Who Should Be Tested For Type 2 Diabetes
Most often, people are diagnosed with type 2 diabetes through routine screening tests. Routine screening means that you are tested because you may be at risk of having diabetes, even when you dont have any signs or symptoms.
Routine screening for diabetes typically starts at age 45. You should be screened sooner if you have:
- high blood pressure
- acanthosis negricans, a skin condition
- a family history of type 2 diabetes
- a history of gestational diabetes or youve given birth to a baby weighing over 9 pounds
- Black, Latino/Hispanic, Asian, Native American, Alaska Native, or Pacific Islander descent
- a low level of HDL cholesterol or a high triglyceride level
- a sedentary lifestyle
Routine screening uses blood tests to check for signs of diabetes.
Next, lets take a closer look at some blood tests commonly used to diagnose diabetes.
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What Else Can I Do
Here are some activities you can do to stay healthy and prevent complications:
- Eat healthy meals and avoid junk food. Consider preparing your meals instead of buying pre-packaged food or take out.
- Be active: Walking regularly is a good start.
- Take all of your medications according to your health care providers instructions.
- Make sure your blood pressure and cholesterol levels are in a healthy range.
- Go for regular eye checkups.
- Regularly check your feet for any sores.
- Manage your stress.
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Learn More About How To Manage Diabetes
Remember, the normal fasting blood glucose level is between 70 and 110 mg/dL.
Frequent Measurements of Blood Glucose. The goal in this part of diabetes management is to strive to keep fasting blood sugars under 140 mg/dL and preferably closer to the 70 to 120 mg/dL range.
Ideally, one could monitor blood sugars 4 times per day to follow how well the sugars are controlled. This information could be used to adjust your diet and medications to achieve this goal. Usually blood glucose measurements are done before each meal and at bedtime.
Occasionally a doctor may want a patient with diabetes to test their blood sugar at 2:00 am to assess what the blood sugar is doing overnight. Generally, it is desirable to have blood sugars at 2:00 am run greater than 65 mg/dL to avoid overnight hypoglycemia .
It is very desirable for patients to keep a diary of these blood sugar measurements since this information will be a great help to the treating physician as he/she makes decisions regarding how best to treat the diabetes.
Bring this diary with you when you go to your doctor as s/he will be quite pleased but donât alter or fudge your results in an attempt to please your doctor this will prevent the appropriate changes to be made in your management.
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Random Plasma Glucose Test
A random blood sugar test looks at blood glucose levels regardless of when youve last eaten for a snapshot of your blood sugar status. This test is usually performed when healthcare professionals want to take a look at your blood sugar without having to wait for you to fast and so it can be performed at any time. While a diagnosis of diabetes can be made with the help of this test, it is not usually used to diagnose prediabetes.
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If your glucose is over 200 mg/dl, then a diagnosis of type 2 diabetes is likely. Again, your healthcare provider will usually perform this test on two different occasions before a confirmed diagnosis is made.
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At 2 Am/middle Of The Night
Overnight blood glucose checks, while inconvenient, are typically done to screen for hypoglycemia as it is more common to not feel a low blood sugar overnight and to sleep through a hypoglycemia event. If you wake up with a headache or a stomach ache it may be due to low blood sugar that unknowingly occurred overnight.
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Oral Glucose Tolerance Test
The oral glucose tolerance test measures your blood sugar before and after you drink a sugary liquid thats specially formulated for the test. Like the fasting plasma glucose test, youll be required to fast overnight beforehand.
When you arrive at your appointment, youll first undergo a fasting blood sugar test. Then youll drink the sugary liquid. After youre done, your doctor will test your blood sugar levels periodically for several hours.
This test detects diabetes better than other tests, such as the fasting plasma glucose test. But its more costly and takes longer than other blood sugar tests.
For an oral glucose tolerance test, heres what your results could mean:
| Oral glucose tolerance |
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Make Physical Activity Part Of Your Daily Routine
Set a goal to be more physically active. Try to work up to 30 minutes or more of physical activity on most days of the week.
Brisk walking and swimming are good ways to move more. If you are not active now, ask your health care team about the types and amounts of physical activity that are right for you. Learn more about being physically active with diabetes.
Following your meal plan and being more active can help you stay at or get to a healthy weight. If you are overweight or obese, work with your health care team to create a weight-loss plan that is right for you.
How Is Blood Sugar Calculated
There are two formulas for calculating blood sugar levels. In the US, the most popular measurement is milligrams per deciliter . In the UK, its millimoles per liter .
If you need to convert measurements, use these formulas:
To go to mmol/L from mg/dL: mmol/L = mg/dL / 18
To go to mg/dL from mmol/L: mg/dL = 18 × mmol/L
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Discuss Blood Sugar Levels With A Doctor
- Make sure to speak with your physician about how often you should be checking your blood sugar and at what times of day or week checks should be done.
- Dont forget to ask your physician: “What should I do with all this information?” Your overall control will likely not improve unless you know what to do with the glucose numbers you are seeing!
- If you are uncertain how to use your meter, ask to meet with a diabetes educator for additional training.
How often do you check your blood sugar?
Check Your Blood Sugar Level
Regular blood sugar checks are a big part of managing your diabetes. You may already be checking your blood sugar at different times of the day, including in the morning before eating, before all meals in general, and 1 to 2 hours after a meal.
Bedtime is another good time to test. Its a good idea to keep our blood sugar goal at bedtime in the range of 80 to 180 milligrams per deciliter .
