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Should You Get Screened for Diabetes?

Diabetes is a condition that most people try to avoid, and for good reason too. Research has shown that it puts you at a much higher risk of complications, including vision loss, heart disease, and kidney failure. What makes it difficult to detect early is that symptoms often come without warning, especially for Type 1 diabetes. As such, the American Diabetes Association (ADA) has laid out some recommendations for early screening and early detection. 

Who should be Screened for Diabetes?

While everyone should take the necessary precautions and remain vigilant of blood glucose levels, there are some who possess certain risk factors that put them at higher risk of developing diabetes. 

You should go for screening especially if you fall into one or more of the following categories: 

  • Have a body mass index (BMI) higher than 25, or higher than 23 for Asian-Americans
  • Are older than the age of 45
  • Are a woman who has previously had gestational diabetes
  • Have been diagnosed with prediabetes 

How do We Test for Prediabetes, Type 1 and Type 2 Diabetes?

The first step in testing for diabetes is usually a glycated hemoglobin (A1C) test. This test measures the percentage of blood glucose attached to the hemoglobin in your blood, a protein that carries oxygen in your red blood cells. It’s often the first test as it does not require any fasting, and is usually indicative of your average blood sugar level for the past few months prior to taking the test. 

The higher the percentage of blood sugar attached to hemoglobin, the higher your blood sugar levels are. Specifically, if your A1C level is below 5.7 percent, your blood sugar level is considered to be normal. However, any A1C level between 5.7 and 6.4 percent is indicative of prediabetes. If your A1C level is 6.5 percent or exceeds it on two separate tests, it means that you have developed diabetes. 

There are instances where the A1C test results are not reliable, for example, if you are currently pregnant, or if you have a different form of hemoglobin. Without consistent results, it’s possible that your doctor may then make use of any of the following tests to screen for diabetes. 

Firstly, your doctor may perform a random blood sugar test. As the name suggests, this test means a blood sample is drawn at a random time, no matter when your last meal was. For this test, a random blood sugar level of 200 milligrams per deciliter (mg/dL) or higher is indicative of diabetes. 

Another method of testing is the fasting blood sugar test. Here, your doctor will take a blood sample after you fast overnight for at least eight hours. 

If your fasting blood sugar level is under 100mg/dL, it is considered to be normal. However, if it falls between 100 to 125mg/dL, you have prediabetes. If it’s 126mg/dL or higher, your doctor will likely opt to repeat the test separately, and if the result falls in this range again, you have diabetes. 

The last method that is commonly used is the oral glucose tolerance test. Similar to the previous test, a blood sample is taken after fasting overnight. However, after the first sample is drawn, you’ll be given a sugary liquid to consume immediately and blood sugar levels are tested at several intervals for the next two hours. 

With this test, a blood sugar level under 140mg/dL is normal. If it falls between 140 and 199 mg/dL, it means you have prediabetes. A reading of 200mg/dL or more would indicate that you have diabetes. 

On top of these regular tests, if your doctor suspects you have Type 1 diabetes, it’s likely you will have to undergo an additional urine test. People who have Type 1 diabetes don’t have enough insulin to use the available glucose for energy, so other tissues such as muscle and fat are used instead. The additional urine test screens for a byproduct of this occurrence. 

What are the Tests for Gestational Diabetes?

It is not uncommon for pregnant women to develop gestational diabetes, and early detection is key to proper treatment and alleviation of its effects. There are some risk factors that would encourage your doctor to test for gestational diabetes early on in the pregnancy.

  • High risk of gestational diabetes: Doctors may test for diabetes at your first prenatal appointment if you are deemed to be at high risk, for instance, if you’ve previously had gestational diabetes during pregnancy, or if you have a family member with diabetes, or if you were obese at the beginning of the pregnancy. 

The average risk of gestational diabetes: Here, your doctor may recommend a gestational diabetes screening test between 24 and 28 weeks of pregnancy, or sometime during the second trimester of your pregnancy.

There are two main tests that are used to screen for gestational diabetes. 

The first test is the initial glucose challenge test. To start off, you’ll be asked to drink a glucose sugar solution, and then a blood test will be run an hour later. Typically, a blood sugar level in this test that falls under 140 mg/dL is deemed normal, though it may vary depending on your doctor’s assessment. This test, however, is not a hundred percent conclusive. It is only indicative of a higher risk of developing gestational diabetes. 

To further determine if you have gestational diabetes, your doctor is likely to order a follow-up glucose tolerance test. Here, you’ll have to fast overnight and have a blood sample drawn immediately after. After your first blood sample is drawn, you will be given another glucose solution, and then your blood sugar level will be checked at a regular interval of an hour for three hours. The results are determined by the resulting blood sugar readings — if two or more of the blood sugar readings are higher than normal, it is indicative of gestational diabetes. 

There are many different tests to test for all the different types of diabetes, including prediabetes, Type 1 and Type 2 diabetes, as well as gestational diabetes. Early detection is a factor for successful treatment, so talk to your doctor about getting screened, especially if you have any of the risk factors. After all, it is better to be safe than sorry.