Tests For Gestational Diabetes
Gestational diabetes is diagnosed using blood tests. Youll probably be tested between 24 and 28 weeks of pregnancy. If your risk is higher for getting gestational diabetes , your doctor may test you earlier. Blood sugar thats higher than normal early in your pregnancy may indicate you have type 1 or type 2 diabetes rather than gestational diabetes.
When Should Testing Occur
A doctor might recommend testing at three different times, and often over the course of several days:
- Morning fasting reading: This provides information about blood glucose levels before a person eats or drinks anything. Taking blood glucose readings before eating provides a baseline number. This number offers clues about glucose processes during the day.
- Before a meal: Blood glucose before a meal tends to be low, so a high blood glucose reading at this time suggests difficulties managing blood sugar.
- After a meal: Post-meal testing gives a good idea about how the body reacts to food, and if sugar can reach the cells efficiently. Blood glucose readings after a meal can help diagnose gestational diabetes, which happens during pregnancy. Most doctors recommend testing about 2 hours after a meal.
The doctor will personalize the glucose monitoring schedule for the individual.
- Fasting : 80â130 milligrams per deciliter
- Before meals: 70â130 mg/dl
- Two hours after starting meals: Below 180 mg/dl
- At bedtime: Under 120 mg/dl
- HbA1c: 7.0 percent or lower
Before beginning home testing, it is important that people get clear, target figures from their doctor.
Target numbers may vary from person to person and may change over time, depending on an individualâs health, age, weight, and other factors.
For people who do not have diabetes, blood sugar levels should be within the following ranges:
Can You Reverse Prediabetes
The first step in preventing the progression of prediabetes is to lead a healthy lifestyle. The sooner you implement lifestyle changes, the more you’ll increase your chances of staving off diabetes.
Even prior to getting a formal diagnosis, it’s important for any at-risk person to take a CDC risk assessment and adopt healthy lifestyle changes, including weight loss, regular and moderate-intensity exercise, and a balanced diet consisting of fruits and vegetables.
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How Blood Sugar Is Measured
There are different devices you can use to measure your blood sugar, which work by checking the levels of glucose, or sugar, in your bloodstream. Blood sugar meters or glucometers take a drop of blood to measure your blood sugar at one particular momentwell get to the specifics on how it works in a minute. Continuous glucose meters or CGMs, use a sensor inserted under the skin with a tiny needle to measure blood sugar every few minutes. They sync up to an app, watch, or receiver that stores information about your readings. Then the patient can review their blood sugar data on their device or keep a detailed written log.
CGMs are worn continuously to give you feedback about your blood sugar 24/7 through a sensor placed under the skin of the arm or belly. They can provide very valuable insights and patterns to help you understand how your body best responds to diet and lifestyle factors that impact blood sugar, Palinski-Wade explains. People who wear CGMs still need to use a blood sugar meter once a day to make sure their CGM readings are accurate, says the CDC.
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Is There Anything Else I Should Know About A Blood Glucose Test
If you have diabetes, you may need to do blood sugar testing at home every day to help manage your blood glucose levels. There are two ways to do this:
- Blood glucose meters require you to prick your finger with a small device called a lancet. You apply a drop of blood to a test strip and insert it into a small, electronic glucose meter, which measures the glucose is in your blood.
- Continuous glucose monitors use a tiny sensor that you insert under your skin. Every few minutes, the sensor measures glucose levels in fluids between your cells. If your glucose is too high or too low, you use a blood glucose meter to check your blood levels before making changes to raise or lower your glucose level.
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Less Common T1d Tests
Because each case can be as unique as the individual, some doctors may employ the following tests to find markers of T1D to ensure the optimal treatment plan:
- C-PeptideWhile most tests check for antibodies, this test measures how much C-peptide is in a persons blood. Peptide levels typically mirror insulin levels in the body. Low levels of C-peptide and insulin can point to T1D.
- Insulin Autoantibodies This tests looks for the antibodies targeting insulin.
- Insulinoma-Associated-2 Autoantibodies This test looks for antibodies mounted against a specific enzyme in beta cells. Both the IA-2A and GADA tests are common T1D antibody tests.
- Zinc Transporter 8 This test looks at antibodies targeting an enzyme that is specific to beta cells.
- Islet Cell Cytoplasmic Autoantibodies Islet cells are clusters of cells in the pancreas that produce hormones, including insulin. This test identifies a type of islet cell antibodies present in up to 80 percent of people with T1D.
- Glutamic Acid Decarboxylase Autoantibodies This test looks for antibodies built against a specific enzyme in the insulin-producing pancreatic beta cells.
