Understanding a Type 2

Diabetes Diagnosis
 Symptoms

 Tests and diagnosis

 Second opinion

 Treatment

 Outlook

Diagnosing type 2 diabetes

Type 2 diabetesisa manageable condition. Once you’re diagnosed, you can work
with your doctor to develop a treatment plan to stay healthy.

Diabetes is grouped into different types. The most commonly diagnosed are
gestational diabetes, type 1 diabetes, and type 2 diabetes.

Gestational diabetes

Maybe you have a friend who was told they had diabetes during pregnancy. This
type of the condition is called gestational diabetes. It can develop during the second
or third trimester of pregnancy. Gestational diabetes usually goes away after the
baby is born.

Type 1 diabetes

You may have had a childhood friend with diabetes who had to take insulin every
day. That type is called type 1 diabetes. The peak age of onset of type 1 diabetes is
the mid-teens. According to the Centers for Disease Control and Prevention
(CDC)Trusted Source, type 1 makes up 5 percent of all cases of diabetes.

Type 2 diabetes

Type 2 diabetes makes up 90 to 95 percent of all diagnosed cases of diabetes,

according to the CDC. This type is also called adult-onset diabetes. Although it can
occur at any age, type 2 diabetes is more common in people older than 45.

If you think you might have diabetes, talk to your doctor. Uncontrolled type 2
diabetes can cause severe complications, such as:

 amputation of the legs and feet

 blindness
 heart disease
 kidney disease
 stroke

According to the CDC, diabetes is the 7th leading cause of death in the United
States. Many of the severe side effects of diabetes can be avoided with treatment.
That’s why an early diagnosis is so important.

Symptoms of type 2 diabetes

Some people are diagnosed with type 2 diabetes because they have noticeable
symptoms. Early symptoms can include:

 increased or frequent urination

 increased thirst
 fatigue
 cuts or sores that won’t heal
  blurry vision

Most often, people are diagnosed through routine screening tests. Routine screening
for diabetes typically starts at age 45. You may need to be screened sooner if you:

 are overweight
 live a sedentary lifestyle
 have a family history of type 2 diabetes
 have a history of gestational diabetes or have given birth to a baby weighing
over 9 pounds
 are of African-American, Native American, Latino, Asian, or Pacific
Islander descent
 have a low level of good cholesterol (HDL) or a high triglyceride level

How doctors diagnose type 2

diabetes
The symptoms of type 2 diabetes often develop gradually. Because you may or may
not have symptoms, your doctor will use blood tests to confirm your diagnosis.
These tests, listed here, measure the amount of sugar (glucose) in your blood:

 glycated hemoglobin (A1C) test

 fasting plasma glucose test
 random plasma glucose test
 oral glucose tolerance test

Your doctor will perform one or more of these tests more than once to confirm your
diagnosis.

Glycated hemoglobin (A1C) test

The glycated hemoglobin (A1C) test is a long-term measure of blood sugar control.
It allows your doctor to figure out what your average blood sugar level has been for
the past two to three months.

This test measures the percentage of blood sugar attached to hemoglobin.

Hemoglobin is the oxygen-carrying protein in your red blood cells. The higher your
A1C is, the higher your recent blood sugar levels have been.

The A1C test isn’t as sensitive as the fasting plasma glucose test or oral glucose
tolerance test. This means that it identifies fewer cases of diabetes. Your doctor will
send your sample to a certified laboratory for diagnosis. It may take longer to get
results than with a test conducted in your doctor’s office.

An advantage of the A1C test is convenience. You don’t have to fast before this
test. The blood sample can be collected at any time of day. Also, your test results
aren’t affected by stress or illness.

Your doctor will go over your results with you. Here’s what your A1C test results
could mean:

 A1C of 6.5 percent or higher = diabetes

 A1C between 5.7 and 6.4 percent = prediabetes
 A1C less than 5.7 percent = normal

This type of testing can also be used to monitor your blood sugar control after
you’ve been diagnosed. If you have diabetes, your A1C levels should be checked
several times a year.

