Testing for Diabetes

Fasting Plasma Glucose. The fasting plasma glucose (FPG) test has become the standard diagnostic test. It is a simple blood test taken after eight hours of fasting. FPG level are considered normal up to 110 mg/dl. Diabetes is diagnosed when FPG levels are 126 mg/dl or higher on two different days. Levels between 110 and 126 are referred to as impaired fasting glucose, which is considered to be a risk factor for developing diabetes and its complications. The test is not always reliable; if a person has normal levels but has symptoms of diabetes and a family history or other risk factors, then diabetes should not be ruled out and other tests should be performed.

Glucose Tolerance Test. A glucose tolerance test is more elaborate; it first employs an FPG test; a blood test is then taken two hours later after drinking a special glucose solution. Normally, blood sugar increases modestly after drinking the glucose beverage and decreases after two hours; in the diabetic, the initial increase is excessive and the level remains high.

Test for Glycolated Hemoglobin. Another diagnostic test examines blood levels of hemoglobin A1c (HbA1c), or glycolated hemoglobin. Hemoglobin, a protein molecule found in red blood cells, becomes modified by having glucose bound to it. The degree of modification depends on the average level of blood sugar that the protein is exposed to over its life span. Although the HbA1c test detects less than half of those with diabetes, the patients identified are those most severely affected and who require medical intervention. The test is also used to monitor the effectiveness of diabetic treatments.

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