Diabetes Testing

The signs of diabetes are not always dramatic. They may not even be noticeable. In fact, the American Diabetes Association estimates that millions of Americans have diabetes type 2 and are not even aware of it.

Watch for these symptoms. If you notice any of the following, ask your doctor to test you for diabetes.

Type 1

Type 2

Gestational Diabetes

Diabetes is Diagnosed with a Number of Tests.

Once you go in for a checkup, your doctor will discuss your medical history with you and take into account any symptoms you have. He or she will give a physical exam and order one or more lab tests that measure glucose levels in your blood.

Random Plasma Glucose Test. This is the simplest test for diagnosing diabetes, and doesn't require you to fast beforehand. Your doctor will have your blood sample drawn and analyzed in a laboratory. If the test registers 200 milligrams (of glucose) per deciliter (mg/dl) of blood or higher, it probably indicates diabetes. To be sure, your doctor will reconfirm these results on a different day with the fasting plasma glucose test or the oral glucose tolerance test, described below.

Fasting Plasma Glucose Test. According to the American Diabetes Association, this is the preferred way to diagnose diabetes. Don't eat or drink anything except water for at least eight hours before taking this test. Usually you can fast overnight. Your doctor will have a blood sample analyzed. A normal result is a blood glucose level of less than 110 mg/dl. A level greater than 126 mg/dl on two or more fasting plasma glucose tests conducted on different days confirms a diabetes diagnosis.

Oral Glucose Tolerance Test. Your doctor may order this test if your blood glucose level is high in one of the two tests above, but not high enough to diagnose diabetes. (In a random plasma glucose test, that means 160 to 200 mg/dl, while fasting plasma test results need to be 110 to 125 mg/dl.)

This blood test evaluates your body's response to glucose. Usually after you eat or drink something, your glucose rises, but then drops quickly. In a person with diabetes, the glucose level stays high longer than normal. This test requires you to fast at least eight but not more than 16 hours beforehand. Avoid anything that may mislead the test, including alcohol,c affeine, vigorous exercise, or smoking.

A lab technician draws a blood sample to get your fasting glucose level. Then you are given 75 grams (g) of glucose in a sweet, syrupy solution(100 g for pregnant women). Drink the entire thing. The technician then tests your blood every 30 minutes to one hour, for two or three hours.

According to the American Diabetes Association, the test is normal if your glucose level at two hours is less than 140 mg/dl. If your fasting plasma glucose is less than 126 mg/dl and two-hour glucose level is 140-199 mg/dl, you're diagnosed with impaired glucose tolerance, which is similar to diabetes but is less serious and won't necessarily progress into the disease (annually, only 1% to 5% of people with this condition develop diabetes). A fasting level of 126 mg/dl or greater and two-hour glucose level of 200 mg/dl or higher confirms a diabetes diagnosis.

Tests Especially for Pregnant Women

Pregnant women should be screened for gestational diabetes between the 24th and 28th week of pregnancy. Women at higher risk for gestational diabetes, such as those with a previous history of the condition or who have given birth to large babies before, should be tested at 16 to 20 weeks, and, if the results are negative, retested at 24 to 28 weeks.

Gestational diabetes is diagnosed with a fasting plasma glucose level of more than 95 mg/dl, a one-hour level of more than 180 mg/dl, a two-hour level of more than 155 mg/dl, or a three-hour level of more than 140 mg/dl.

Is It Type 1 or 2?

The symptoms and test results of type 1 and type 2 diabetes are similar, but the two are different. In general, you're more likely to have diabetes type 1 if you suddenly developed symptoms, perhaps after an illness; were diagnosed before turning 30 years old; are not overweight; or your urine has ketones, which turn up in the blood and urine as a result of low insulin levels.

You're more likely to have diabetes type 2 if you're older than 30, overweight, have no urine ketones, or are African-American or Latino.

Other Tests to Expect

Laboratory diagnostic tests also include measurement or analysis of:

What Can You Do To Help Yourself With Blood Sugar Imbalances?

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