Diagnosing Diabetes

Diabetes and You Series: Part 2

How do I know if I have diabetes? 

Usually, the best way to find out if you have diabetes is through testing. In most cases, testing is done if you have signs or symptoms that make your doctor think you have diabetes. Also, you may be tested, irrespective of symptoms. This is called a screening test. Oftentimes, screening tests can see the illness before you notice any symptoms. But, diabetes diagnosed through screening tests is very early in the disease process. And it gives you the best chance of success.

What are the Diagnosing Diabetes of diabetes? 

Frequently, Type 1 Diabetes is diagnosed when a child has symptoms of very high blood glucose.

Symptoms of Type 1 Diabetes

• Frequent urination (at night, bedwetting, or not being able to hold it). 
• Excessive thirst.
• Weight loss.
• Genital yeast infections.
• Blurred vision.

Type 2 Diabetes Symptoms

Sometimes type 1 diabetes isn’t diagnosed until you have diabetic ketoacidosis (DKA, pronounced D-K-A). In most cases, this is a life-threatening complication of diabetes that needs urgent treatment in a hospital. Sadly, about one-third of children will be diagnosed when they have DKA. In DKA, high blood sugar levels and low insulin levels create too much acid in the bloodstream. Sometimes, this is dangerous. So, DKA is a life-threatening condition that requires urgent hospitalization. Yet, in a child who does not have symptoms, type 1 diabetes may be diagnosed by a blood test showing high blood sugars. But, this is less common, as most children will have symptoms.

Diabetic Ketoacidosis Symptoms

Usually, symptoms include:

• Loss of Appetite.
• Nausea and/or Vomiting.
• Abdominal Pain.
• Rapid Breathing.
• Fruity Breath Odor.
• Drowsiness- may be severe.
• Frequent Urination.
• Excessive Thirst.
• Weight Loss.
• Genital Yeast Infections.
• Blurry Vision.

Oftentimes, Type 2 Diabetes is diagnosed on routine screening blood work. Further, this means that your doctor checks even though you have no symptoms. In most cases, common symptoms are the same as those for type 1 diabetes. But, the symptoms can start slowly over time. Sometimes, you may not even know there is a problem until after your diagnosis. But, by the time you have symptoms, your blood sugar is likely very high. Usually, adults with type 2 diabetes do not have DKA. Still, they can develop another life-threatening diabetic emergency caused by extremely high blood sugars. In fact, this is called a hyperosmolar hyperglycemic state. And, these people do not have DKA’s high acid levels.

So, the rapid breathing, stomach pain, and fruity breath are not usually seen. And if you have this, you will likely feel really tired. Also, you could have stroke symptoms. For example, you could start to have paralysis on one side of your body or go into a coma.

Diabetes Testing

Type 1 diabetes—Testing for type 1 diabetes is only done if you have symptoms. And research is underway for lab testing that will show the antibodies involved in type 1 diabetes. Ultimately, the goal is to find a test that will catch the disease before you even start showing symptoms.

Type 2 diabetes– Screening tests are more available for type 2 diabetes. And today’s tests can find out if you have diabetes. Or, they can see signs that it will develop. But this state of pre-diabetes has been given lots of names. For example, it is called pre-diabetes, glucose intolerance, insulin resistance, or borderline diabetes. Treating pre-diabetes can slow or halt the development of diabetes. Yet, even if you cannot prevent diabetes, slowing the diagnosis is still a major feat. Sometimes problems vary based on the length of the diabetes. But the shorter time you have diabetes, the lower the risk of these issues. Still, most people will need yearly testing. In most cases, you get tested every three years if you are age 45 or less. And initial testing is normal.

Who Should be Screen Tested for Type 2 Diabetes? 

• Age 45 or older.
• Pre-diabetics.
• Persons with cardiovascular disease. For example, this includes history of a heart attack or stroke.
• Those with a parent or sibling with type 2 diabetes. 
• Persons with high cholesterol. HDL( good) cholesterol <35 mg/dL and/or triglyceride level >250 mg/dL.
• Some ethnic group. For instance, this includes black, Native American/Alaska Native, Hispanic/Latino, Asian American, Native Hawaiian/Pacific Islander).
• Persons with high blood pressure (140/90). Or any blood pressure if you are taking blood pressure medication.
• People with little to no regular exercise.
• Polycystic ovary syndrome.
• Persons who had gestational diabetes. Or people who delivered a baby weighing more than 9 lbs.
• Those with a body mass index (BMI) over 25 kg/m^2.
• Persons with acanthosis nigricans. To be clear, this is a skin condition that causes very dark skin in body folds.

Who Should be Screen Tested for Type 1 Diabetes?

To be clear, any overweight child age 10 or more, or who has reached puberty should be tested. And if the child continues to be overweight and has two or more risk factors, testing is repeated every two years.

