Blood Test
Screening for Diabetes
Anyone over the age of 45 should be screened for glucose abnormalities every three years. In high-risk individuals, testing should be done annually, starting at a younger age.
High risk being overweight, family history of Type 2 Diabetes, over the age of 45, history of high blood pressure, a low HDL cholesterol, elevated triglycerides, prediabetes, history of gestational diabetes, any history of peripheral vascular disease, any history of coronary artery disease, polycystic ovarian syndrome, presence of acanthosis nigricans, certain ethnic groups such as American Indians, Alaskan natives, African-Americans, Asians, Native Hawaiians, Pacific Islanders, and Hispanics.
The diagnosis of diabetes is made if random blood glucose is more than 200-mg/dl (11.1 mmol/L) with symptoms of high blood glucose or if the fasting glucose is equal to or greater than 126-mg/dl (7 mmol/L) on two separate days. The fast should be at least 8 hours, and the blood should be drawn before 9 am. On a 75-g oral glucose tolerance test, two-hour blood glucose more than or equal to 200mg/dl is consistent with diabetes.
High blood sugar symptoms include excessive urination at night, increased urination, excess thirst, blurred vision, increased appetite, weight loss, and tiredness. Also, one may have frequent urinary tract infections, yeast infections, or skin infections.
An A1c of 6.5 or higher is now considered diagnostic of Diabetes.
If Pregnant
Screening for gestational diabetes:
Women at low risk for developing glucose intolerance during pregnancy need not be tested for gestational diabetes mellitus. Women at high risk, namely, if obese, the previous history of gestational diabetes, high-risk ethnic group, and strong family history of Type 2 Diabetes should undergo glucose testing at the initial prenatal visit. The testing involves a 50g glucose load without regard to the last meal or the time of the day.
If not found to have gestational diabetes at initial testing, retesting should be conducted at 24 to 28th week of gestation. This test is only recommended in individuals at risk for diabetes. A one-hour plasma glucose concentration greater than 130-mg/dl is considered an abnormal test. This calls for a formal three-hour 100-g glucose tolerance test. Gestational diabetes is diagnosed when two or more of these samples meet or exceed the following values: Fasting glucose 95, 1-hr 180, and 2-hr 155, 3-hr 140mg/dl.
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