Why Are Blood Tests Done To Screen For Diabetes
Many people who have diabetes don’t feel unwell in the early stages. By the time you get symptoms of diabetes, there may already be damage to important parts of your body. Treatment of diabetes can slow down further complications but cant usually repair this damage. This is why your healthcare provider might test you for diabetes even if you feel well.
Testing people for a condition like diabetes when they do not have any symptoms is called screening. Studies have been done to work out who is more likely to have diabetes so they can be screened.
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Is There Anything Else I Need To Know About Diabetes Testing
If you’ve been diagnosed with type 1 diabetes, you will need to monitor blood glucose levels daily, often several times a day. Your health care provider can recommend a kit you can use at home. Most kits include a lancet, a device that pricks your finger. You will use this to collect a drop of blood for testing. There are some newer kits available that don’t require pricking your finger. Some pregnant women with gestational diabetes may also need to monitor their glucose levels in this way.
People with type 2 diabetes will also have to check their blood sugar on a regular basis. If you have type 2 diabetes, talk to your provider about how often it should be checked.
People with type 2 diabetes may also need to have their insulin levels checked regularly. Insulin plays a key role in keeping glucose at the right levels. An insulin in blood test is done at a provider’s office.
What Is Diabetic Ketoacidosis
If you think you may have low blood sugar, check it even if you dont have symptoms.
When too many ketones are produced too fast, they can build up in your body and cause diabetic ketoacidosis, or DKA. DKA is very serious and can cause a coma or even death. Common symptoms of DKA include:
- Fast, deep breathing.
- Nausea and vomiting.
If you think you may have DKA, test your urine for ketones. Follow the test kit directions, checking the color of the test strip against the color chart in the kit to see your ketone level. If your ketones are high, . DKA requires treatment in a hospital.
DKA happens most in people with type 1 diabetes and is sometimes the first sign of type 1 in people who havent yet been diagnosed. People with type 2 diabetes can also develop DKA, but its less common.
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Before And After Meals And Snacks
If you eat first thing in the morning, your first blood sugar check of the day can also count as your pre-meal check, but if you dont, youll need to check again before breakfast.
This can inform you as to how much insulin youll need for your meal . If youre running a little high, youll need to bolus extra, but if your blood sugar is on the lower end, you can take a little less insulin for any carbohydrates eaten.
Checking before every meal and snack can help curb postprandial glucose excursions, otherwise known as the stubborn high blood sugars you sometimes can experience after eating a meal and not adequately bolusing for said meal.
Ideally, you should also be checking 2 hours after all meals as well, to determine if your meal bolus was adequate, if you took too much insulin, or if you need to adjust and take more insulin.
Two hours is the recommended time frame, because by then most carbohydrates have been absorbed into the body and most fast-acting insulin has already peaked.
When checking before snacks , make sure youre calculating any active insulin on board so you dont overtreat a high and end up going low.
If You Have Questions About Your Diagnosis
It’s usually difficult to take in everything the GP tells you during the appointment.
Talk to family and friends about what the GP told you, and write down any questions you have.
Then make another GP appointment and take your list of questions with you.
There’s also a lot of information on diabetes available.
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When To Get Tested
You can have prediabetes for years with no clear symptoms. The U.S Preventive Services Task Force now recommends regular screening for prediabetes starting at age 35. If you have a family history of diabetes, you may want to consider getting screened for diabetes sooner.
If you’re feeling the following symptoms, you may want to get tested for diabetes:
- Increased hunger
- Extreme fatigue
- Poor wound healing
Early diagnosis and treatment are key to halting the progression of prediabetes. The longer you wait, the greater the risk of serious complications, like heart or kidney disease or vision loss.
If left untreated, high blood sugars can damage organs throughout the body over time, underscoring the need to take immediate action if you have any concern that your symptoms might be caused by prediabetes or type 2 diabetes.
Remember that prediabetes means your body is not producing enough insulin or the insulin does not work properly. Still, your high blood sugar levels have not yet begun to damage your organs, which is a major complication of type 2 diabetes.
What Can Make My Blood Glucose Fall
Hypoglycemia is the technical term for low blood glucose . Its when your blood glucose levels have fallen low enough that you need to take action to bring them back to your target range. Here are a few of the causes:
- Not enough food, like a meal or snack with fewer carbohydrates than usual, or missing a meal or snack
- Alcohol, especially on an empty stomach
- Too much insulin or oral diabetes medications
- Side effects from other medications
- More physical activity or exercise than usual
Dont worry: There are things you can do to avoid lows. Be sure to learn the symptoms, and how to treat them when you get them.
