The CDC (Centers for Disease Control and Prevention) reports that almost 26 million children and adults in the U.S., or over 8% of the population, have diabetes today. Unfortunately, millions of people in the U.S. are unaware that they have diabetes, because there may be no warning signs and they don’t feel any complications until it is too late and they have it.
If you experience symptoms such as severe or increased thirst, frequent urination, unexplained weight loss or weigh gain, increased hunger, a tingling feeling on your hands or feet, your doctor needs to run a test for diabetes.
The A1C is the most popular and best examine to check if you have diabetes or are at risk of getting it. It is a laboratory test you need to get from your doctor. As a comparison, using a glucose meter is very important to do every day to monitor how your blood sugar is doing, but it is limited because it can only tell you what your blood sugar is at that moment you check your blood. This depends on what you ate or drank, the time of day, your stress level, medications, and other factors.
The AIC test is different and we sometimes nickname it “El Chismoso” (The Gossip) because it tells on you. It tells you what your average blood sugar level is for the past 90 days; 3 months, giving a much better picture of your average daily blood sugar levels. So if you ARE diabetic you need to know how you have been doing in the past 90 days, especially if you have not been feeling good, not taken good care of yourself, or seen your doctor in a while.
If you ARE NOT diabetic but think you might be or if it runs in your family, it is very important to get screened. This test can tell you for sure if you are or not, or warn you if you are getting close to being pre-diabetic so you can make changes to your lifestyle.
Either way, if you are close to being diabetic or your number is high, you need to make changes to your nutrition and exercise so you can avoid complications such as blindness, amputations, heart attack, stroke, kidney failure, and other complications.
This test is also called glycated hemoglobin, glycosylated hemoglobin and HbA1c, but for short, it is simply called “A1C”.
For diabetics, the goal is to keep blood glucose levels as close to normal as possible. Chronically elevated blood glucose can lead to serious complications, such as damage to the cardiovascular system, nerves, kidneys and eyes. By monitoring blood sugar levels over a period of months, you and your doctor can see whether you are successfully keeping your diabetes under control.
The A1C test checks what percentage of hemoglobin is glycated (coated with sugar). If you have Type 2 diabetes that does not require insulin, and your blood sugar is regularly under control, the test is usually taken twice a year. For persons who are not controlling their diabetes or have just been diagnosed, the test is often ordered more frequently.
If you have Type 1 diabetes, the test will probably be taken every 3 or 4 months.
An international committee of diabetes experts recommended in 2009 that the A1C be used to diagnose both Type 1 and Type 2 diabetes, and prediabetes. After diagnosis, this test is used to monitor success of treatment.
Unlike daily glucose monitoring the A1C is reported as a percentage. The normal range for A1C levels for non-diabetics is 4%-6%. An A1C of 6.5% or higher on two separate occasions indicates diabetes, and between 6% and 6.5% indicates prediabetes. Diabetics should aim to keep their A1C level below 7%. As the A1C level increases, so does the risk of complications. If you have had uncontrolled diabetes for a long period of time, your A1C level may rise to as high as 25%.
Usually you must request the A1C from your doctor as doctors do not usually volunteer to recommend one, unless you tell them of your risks including diabetes running in your family or if you are obese. If you do not have health insurance, you can call “211” for referral to a low-cost clinic or find a clinic in the LDA Low-Cost or Free Community Clinic Directory.
The A1C test will not reflect possible daily fluctuations of blood glucose. Test results may be inaccurate if you have sickle cell hemoglobin or anemia. If you are iron deficient, your A1C level may also increase. A recent transfusion will also cause the A1C level to be falsely elevated.
Your doctor may order a Fasting Plasma Glucose Test or Casual Plasma Glucose to confirm the diagnosis of type 2 diabetes.
Aside from the A1C, this is a preferred method for diagnosing diabetes because it is easy to do, convenient, and less expensive than other tests.
This test is usually done only during pregnancy to diagnose gestational diabetes or for a pregnant woman who is suspected of having type 2 diabetes but have a normal fasting glucose level. It can also be done to diagnose prediabetes.
The casual plasma glucose test is another method of diagnosing diabetes. Your blood sugar is tested without having to fast before taking the test. A glucose level greater than 200 mg/dL may indicate diabetes, especially if the test is repeated at a later time and shows similar results.
It is important for people with diabetes to have a dilated eye exam at least once a year as part of their complete eye exam. This can detect early signs of Diabetes Retinopathy, which is the leading cause of blindness in the U.S. and may show no symptoms in the beginning.
A foot exam once or twice a year, or at every doctor’s visit is also key to detect decreased circulation and sores that may not be healing. Early detection of eye and foot problems in diabetes allows your doctor to prescribe proper treatment. Also check your feet daily with a mirror on a carpeted floor if you cannot see the bottom of your feet. If you have the smallest sore or “ulcer”, see your podiatrist immediately as a serious infection like gangrene can begin in just a couple of days.
Many children show no signs before they are diagnosed with type 2 diabetes. Most of the time, diabetes is discovered when a blood or urine test taken for other health problems shows the presence of diabetes.
Talk to your doctor about your child’s risk for diabetes, especially if they are overweight or if you have diabetes. If your child’s blood sugar tests are higher than normal, but not yet at the level of diabetes (called prediabetes), ask your doctor for a specific diet and exercises to prevent your child from getting diabetes. Also ask for a referral for a nutritionist.
