Diabetes Mellitus Tests to Establish the Diagnosis

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Do you suffer from any of these 4Ps symptoms: polyphagia (excessive hunger), polydipsia (excessive thirst), polyuria (frequent urination), or pruritis (itching)? Or do you get sleepy and tired easily? Or do you have some close relatives, your father or mother, uncle and so on with diabetes? Well, you should be aware that you have diabetes mellitus. However, to make a solid diagnosis, you need to see your doctor, who can also send you for a blood test to check your blood sugar levels…

There are several tests that need to be done to determine if you have diabetes or not. These tests include:

#1 – Fasting Plasma Glucose Test (FPGT). This test measures your blood sugar or glucose levels. You will be asked to be sober for at least 8 hours prior to blood collection. This test is usually arranged so that you can have your blood sample taken on an empty stomach in the evening and your blood sample in the morning. The result indicates whether you have diabetes or are in the pre-diabetes stage.

#2 – Oral Glucose Tolerance Test (OGTT). This test is designed to measure your blood sugar level in two stages. The first is similar to FPGT, where your blood sample is taken after a minimum 8-hour fast. After the blood is drawn, you will be asked to drink a type of syrup (sugar diluted with water). The second blood sample will be taken after 2 more hours of your drinking. This test will diagnose diabetes or prediabetes.

#3 – Random Plasma Glucose Test.Your blood sugar level can also be measured at any time, regardless of when you had your last meal. This test is used in conjunction with an assessment of other symptoms, such as the 4 Ps above, to help diagnose diabetes, but not prediabetes.

Positive results from these three tests should be confirmed by repeating the fasting plasma glucose test and the oral glucose tolerance test on another day.

Fasting plasma glucose (FPG) test

This is the test of choice to diagnose diabetes because it is most convenient and reliable when done in the morning. The test results can be read as follows:

  • A fasting glucose level of 99 milligrams/dl or below means your glucose level is normal
  • A fasting glucose level of 100 – 125 milligrams/dL suggests that you are in a stage of prediabetes, also known as impaired fasting glucose (IFG). It means that you are more likely to develop type 2 diabetes in the future, but it is not yet occurring.
  • A sugar level of 126 milligrams/dL and above means that you have diabetes mellitus, which should then be confirmed by repeating the same test on another day.

Oral Glucose Tolerance Test (OGTT)

Research has shown that the OGTT appears to be more sensitive than the FPGT in diagnosing the stage of prediabetes. However, it is less convenient to manage. The test results can be read as follows:

  • A blood glucose level after 2 hours of 139 milligrams/dl or below means that your glucose level is normal
  • A blood sugar level between 140 – 199 milligrams/dl 2 hours after drinking the syrup suggests you may have a stage of prediabetes called impaired glucose tolerance or IGT, which means you are more likely to have type 2 diabetes develop the future, but it does not appear yet.
  • A 2-hour blood glucose reading of more than 200 milligrams/dL means you have diabetes mellitus, which should then be confirmed by repeating the same test another day.

To make the diagnosis gestational diabetes, measured plasma glucose levels can be observed during the OGTT. In this case, however, the blood glucose level is checked 4 times during a test with an interval of one hour between two blood samples. If your blood sugar level is at least two times higher than normal during the test, you can be considered to have gestational diabetes.

The following scheme shows the above-average results for the oGTT for cases of gestational diabetes:

  • Fasting – 95 milligrams/dl or more
  • After 1 hour – 180 milligrams/dl or more
  • After 2 hours – 155 milligrams/dl or more
  • After 3 hours – 140 milligrams/dL or more

Note: Some laboratories may use different standards for this test.

Random plasma glucose test

An incidental plasma glucose level of 200 milligrams/dL or more, supplemented by the following symptoms, suggests you have diabetes:

  • Polyuria or frequent urination
  • Polydypsia, or excessive thirst
  • Polyphagia, or excessive hunger
  • Pruriitis or itching
  • Unexplained weight loss
  • Or other symptoms like fatigue, blurred vision, and non-healing wounds.

Based on these findings, your doctor will test your blood glucose levels with the FPGT or the OGTT on another day to make the diagnosis.

Thanks to Uno Birawan

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