Early diagnosis of type 2 diabetes is crucial in order to prevent its complications. Since the early stages of type 2 diabetes usually don’t cause any symptoms, diagnosis is often delayed. During this time, complications of diabetes develop. Many of these complications of diabetes are not reversible.
So, the earlier you get a diagnosis of type 2 diabetes, the better. However, that also means you need to look for diabetes and not wait until it blindsides you with a heart attack or a stroke.
Who is at risk for developing Type 2 Diabetes
Roughly 95% of diabetics are type 2. And about 5 % are type 1 diabetics.
People with the following characteristics are at high risk for developing Type 2 diabetes and therefore, should undergo testing for diabetes even if they have no symptoms. Remember, diabetes is a silent killer.
1. Age over 40 years.
2. Family history of diabetes, high blood pressure, cholesterol disorder,heart attack or stroke.
3. Overweight, especially in the abdominal area (waistline more than 35 inches in females and 38 inches in males. For Asians, these numbers are 32 inches in females and 35 inches in males).
4. High blood pressure (blood pressure greater than 130/85 mg Hg, even in a physician’s office).
5. Triglyceride level greater than 150 mg/dl.
6. HDL cholesterol less than 40 mg/dl. in males and less than 50 mg/dl in females.
7. History of heart attack, angioplasty, stent placement or heart bypass surgery.
8. History of Stroke, mini-strokes or dementia.
9. History of gestational diabetes or delivery of a baby over nine pounds.
10. Women with a history of irregular menses, excessive hair growth or facial acne.
The Best Test for the Diagnosis Type 2 Diabetes
The tests used to diagnose diabetes are:
1. Fasting Blood Glucose
Usually this is done as part of a routine blood test after you have fasted overnight.
A Fasting Blood Glucose greater than 125 mg/dl = Diabetes.
A Fasting Blood Glucose between 100 mg/dl to 125 mg/dl = Impaired Fasting Glucose (IFG).
Impaired Fasting Glucose (IFG) means that you have pre-diabetes and need further testing with an Oral Glucose Tolerance Test.
2. Hemoglobin A1c ( HBA1C)
Hemoglobin A1c is another blood test for the diagnosis of diabetes. Hemoglobin A1 C above 6.5% clinches the diagnosis of diabetes. However, this is a lazy way to diagnose diabetes. I have found a lot of individuals who have the diagnosis of diabetes based on fasting blood glucose and/or oral Glucose tolerance test, but their HBA1C is still below 6.5%.
3. Oral Glucose Tolerance Test (OGTT)
Oral Glucose Tolerance Test (OGTT) is the best test for the diagnosis of type 2 diabetes in its early stages. After an overnight fast, a blood test is drawn for glucose. Then, you are given a drink containing 75 grams of glucose. Another blood test is drawn at one hour and then again at two hours. You do not eat or drink anything else during this two hour period.
Blood Glucose at 2 Hours:
Greater than 200 mg/dl = Diabetes.
Between 140 mg/dl & 200 mg/dl = Impaired Glucose Tolerance (IGT).
Between 100 mg/dl & 140 mg/dl = Mild Glucose Intolerance.
In normal people, the value should come back to near baseline after 2 hours. For example, if your fasting blood glucose was 95 mg/dl, then two hours after drinking the 75 grams of glucose, it should come back to about 95 mg/dl.
The 2-hour Oral Glucose Tolerance Test (OGTT) has been the international standard for the diagnosis of type 2 diabetes for a long time. Most scientific studies about diabetes utilize it as THE diagnostic test.
Several excellent scientific studies have demonstrated that the Oral Glucose Tolerance Test is a superior test for the diagnosis of type 2 diabetes as compared to the fasting blood glucose test or hemoglobin A1c ( HBA1C). This observation is in line with our clinical experience at the Jamila Diabetes And Endocrine Medical Center.
Conversion from mmol/L to mg/dl
Please pay attention to the units in which your blood glucose is reported by the laboratory. In the U.S.A., blood glucose is reported as mg/dl. But in many parts of the world, it is reported as mmol/L.
The conversion factor from mmol/L to mg/dl is 18. For example:
1 mmol/L = 18 mg/dl
7 mmol/L = 126 mg/dl
7.8 mmol/L =140 mg/dl
11.1 mmol/L = 200 mg/dl
For more details, please refer to Dr. Zaidi’s book, “Reverse Your Type 2 Diabetes Scientifically.”
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