Its natural for blood sugar to be on the higher end of that range if youve eaten a meal in the last 2 hours. If its on the lower end of that range, you may consider having a snack to prevent blood sugar from going too low.
Testing at bedtime for at least 1 or 2 weeks can allow you to see some patterns.
If your blood sugar level is high before bed, its more likely to stay high overnight and be above target in the morning. Having the occasional high blood sugar before bed can happen to anyone with diabetes.
If you start to notice that your blood sugar is often above target before bed, there are things you can do. Talk with your doctor about managing blood sugar at this time of the day.
Here are some steps that may help lower blood sugar in the evening:
- Change the type, timing, or dose of medications or insulin.
- Eat supper earlier.
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Remedies For Low Blood Sugar Levels
If you experience any of the low sugar symptoms, immediately test your blood glucose levels. For levels between 60 to 80 mg/dL, consume 15 grams of fast-acting carbs. Repeat the test after 15 minutes and eat till sugar levels settle to normal.
But if the levels are below 50 mg/dL and if the patient is conscious and able to eat, give 15 gm. of fast-acting carbs. But if the patient is unable to speak, dont give anything to eat. Call emergency services immediately. If possible, administer glucagon via injection.
Blood Glucose Monitoring Fact Sheet
This fact sheet is available in two formats.
You can download and print out the PDF version.
Or you can read it as a website page below.
Regularly checking your blood glucose levels can help you manage your diabetes. Your diabetes health professionals can help you with information and advice about blood glucose monitoring.
Regular monitoring can help you see the effects of food, exercise, medication and illness on your blood glucose levels. It can also help you identify any patterns or changes that you should discuss with your doctor or diabetes health professionals.
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How Can I Treat High Blood Sugar
Talk to your doctor about how to keep your blood sugar levels within your target range. Your doctor may suggest the following:
- Be more active. Regular exercise can help keep your blood sugar levels on track. Important: dont exercise if ketones are present in your urine. This can make your blood sugar go even higher.
- Take medicine as instructed. If your blood sugar is often high, your doctor may change how much medicine you take or when you take it.
- Follow your diabetes meal plan. Ask your doctor or dietitian for help if youre having trouble sticking to it.
- Check your blood sugar as directed by your doctor. Check more often if youre sick or if youre concerned about high or low blood sugar.
- Talk to your doctor about adjusting how much insulin you take and what types of insulin to use.
Home Blood Sugar Monitoring For Type 2 Diabetes
People with diabetes are often advised to check their blood sugar levels at home by pricking a finger and testing the blood with a glucose meter. They can review the results with their doctors over the phone, online, or at the next office appointment. The value of this for people with type 2 diabetes is uncertain.
In a study published in JAMA Internal Medicine, researchers enrolled 450 people with Type 2 diabetes, none of whom were taking insulin. They were randomly assigned to one of three groups:
- no self-monitoring of blood sugar
- once daily self-monitoring of blood sugar
- once-daily self-monitoring of blood sugar with enhanced feedback from their blood glucose meters with messages intended to educate and motivate the study volunteers.
After one year these researchers found that, compared with those not self-monitoring blood sugar, those who self-monitored had no improvement in the control of their blood sugar, and had no improvement in measures of quality of life.
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The Surprising Percentage Of People Who May Test Their Glucose Unnecessarily
Dr. Platt decided to look at the frequency of home testing after noticing that some patients who didnt need to test kept precise notes on their daily blood sugar measurements over long periods of time. The researchers, including senior author A. Mark Fendrick, MD, a professor in general medicine at the University of Michigan, reviewed national insurance data from 370,740 people with type 2 diabetes. They reviewed data from January 1, 2013, to June 30, 2015 after several medical societies issued guidelines to curb unnecessary home glucose testing. The data reflected patients with private insurance or Medicare Advantage plans who were not taking insulin and who filled prescriptions for packets containing 90 test strips three or more times a year. This pattern of prescribing suggests the patients were monitoring their blood sugar levels regularly.
The study found that 14 percent of people who likely didnt need to perform glucose monitoring were using an average of two test strips a day.
We were pretty surprised at how prevalent this was, Platt says. We also found that almost 25 percent of people were filling at least three prescriptions for at least 90 strips which is 180 strips in a given year. These were not people who were checking their blood sugar for a month or so. This was regular usage over a period of time.
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When Should I Check My Blood Glucose Level
When you should check your blood glucose levels and how often you should check varies depending on each individual, the type of diabetes and the tablets and/or insulin being used. Your doctor or Credentialled Diabetes Educator will help you decide how many checks are needed and the levels to aim for. Possible times to check are:
- Before breakfast
- Before rigorous exercise
- When you are feeling unwell
Even though your meter may have a memory, it is important to keep a record of your readings in a diary and to take this with you to all appointments with your diabetes health team. This will provide both you and your diabetes health team with important information in deciding if and how your treatment may need to be adjusted.
Most meters on the market have software which allows you to download your records in different formats such as graphs and charts. Even if you can do this, it is still helpful to keep a diary, not only for your checks but also details of your daily activities, the food you eat and other relevant information. There are some apps that record all of this information in one place. Ask your doctor or diabetes educator how you can use a diary to help you to better manage your diabetes.
Checking four times a day is usually recommended for people with type 1 diabetes. However many people check more often, such as those using an insulin pump .
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