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What Can I Expect During A Blood Glucose Test
You can expect the following during a venous glucose test, or blood draw:
- Youll sit in a chair, and a phlebotomist will check your arms for an easily accessible vein. This is usually in the inner part of your arm on the other side of your elbow.
- Once theyve located a vein, theyll clean and disinfect the area.
- Theyll then insert a small needle into your vein to take a blood sample. This may feel like a small pinch.
- After they insert the needle, a small amount of blood will collect in a test tube.
- Once they have enough blood to test, theyll remove the needle and hold a cotton ball or gauze on the site to stop the bleeding.
- Finally, theyll place a bandage over the site, and youll be finished.
You can expect the following during a capillary blood glucose test :
- A healthcare provider will ask you which finger youd like them to use.
- Theyll disinfect your fingertip with an alcohol swab and prick it with a small needle called a lancet, which is usually contained within a small plastic device.
- Theyll squeeze your fingertip to form a drop of blood.
- Theyll place your finger/the drop of blood against a test strip thats inserted into a glucometer.
- After they have enough blood for the test, theyll give you a cotton ball or gauze to hold against your fingertip to stop the bleeding.
- The glucometer will show your blood glucose level within seconds.
What Test Results Tell Me If I Have Diabetes Or Prediabetes
Each test to detect diabetes and prediabetes uses a different measurement. Usually, your doctor will use a second test to confirm you have diabetes.
The table below helps you understand what your test results mean if you are not pregnant.1 If you are pregnant, some tests use different cutoffs. Ask your doctor what your test results mean.
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When Should I Check My Blood Sugar
How often you check your blood sugar depends on the type of diabetes you have and if you take any diabetes medicines.
Typical times to check your blood sugar include:
- When you first wake up, before you eat or drink anything.
- Two hours after a meal.
If you have type 1 diabetes, have type 2 diabetes and take insulin, or often have low blood sugar, your doctor may want you to check your blood sugar more often, such as before and after youre physically active.
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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Gaining Insights From Routine Blood Glucose Testing
Day-to-day blood sugar checks can give you a good idea of how youÃ¢re doing at this moment, and they can be reviewed overall to see trends. They can help answer questions such as:
- Are your medications working as they should?
- How does the type or amount of food you eat affect your blood sugar?
- How does activity or stress affect your blood sugar?
Should You Take Your Insulin Or Antidiabetic Medication Before Going For Your Fasting Blood Tests
No. You should never take your insulin or antidiabetic medication prior to having a fasting blood test.
The first reason is because the injected insulin will lower your glycemia and you could find yourself in a state of hypoglycemia. The second reason is that your test results will be skewed, their interpretation inaccurate, making your glycemic control difficult because the insulin will have already begun to act when your blood test was done.
You should book your appointment for as early in the morning as possible. Once your blood test is done, check your blood glucose levels and give yourself your injection, or take your antidiabetic medication, and then eat breakfast. You should eat within minutes of taking insulin. If you dont, you risk becoming hypoglycemic.
Adapted from: Tremblay, L., Nurse, Prise de sang : Quand prendre son insulin, Plein Soleil, Diabète Québec.
Revised August 2014
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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.
Blood Tests For Diagnosing Diabetes
Both type 1 and type 2 diabetes can be diagnosed using blood tests. These include:
- A random plasma glucose test, which measures blood sugar at a single point in time
- A fasting blood glucose test, which is done after the person fasts for at least eight hours
- An oral glucose tolerance test , which involves fasting overnight, having a blood test, then drinking a sugary drink and having the blood sugar checked over the course of two hours
- An A1C test, which is a blood test that shows the average blood sugar over the past three months
Here are blood test results that indicate diabetes:
- Random plasma glucose: 200 mg/dl or above
- Fasting blood glucose: 126 mg/dl or above
- OGTT: 200 mg/dl or above
- A1C: 6.5% or above
Diagnosis of diabetes requires two abnormal screening test results, either from the same sample or in two separate test samples, according to the American Diabetes Association, unless there is a clear clinical diagnosis with classic symptoms of hyperglycemia .
Its important to note that these blood test results dont distinguish between type 1 and type 2 diabetes.
Another potential indicator of type 1 diabetes is the presence of ketones in the urine. A lack of insulin causes fat to be used for energy, and this process forms substances called ketones. However, people with type 2 diabetes may also have ketones, although its not as common as it is with type 1 diabetes.
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