This is really directed towards new people, people that either have just found out that they are diabetic, or are wondering if they are or not, but I try to make all the posts and articles on here interesting for all of you, as best I can anyway, by trying to at least add some additional info that you don't normally see on diabetes related sites.
The view here is that there are three classes of people, non diabetics, prediabetics, and diabetics, and everyone on Earth fits into one of these. Non diabetics have nothing to worry about, prediabetics might have a little to worry about but not really that much, this is treated as more of a see me in a while and when you become a real diabetic then we'll talk, and of course there are diabetics which we do become concerned about, although this disease does present itself in degrees, and is approached that way as well.
With the amount of people that are estimated to have glucose intolerance these days, impaired glucose intolerance to some degree, and diabetes exploding, you would think we'd be screening a lot for this, so we can catch this earlier rather than later.
Shamefully, this isn't the case. We should be actually screening people for high insulin actually, which appears long before diabetes develops, but we don't. We don't even screen people for high blood sugar very much, there are a lot of people who have never had their blood sugar tested. I never did, until I got neuropathy, I then had a reason to do it, and my blood sugar was extremely high, the kind that indicates that I had impaired glucose tolerance for decades without knowing it.
I've been campaigning on the internet for people to get screened for this and I even think that every household should have a glucose meter, like they often have a blood pressure meter, and check themselves periodically to make sure they aren't developing diabetes.
Even better is to get a fasting insulin test, although you do have to get your doctor to agree to this, which usually isn't easy, since doctors are pretty clueless about diabetes actually and especially when it comes to how elevated insulin is harmful to one's health.
People only tend to buy glucose meters after they have been diagnosed, and their doctors don't generally bother looking, without a medical reason to suspect this anyway, so no one is screening at all and generally the only time you tend to get tested is after you have problems with blood sugar, usually long after.
So buying a glucose meter does involve spending a little money, but they are modestly priced and sometimes you can get them for free as long as you buy the strips. It is an investment in your health though, and we need to start taking diabetes a lot more seriously than we do, and this is a great place to start.
You can also buy urine strips to test for glucose, but if you see anything but a negative result, then you not only have diabetes, you have it bad, because you only pee out glucose when your blood sugar is very high, well beyond what it takes to be diagnosed as a diabetic.
There are three accepted methods for testing for diabetes, and since we define diabetes as high blood sugar, that's exactly what they are testing for, and they only test blood sugar for this generally. Everyone who has a lab test for blood sugar though should also have their insulin tested, this is just plain good information to have, and it tells us a lot more than whether we might be a type 1 or a 1.5 or LADA.
The most reliable test is the HbA1C, commonly just called an A1C, which basically measures how much glucose has stuck to our red blood cells. Since this effect takes place over the life of the red blood cells, 2 to 3 months, it's more accurate in showing the effects of high blood sugar over time than just measuring blood sugar is.
This is a lab test where they draw your blood, and they will often do a fasting glucose test as well, in addition to whatever else is run, usually several other tests including checking for proper kidney and liver function. Typically a urine sample is collected as well.
The A1C has really taken over, and some doctors don't even look at anything else, when I was seen by a doctor my blood sugar was constantly in the 300's and she told me that this means I might have diabetes but we need an A1C to confirm this. That's ridiculous of course but this goes to show how reliant a lot of them have become on this test.
It is important to not just look at A1C results, as if they are only mildly high, this can be caused by things like anemia, which causes false positives, since there are less red blood cells to go around and therefore they will get more than their share of glucose, or glycation to be specific, as this just doesn't measure sugar it measures damage caused by sugar.
A1C's of 5.7 to 6.4 indicate prediabetes, and an A1C of 6.5 and over indicates diabetes.
There is another test that is used, which is called an oral glucose tolerance test, where patients fast and then drink 75 grams of liquid glucose and see how their blood sugar responds to this. If you are over 140-199 after 2 hours you are prediabetic, and if you are 200 or higher you are diagnosed with diabetes.
Fasting glucose levels can also be used, where we're looking for over 126 mg/dl or over 7 mmol/l to determine diabetes. If you are way over that, then you can be pretty certain you are a diabetic, but if it's close, then you will want to look at other tests, and doctors don't tend to diagnose merely based upon fasting levels, no matter how high, even though this makes no sense if you are high enough.