In an era of constant growth of patients with “sweet sickness”, more and more people are interested in what tests for diabetes can give a 100% accurate result. It should be said right away that there are several of them.
More precisely, a certain set of examinations can reliably confirm the presence of an ailment. All of them are carried out by donating blood, but each has its own characteristics. In addition, patients who already know about their disease also need to undergo a course of diagnostic procedures once every 3 months.
What tests should be done for diabetes
Often a person learns that he has diabetes by accident. Having donated blood or urine for a general analysis, it suddenly turns out that the glucose level is higher than normal. However, if you have not undergone any examinations and you are concerned about the symptoms from the previous paragraph, it is time to conduct tests for diabetes.
What tests should be taken, first of all, if you suspect diabetes mellitus:
- for glucose content. Simple, fast, but not exact way. From 3.3 to 5.5 mmol / l is the normal concentration of sugar in the blood. At a level higher, a re-analysis and an appointment with an endocrinologist are necessary.
- Analysis of morning urine for glucose. In healthy people, the presence of sugar in the urine is impossible, but in diabetics this phenomenon is common. Collect the average portion of the morning secretions. If sugar is still found in your urine, do a daily urine test.
- Daily analysis – determines the daily excretion of sugar in human urine. It is the most informative, as it helps to accurately establish the disease and its severity. The material is collected throughout the day, excluding morning urine. By the end of the day, approximately 200 ml is collected, which will be needed for analysis.
In addition to the general, not too reliable, use:
- The glucose tolerance test is the most accurate and modern way to diagnose diabetes. You will need to donate some blood on an empty stomach, then drink 100 ml of sugary liquid in 10 minutes. Now you have to repeat the donation procedure every half an hour for two hours, and the doctor will record what changes will occur with the sugar level during this time.
- On glycohemoglobin , the level of which rises in proportion to the increase in glucose levels.
Analysis for latent diabetes mellitus
The first stage of diagnosis is carried out on an empty stomach, for the procedure to be carried out, it is necessary that the time between the last meal and blood donation is at least 8 hours. It is assumed that during this time the level of glucose in the blood should stabilize, even if a lot of sweets were eaten.
For a normal state, glucose should take no more than 100 mg / dl. Diagnosis of diabetes suggests a glucose level greater than 126 mg/dl. Accordingly, all borderline values from 100 to 125 mg / dl indicate the presence of latent diabetes.
But one such test is not enough, so another blood test is performed. Before this, you need to drink 1 glass of water with the addition of a large amount of glucose, and after 2 hours you can conduct a glucose tolerance test.
values less than 140 mg/dL would be normal and not prediabetic . Latent diabetes is diagnosed when glucose levels are between 140 and 200 mg/dL.
In order to be completely sure of the diagnosis, it is necessary to conduct additional tests. Fasting blood and a glucose tolerance test show the current sugar level, and to check if this condition is constant, a glycated hemoglobin (A1C) test is performed.
It shows how much glucose was on average in the blood over the past 2-3 months (during this time, glucose in combination with hemoglobin molecules exists in the body). For this analysis, no restrictions need to be adhered to, i.e. You can’t donate blood on an empty stomach. The reference value of the normal state is less than 5.7%, values from 5.7 to 6.4% are typical for latent diabetes.
The third test, which provides the most reliable diagnosis, is the test for antibodies to glutamate decarboxylase (AT to GAD). Exceeding the reference value of antibodies indicates damage to beta cells that are involved in the production of insulin in the body, and, therefore, a violation of glucose uptake that will occur over time (about 3 years). It is necessary to take measures to treat latent diabetes if the amount of antibodies on this test exceeds 1.0 per ml.
Tests for type 1 diabetes
Usually, either blood or urine is taken for research. The doctor himself will prescribe the type. The main role in such an issue as tests for diabetes is played by the time of treatment and regularity. The sooner and more often (the latter – with a predisposition to the disease) – the better.
There are the following types of research:
- With a glucometer . It is not carried out in the laboratory, and you can do it while at home and without being a specialist in medicine. A glucometer is a device that measures the level of glucose in a person’s blood. It must be present in the house of a diabetic, and if you suspect a disease, the first thing you will be offered is to use a glucometer ;
- Glucose analysis. It is also called the glucose tolerance test. This method is perfect not only for detecting the disease itself, but also for the presence of a condition close to it – prediabetes . For him, they will take blood from you, then they will give you 75 g of Glucose to drink, and after 2 hours you need to donate blood again. The results of this study can be influenced by various factors, from physical activity, to the dishes that the person consumed;
- on the C-peptide. This substance is a protein, if it is present in the body, then insulin is produced. Often taken together with blood for glucose, and also helps to determine the pre- diabetic state;
- General analysis of blood and urine. They are always handed over when any medical examinations take place. By the number of blood cells, platelets and leukocytes, doctors determine the presence of hidden diseases and infections. For example, if there are few white bodies, this indicates the presence of problems with the pancreas – which means that sugar may rise in the near future. It can also be found in the urine;
- for serum ferritin. Few people know that an excess of iron in the body can be the cause of resistance (immunity) to insulin.
If there are concomitant diseases, or you have already been diagnosed with diabetes, other studies may be prescribed – for example, with hypertension, blood is checked for the presence of magnesium in it.
Glucose test for diabetes
There are several ways to introduce glucose into the body:
- oral, or through the mouth, by drinking a solution of a certain concentration;
- intravenous, or by drip or injection into a vein.
