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As discussed, the signs and symptoms of diabetes may develop gradually or may remain unnoticed until the development of complications, international societies such as the American diabetes association (ADA) have devised a recommendation to screen people for timely detection of diabetes.
According to the recommendation individuals with the following conditions should undergo screening for diabetes in Diabetes mellitus Diagnosis:
Age of more than 45 years: a person above 45 years of age should go for initial screening and if the results turn out to be normal, then followed by screening after every 3 years.
Body mass index (BMI) of higher than 25 with other risk factors such as abnormal cholesterol levels, high BP, inactive lifestyle, and other conditions such as PCOS or heart disease should go for diabetes screening. The criteria for BMI is higher than 23 for Asian population.
Women with a history of gestational diabetes are to be screened for diabetes every three years.
Pre-diabetics are advised to be screened every year.
Glycosylated hemoglobin (HbA1C) test:
This blood test measures your average blood glucose level for the past three months. It measures the percentage of blood glucose seen attached to the hemoglobin (Hb) which is present in RBCs that have a life span of 3 months. Higher the blood glucose levels you have in the past 2 to 3 months, higher is the percentage of glucose attached to the Hb and higher the results of the HbA1C test.
• Normal: Less than 5.7%
• Pre-diabetes: 5.7 – 6.4%
• Diabetes: 6.5% or higher (on two separate days)
You are not required to fast prior to the test.
The doctor may also use some other blood tests to confirm the Diabetes mellitus Diagnosis especially if the HbA1c results are not consistent or the test is not available.
Fasting blood sugar test (H4):
This test measures the level of glucose in blood during the fasting state. For this test, you need to fast overnight (about 8 hours) and give the sample of blood in the morning.
• Normal: level less than 100 mg/dL
• Pre-diabetes: 100 to 125 mg/dL
• Diabetes: 126 mg/dL or higher (on two separate days)
This test measures the level of glucose in the blood at a random time irrespective of when you last ate.
• Diabetes: level equal to or higher than 200 mg/dL.
Oral glucose tolerance test:
This test needs you to fast overnight so that a fasting blood glucose level can be measured in the morning. After this, you are asked to drink a glucose-containing liquid which is then followed by blood samples taken at 1 and 2 hours after the drink.
Results: taken after 2 hours suggests the following
• Normal: levels less than 140 mg/dL.
• Pre-diabetes: levels between 140 and 199 mg/dL
• Diabetes: levels more than 200 mg/dL
Additional tests may be done in case of type 1 diabetes to look for ketones in the urine and to check for auto-antibodies.
Screening test is also done in females during pregnancy to check for the development of gestational diabetes in Diabetes mellitus Diagnosis.
You are at a higher risk of developing gestational diabetes if you have the following risk factors:
• Age above 35 years
• Overweight at the start of the pregnancy
• Family history of diabetes (diabetes in parents, siblings or child)
• History of gestational diabetes in a previous pregnancy
• History of polycystic ovarian syndrome
If any of the above factors are present in you, your doctor would test you for gestational diabetes at the first visit irrespective of the week of pregnancy.
If none of the factors is present then you would be screened typically between 24 to 28 weeks of pregnancy.
Following screening tests may be used for gestational diabetes:
Initial glucose challenge test:
In this test, you will be asked to drink a glucose-rich liquid. After an hour a blood sample is taken to measure the level of the glucose.
• Normal: levels below 140 mg/dL,
• If levels are above 140mg/dL, it suggests higher risk for gestational diabetes and your doctor would suggest a follow-up test in Diabetes mellitus Diagnosis.
Follow-up glucose tolerance testing: here you will be asked to fast overnight and get your fasting blood sample done. After this you will be asked to drink glucose contains a liquid which would be more concentrated than the one used in the previous test. Following this, your blood samples would be taken hourly for 3 hours and the levels of blood glucose are checked.
• If the blood glucose levels are found higher than normal for any of the two samples taken after the drink you are diagnosed with gestational diabetes.
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