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Identify diabetes early to prevent complications.

Diabetes rates are on the rise, and while there are numerous ways to reduce your risk, such as exercise and weight loss, not everyone can avoid developing the disease. But while diabetes is a serious condition that can cause major health problems, the risk of these complications can be greatly reduced by proper treatment. The first step to protecting yourself from diabetes is proper testing. We asked Zhaoping Li, MD, a physician at UCLA Health System, which is the best test for identifying diabetes.

"There are four ways to diagnose diabetes, and they are all effective, especially if you combine any of the two," she says. "These include a fasting plasma glucose (FPG) test [greater than or equal to]126 mg/dl; symptoms such as increased urination and unexplained weight loss plus an oral glucose tolerance test (OGTT) of [greater than or equal to]200 mg/dl; an OGTT of [greater than or equal to]200 mg/dl two hours after a 75-gram glucose load; and an A1C of [greater than or equal to]6.5 percent." (See "Tests for Diagnosing Prediabetes and Diabetes" for more information about these tests.)


Ensuring an accurate test. According to Dr. Li, any positive finding on a test should be repeated on a subsequent day with another test. "For example, an oral glucose tolerance test with symptoms might be followed up with a fasting plasma glucose," she says. It's also important to follow your doctor's instructions before each test. If you're required to fast, make sure that you don't eat or drink anything (except water) eight hours before the test.

Symptoms to watch for. "Most people may not have any noticeable symptoms," says Dr. Li. "The traditional triads of diabetes are increased thirst, urination, and appetite. Those symptoms are often associated with fatigue, weakness, blurred vision, recurring skin, gum, or bladder infections, cuts/bruises that are slow to heal, and tingling/numbness in the hands/feet." If you experience any of these symptoms, see your doctor right away.
Tests for Diagnosing Prediabetes and Diabetes

Prediabetes (also called Impaired Fasting Glucose)--Blood glucose
levels are higher than normal but not high enough to be diagnosed as
diabetes. This condition puts you at increased risk for developing type
2 diabetes, heart disease, and stroke.

Diabetes mellitus (type 2 diabetes)--Type 2 diabetes develops when your
body doesn't make enough insulin or develops "insulin resistance" and
can't make efficient use of the insulin it makes. It greatly increases
your risk of heart disease and stroke.

Fasting Plasma Glucose Test (FPG)

Just prior to having this test run, the patient must fast (nothing to
eat or drink except water) for eight hours. The healthcare provider
draws blood from the patient. Then the plasma (the fluid part of the
blood) is combined with other substances to determine the amount of
glucose in the plasma, as measured in mg/dL. The chart below contains
the FPG test's blood glucose ranges for prediabetes and diabetes:

Blood Glucose Range    Diagnosis

100 to 125 mg/dL       Prediabetes (also called Impaired Fasting

126 mg/dl or more      Diabetes mellitus (typs 2 diabetes)

Oral Glucose Tolerance Test (OGTT)

This test measures how well the body handles a standard amount of
glucose. The health care provider draws the patient's blood before and
two hours after the patient drinks a large, premeasured beverage
containing glucose. Then, the doctor can compare the before-and-after
glucose levels contained in the person's plasma to see how well the
body processed the sugar. These levels are measured in mg/dL. The chart
below contains the OGTT's blood glucose ranges for prediabetes and

Blood Glucose Range    Diagnosis

140 to 199 mg/dL       Prediabetes (also called Impaired Fasting

200 mg/dL or higer     Diabetes mellitus (type 2 diabetes)

HbA1c(A1C or glycosylated hemoglobin test)

If diagnosed with type 2 diabetes, your health care provider will
regularly run a test called HbA1c (A1C or glycosylated hemoglobin
test). An A1C test provides a picture of your average blood sugar
control for the past two to three months. Blood sugar is measured by
the amount of glycosylated hemoglobin (HbA1 c) in your blood. The chart
below contains the A1C blood glucose ranges for prediabetes and

Blood Glucose Range    Diagnosis

5.7 to 6.4 percent     Prediabetes (also called Impaired Fasting

6.5 percent or higher  Diabetes mellitus (type 2 diabetes)

Source: The American Heart Association
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Title Annotation:PREVENTION
Publication:Healthy Years
Date:Jun 1, 2011
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