Diagnosis of Diabetes

 Persons at HIGH RISK for diabetes

a) All persons manifesting any of the following signs and symptoms: polyuria, polydipsia, polyphagia, weight loss inspite of adequate food intake, undue tiredness and fatigue etc.

b) All persons with a family history of diabetes.

c) All obese patients, especially those with central obesity, waist-hip (W-H) ratio, approx. >0.95 in men and >0.85 in women, and/or a Body Mass Index (BMI) >25.

d) All adult patients with tuberculosis, atherosclerosis, recurrent infections, high blood pressure and lipid abnormalities, non- healing ulcers etc.

e) All women with a bad obstetric history, recurrent fetal wastage, and those who give birth to large weight babies.

f) Persons who show an acute rise in the blood glucose levels at time of physical (myocardial infarction, cerebrovascular accidents, acute infections, trauma, etc.) or mental stress.

g) Persons taking drugs which are known to increase blood glucose levels like steroids, thiazide diuretics, oral contraceptives, beta-blockers, phenytoin sodium, etc. 

ALL PERSONS OVER THE AGE OF 30 YEARS SHOULD UNDERGO AN ANNUAL TEST FOR THE PRESENCE OF DIABETES.

METHODS:

A. Glycated hemoglobin (HbA1C) test :

This blood test indicates your average blood sugar level for the past two to three months. It's also called HbA1c, glycated hemoglobin test, and glycohemoglobin. It measures the percentage of blood sugar attached to hemoglobin, the oxygen-carrying protein in red blood cells. The higher your blood sugar levels, the more hemoglobin you'll have with sugar attached.

How the Test Works

The sugar in your blood is called glucose. When glucose builds up in your blood, it binds to the hemoglobin in your red blood cells. The A1c test measures how much glucose is bound.

Red blood cells live for about 3 months, so the test shows the average level of glucose in your blood for the past 3 months.

If your glucose levels have been high over recent weeks, your hemoglobin A1c test will be higher.

What's a Normal Hemoglobin A1c Test?

For people without diabetes, the normal range for the hemoglobin A1c level is between 4% and 5.6%. Hemoglobin A1c levels between 5.7% and 6.4% mean you have a higher chance of getting of diabetes. Levels of 6.5% or higher mean you have diabetes.

B. Random blood sugar test :

 A blood sample will be taken at a random time. Blood sugar values are expressed in milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L). Regardless of when you last ate, a random blood sugar level of 200 mg/dL (11.1 mmol/L) or higher suggests diabetes, especially when coupled with any of the signs and symptoms of diabetes, such as frequent urination and extreme thirst.

C. Fasting blood sugar test :

 A blood sample will be taken after an overnight fast. A fasting blood sugar level less than 100 mg/dL (5.6 mmol/L) is normal. A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes. If it's 126 mg/dL (7 mmol/L) or higher on two separate tests, you have diabetes.

D. Oral glucose tolerance test : For this test, you fast overnight, and the fasting blood sugar level is measured. Then you drink a sugary liquid, and blood sugar levels are tested periodically for the next two hours.

Glucose Test
	Glucose Concentration (mg/100ml)
	Whole Blood		Plasma
	Venous	Capillary	Venous
Diabetes Melittus
Fasting	>/=110	>/=110	>/=126
2 hours post Glucose Load or both	>180	>200	>200
Impaired Glucose Tolerance
Fasting(If measured)	<110	<110	<126
2 hours post Glucose Load	>/=120 & </=180	>/=140 & </=200	>/=140 & </=200
Impaired Fasting Glycemia
Fasting	>/=100 & </=110	>/=100 & </=110	>/=110 & </=126
2 hours PG (If measured)	<120	<140	<140

 

A blood sugar level less than 140 mg/dL (7.8 mmol/L) is normal. A reading between 140 and 199 mg/dL (7.8 mmol/L and 11.0 mmol/L) indicates prediabetes. A reading of 200 mg/dL (11.1 mmol/L) or higher after two hours may indicate diabetes.