Guest Author - Dr. Denise Howard
Type 2 Diabetes Mellitus (T2DM) affects approximately 8-10% of people and the prevalence is increasing, even in children. It is a condition of elevated glucose (hyperglycemia) and resistance to insulin which causes damage to the blood vessels in the body. The long term affects include heart disease, kidney failure, stroke, loss of limbs and blindness. This problem can be identified early enough where appropriate treatment can prevent these undesirable results. This is done through screening.
It is impossible to screen everyone so the focus of early diagnosis should be on those at risk. Risk factors are certain characteristics that is found in common with the majority of people with the condition. Risk factors for T2DM include age greater than 45, overweight (body mass index greater than 25), sedentary lifestyle, first degree relative with diabetes, certain ethnic groups, birthing a child more than 4.1 kilograms, certain medical conditions and others.
The American Diabetes Association (ADA) recommend screening every 3 years for everyone over the age of 45. Other screening should be done based on the presence of risk factors and is at the discretion of the doctor. Obesity, family history and being a member of a high risk group are factors that should drive earlier screening.
Available screening tests include a fasting serum (blood) glucose level, a 2 hour glucose tolerance test or a hemoglobin A1C. The fasting glucose level is checked after 8-16 hours without food or drink. The value is less than 100 mg/dl in healthy individuals. If it is 100-125 then the person is considered to have pre-diabetes and if 126 or greater then diabetes is present. The values should be repeated to confirm the diagnosis.
The 2 hour glucose tolerance test requires checking a fasting serum glucose, followed by the consumption of 75 grams of glucose. The serum glucose level is then measured again 1 hour and 2 hours later. The fasting values are the same as above. The 2 hour result should be less than 140. They are described as having impaired glucose tolerance when the value is 140-200 and diabetes when it is more than 200. A similar test is done during pregnancy with different cut-off values.
The hemoglobin (hgb) A1C test, also referred to as glycosylated hemoglobin or A1C test is used to diagnose both types of diabetes. It measures the percentage of hemoglobin that is coated in sugar. The values reflect the average blood sugar (glucose) levels for the past 2-3 months. Normal individuals have values less than 5.7% while pre-diabetes is considered to be present when the value is 5.7-6.4% and 6.5% and greater is confirmation of diabetes.
If you or any family member has symptoms or risk factors for diabetes, then you should undergo a screening test. Tests with abnormal values can be repeated to confirm accuracy. If your values reflect pre-diabetes then you can initiate lifestyle changes that can prevent or prolong the onset of diabetes. If you are diagnosed with diabetes then treatment is available to manage the condition before it causes irreversible damage. You have the power to prevent long term problems. If you are at risk get screened.
I hope this article has provided you with information that will help you make wise choices, so you may:
Live healthy, live well and live long!