Fasting plasma glucose test

In some circumstances, the A1C test isn’t valid. For example, it can’t be used for
pregnant women or people who have a hemoglobin variant. The fasting blood sugar
testing may be used instead. For this test, a sample of your blood will be taken after
you’ve fasted overnight.
Unlike the A1C test, the fasting plasma glucose test measures the amount of sugar
in your blood at a single point in time. Blood sugar values are expressed in
milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L). It’s important to
understand that your results can be affected if you’re stressed or sick.

Your doctor will go over your results with you. Here’s what your results could
mean:

 fasting blood sugar of 126 mg/dL or higher = diabetes

 fasting blood sugar of 100 to 125 mg/dL = prediabetes
 fasting blood sugar less than 100 mg/dL = normal

Random plasma glucose test

Random blood sugar testing is used in people who have symptoms of diabetes.
A random blood sugar test can be done at any time of day. The test looks at blood
sugar without considering your last meal.

No matter when you last ate, a random blood sugar test of 200 mg/dL or above
suggests that you have diabetes. This is particularly true if you already have
symptoms of diabetes.

Your doctor will go over your results with you. Here’s what your test results could
mean:

 random blood sugar of 200 mg/dL or more = diabetes

 random blood sugar level between 140 and 199 mg/dL = prediabetes
 random blood sugar less than 140 mg/dL = normal

Oral glucose tolerance test

Like the fasting plasma glucose test, the oral glucose tolerance test also requires
you to fast overnight. When you arrive at your appointment, you’ll take a fasting
blood sugar test. Then you’ll drink a sugary liquid. After you’re done, your doctor
will test your blood sugar levels periodically for several hours.

To prepare for this test, the National Institute of Diabetes and Digestive and Kidney
Diseases (NIDDK) recommends that you eat at least 150 grams of carbohydrates
per day for the three days leading up to the test. Foods like bread, cereal, pasta,
potatoes, fruit (fresh and canned), and clear broth all contain carbohydrates.

Tell your doctor about any stress or illness you’re experiencing. Make sure your
doctor knows about all of the medications you’re taking. Stress, illness, and
medications can all affect the results of the oral glucose tolerance test.

Your doctor will go over your results with you. For an oral glucose tolerance test,
here’s what your results could mean:

 blood sugar of 200 mg/dL or more after two hours = diabetes

 blood sugar between 140 and 199 mg/dL after two hours = prediabetes
 blood sugar less than 140 mg/dL after two hours = normal

Glucose tolerance tests are also used to diagnose gestational diabetes during
pregnancy.

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Getting a second opinion

You should always feel free to get a second opinion if you have any concerns or
doubts about your diagnosis.

If you change doctors, you’ll want to ask for new tests. Different doctors’ offices
use different laboratories to process samples. The NIDDK says it can be misleading
to compare results from different labs. Remember that your doctor will need to
repeat any test to confirm your diagnosis.

Are the test results ever wrong?

Initially, your test results may vary. For instance, a blood sugar test may show that
you have diabetes but an A1C test may show that you don’t. The reverse can also
be true.

How does this happen? It could mean that you’re in an early stage of diabetes, and
your blood sugar levels may not be high enough to show on every test.

The A1C test can be wrong in some people of African, Mediterranean, or Southeast
Asian heritage. The test can be too low in people with anemia or heavy bleeding,
and too high in people with iron deficiency anemia. Don’t worry — your doctor
will repeat the tests before making a diagnosis.

Treatment planning
Once you know you have diabetes, you can work with your doctor to create a
treatment plan that’s right for you. It’s important to follow through on all your
monitoring and medical appointments. Getting your blood tested regularly and
tracking your symptoms are essential steps to ensure long-term health.

Talk with your doctor about your blood sugar goal. The National Diabetes
Education Program says that the goal for many people is an A1C below 7. Ask
your doctor how often you should test your blood sugar.
Create a self-care plan to manage your diabetes. This may include lifestyle changes
like eating healthy food, exercising, stopping smoking, and checking your blood
sugar.

At every visit, talk to your doctor about how your self-care plan is working.

Outlook
There’s no existing cure for type 2 diabetes. However, this condition is highly
manageable with many effective treatment options.

The first step is diagnosis and understanding your test results. To confirm your
diagnosis, you doctor will need to repeat one or more of these tests: A1C, fasting
blood glucose, random blood glucose, or oral glucose tolerance.

If you’re diagnosed with diabetes, create a self-care plan, set a blood sugar goal,
and check in with your doctor regularly.