The purpose of the glucose tolerance test is to:
- confirmation of the diagnosis of diabetes mellitus;
- diagnosing hypoglycemia;
- diagnosing the syndrome of impaired glucose absorption in the lumen of the gastrointestinal tract.
Before the procedure, the doctor must conduct an explanatory conversation with the patient. Explain in detail the preparation and answer all questions of interest. The norm of glucose for each is different, so you should learn about previous measurements.
- The doctor should inquire about the medications the patient is taking and rule out those that may change the test results. If the abolition of medications is not possible, then it is worth choosing an alternative or taking this factor into account when deciphering the results.
- Within 3 days before the procedure, you should not limit the intake of carbohydrates, the food should be normal. The amount of carbohydrates should be 130-150 grams (this is the norm for the diet).
- On the last evening before the procedure, it is worth reducing the amount of carbohydrates to 50-80 grams.
- Immediately before the glucose tolerance test itself, 8-10 hours of fasting should pass. Only non-carbonated water is allowed to drink. Smoking and consumption of alcoholic beverages and coffee is prohibited.
- Physical activity doesn’t have to be exhausting. However, physical inactivity (reduced physical activity) should be avoided.
- In the evening before the test, you should avoid heavy physical exertion.
- During a consultation with a doctor, it is necessary to find out the exact place and time of blood sampling from a vein before administering glucose (using the oral or intravenous route of administration).
- During blood sampling, discomfort, dizziness, nausea, irritation from the use of a tourniquet are possible.
- It is necessary to immediately inform the doctor or nursing staff about the state of hypoglycemia (nausea, dizziness, excessive sweating, cramps in the arms and legs).
- In the morning, usually at 8 o’clock, blood is taken from the patient. Before this, there was an 8-10 hour fast, so this sample will be the control. Blood is taken either from a finger (capillary) or from a vein. Using an intravenous method of administering glucose rather than oral, a catheter is used that remains in the vein until the end of the test.
- The level of glucose in the urine is measured. You can bring the jar with the analysis to the patient yourself or take the analysis directly at the hospital.
- The patient is given to drink 75 grams of dissolved glucose in 300 ml of pure warm non-carbonated water. It is recommended to drink a volume of liquid within 5 minutes. From this moment, the study begins and the countdown begins.
- Further, every hour, and if necessary, every 30 minutes, blood is taken for analysis. Using the oral route of administration – from a finger, intravenous – from a vein using a catheter.
- Urine is also taken at regular intervals.
- Drinking clean, warm water is recommended to produce enough urine.
- If during the test the patient becomes unwell, it is necessary to lay him on the couch.
- After the study, the medical staff should check that the patient eats well, without excluding carbohydrates from the diet.
- Immediately after the study, it is worth resuming the use of drugs that could affect the result of the analysis.
During pregnancy, the test is not performed if the concentration of glucose before meals is more than 7 mmol / l.
Also during pregnancy, it is worth reducing the concentration of glucose in the solution you drink. In the third trimester, the use of 75 mg is unacceptable, as it will affect the health of the child.
In most cases, results are given for a tolerance test that was performed using the oral route of glucose administration. There are 3 end results, according to which the diagnosis is made.
- Glucose tolerance is normal. It is characterized by the level of sugar in venous or capillary blood after 2 hours from the start of the study, not more than 7.7 mmol / l. This is the norm.
- Impaired glucose tolerance. It is characterized by values from 7.7 to 11 mmol / l two hours after drinking the solution.
- Diabetes. The result values in this case are above 11 mmol/l after 2 hours using the oral route of glucose administration.
What can affect the test result
- Non-compliance with the rules regarding nutrition and physical activity. Any deviation from the required limits will change the result of the glucose tolerance test. With certain results, it is possible to make an incorrect diagnosis, although in fact there is no pathology.
- Infectious diseases, colds, tolerated at the time of the procedure, or a few days before it.
- Age. The retirement age (50 years) is especially important. Every year, glucose tolerance decreases, which affects the test results. This is the norm, but it should be taken into account when deciphering the results.
- Refusal of carbohydrates for a certain time (illness, diet). The pancreas, which is not accustomed to steadily release insulin for glucose, is unable to quickly adjust to a sharp increase in glucose.
Testing during pregnancy
Gestational diabetes is a condition similar to diabetes that occurs during pregnancy. However, there is a chance that the condition will remain after the birth of the child. This is far from the norm, and such diabetes during pregnancy can adversely affect the health of both the baby and the woman herself.
Gestational diabetes is associated with hormones that the placenta secretes, so even an increased glucose concentration should not be taken as abnormal.
The test during pregnancy for glucose tolerance is carried out no earlier than 24 weeks. However, there are factors under which early testing is possible:
- the presence of relatives with type 2 diabetes;
- detection of glucose in the urine;
- early or present disorders of carbohydrate metabolism.
The glucose tolerance test is not carried out with:
- early toxicosis;
- inability to get out of bed
- infectious diseases;
- exacerbation of pancreatitis.
The glucose tolerance test is the most reliable research method, according to the results of which one can accurately say about the presence of diabetes mellitus, a predisposition to it or the absence of it. During pregnancy, 7-11% of all women develop gestational diabetes, which also requires such a study. Taking a glucose tolerance test after 40 years is worth every three years, and if there is a predisposition, more often.