200 or above |
[b]: At 2 hours after drinking 75 grams of glucose. To diagnose gestational diabetes, health care professionals give more glucose to drink and use different numbers as cutoffs.
Which tests help my health care professional know what kind of diabetes I have?
Even though the tests described here can confirm that we have diabetes, they can’t identify what type we have. Sometimes health care professionals are unsure if diabetes is type 1 or type 2. A rare type of diabetes that can occur in babies, called monogenic diabetes, can also be mistaken for type 1 diabetes. Treatment depends on the type of diabetes, so knowing which type we have is important.To find out if our diabetes is type 1, our health care professional may look for certain auto-antibodies. Auto-antibodies are antibodies that mistakenly attack our healthy tissues and cells. The presence of one or more of several types of auto-antibodies specific to diabetes is common in type 1 diabetes, but not in type 2 or monogenic diabetes. A health care professional will have to draw our blood for this test.
If we had diabetes while we were pregnant, we should get tested no later than 12 weeks after our baby is born to see if we have type 2 diabetes.
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