Factors That Increase Your Risk For Developing Type 2 Diabetes

• Family member(s) with type 2 diabetes. 
• Member of high-risk ethnic group. For example, this includes black, Native American/Alaska Native, Hispanic/Latino, Asian American, Native Hawaiian/Pacific Islander).
• High blood pressure.
• High lipids/cholesterol.
• Polycystic Ovary Syndrome[DSM3]. 
• Acanthosis nigricans -a skin condition characterized by very dark skin in body folds.

Tests for Diagnosing Diabetes

There is more than one lab test to diagnose diabetes. So, if you have any of the following, you have diabetes:

1. Random (non-fasting) blood glucose – In every case, this is a test done without regard to when or what you have eaten. Your blood glucose (blood sugar) level is tested at random. As a result, 200 mg/dL (11.1 mmol/L) or greater plus symptoms of diabetes is enough for a diagnosis.
2. Fasting Blood Glucose – In every case, this involves checking your blood sugar level when you have not eaten for at least eight hours. A value of 126 mg/dL (7.0 mmol/L) or higher at least twice is enough for a diagnosis. 
3. 2-hour oral glucose tolerance test (OGTT) – This test challenges your body with a high volume of sugar. And then it tests how well your body breaks it down. First, you drink a glucose syrup. Then you have your glucose level measured 2 hours later. And results of 200 mg/dL (11.1 mmol/L) or higher at least twice is abnormal. However, this test is rarely used. 
4. Glycosylated Hemoglobin (Hb A1C) – Simply called an A1C (pronounced A-one-see). The A1C test gives an average measure of your blood sugar over a 2-3-month period. And this test does not require fasting. Oftentimes, accuracy of the A1C testing may be influenced by several factors. But an A1C level of 6.5% (48 mmol/mol) or higher at least twice is enough to diagnose diabetes.

Conditions Affecting Glycosylated hemoglobin (Hb A1C) Testing

Anemias	Malnutrition
Liver and kidney disease	Supplements
Pregnancy	High triglyceride levels
Medications	Surgical removal of your spleen

Fortunately, not all abnormal diabetes testing means you have diabetes. In fact, a test that is only slightly above normal may show you are at risk. In fact, this is called pre-diabetes. But in pre-diabetics, lifestyle changes can greatly reduce your risk of developing it.

Diabetes Testing Results

Test	Pre-Diabetes	Diabetes
Fasting Blood Glucose	100-125 mg/dL	126 mg/dL(at least twice testing)
2 hour Oral Glucose Tolerance Test	140-199 mg/dL	200 mg/dL(at least twice testing)
A1C	5.7-6.4%	6.5 % (at least twice testing)

First, you must get tested for diabetes to take control of this condition. But be sure to check out parts one and three in the diabetes and you series to find out the cause and treatment of diabetes, respectively.

Written by: myObMD writing team, June 07, 2020 | Editor: Dayna Smith, MD | Reviewed October 1, 2020 | Copyright: myObMD Media, LLC, 2020

 

Glossary:

• Autoimmune-immune disorder – a condition in which your immune system attacks your own body, causing that organ or system to not function properly.
• Chronic – something that lasts a long time, or something that never goes away.
• Chronic pain – pain that persists more than 3 months.
• Diabetic Ketoacidosis – a life-threatening emergency, usually in Type 1 diabetes, where  high blood sugar levels and low insulin levels create a dangerous overproduction of acid in the bloodstream
• Endocrinologist – a medical doctor who specializes in disorders of the endocrine, or hormonal system.
• Glucose – aka blood sugar. Glucose is the main sugar in your body and its main source of energy.
• Glycosylated Hemoglobin (Hb A1C) – simply called an A1C (pronounced A-one-see). The A1C test gives an average measure of your blood sugar over a 2-3-month period.
• Insulin – the hormone that breaks down the sugars you eat so your bodies can use it for energy
• Insulin Pump – device that have small flexible plastic catheters inserted just under your skin. Kept in place for multiple days by a special adhesive and deliver continuous insulin.
• Internal Organs – the main body parts that are not visible from the outside of your body. For example, this includes your kidneys, liver, pancreas, or ovaries.
• Peripheral Neuropathy – a disorder of the nerves of the legs and/or arms, often leading to chronic pain or numbness.
• Retina – the lining of the inside of your eyeball where your vision cells are located. 
• Renal Dialysis – having your blood filtered by a machine that does the job of the kidneys in removing waste and toxins from the body.
• Screening Bloodwork – a test that is done to look for a condition before any symptoms are present
• Sedentary Lifestyle – having little to no exercise or other physical activity in your routine
• Discard tissue immediately after blowing your nose. Do not place them on surfaces.
• Sepsis – a severe system-wide reaction to infection that can involve the shutdown of multiple internal organs.
• Vascular Disease – Also, people know this as hardening of the arteries. Usually, this causes impaired blood flow to the affected area of your body.