What is Diabetes?
Diabetes is a chronic condition which requires the individual to take good care of themselves and monitor their blood sugar levels.
If the body’s glucose levels are not kept under control, then some adverse effects can occur. Long term complications associated with high blood glucose levels can include:
- Heart disease
- Diabetic retinopathy
Most of these conditions are linked to our major organs such as our kidneys, heart and eyes. Scientists believe they occur when blood vessels and nerves which supply these organs become damaged by continuously high blood sugar levels.
Monitoring blood sugar levels
Blood glucose measurements can easily be taken using a blood glucose meter. These compact machines can be purchased in most pharmacies and give an accurate and up to date blood glucose reading.
In the UK there are over 65 different blood glucose meters available and choosing the right one will depend on several factors, including whether you will be able to get a prescription for the test strips. However, essentially all blood glucose meters do the same thing in that they measure the sugar in your blood.
Blood Glucose Levels
The following guidelines except those for the non-diabetic are provided by NICE.
Blood glucose is measured in millimoles per litre.
Although it is possible to self-monitor blood glucose levels it is not always the best way. Some studies have shown in patients with type 2 diabetes that self-monitoring their glucose levels can increase levels of depression. Further studies have also concluded that self-monitoring doesn’t improve glycaemic control in such patients compared to those who are monitored by the health service.
Diagnosing diabetes can be carried out using various tests by a GP. These tests include:
- Random plasma glucose test
- Fasting plasma glucose test
- Oral glucose tolerance test (OGTT)
- HbA1c test
Random Plasma Glucose Test
The test is used in the diagnosis of type 1 diabetes. It is a blood test which can be taken at any time and does not require the individual to fast.
Fasting Plasma Glucose Test
The fasting plasma glucose test can be a good indicator for type 2 diabetes or a stage known as prediabetes. A blood test is usually carried out around 8 hours after the person ate a meal, normally first thing in the morning. The results of the fasting plasma glucose test can be defined as follows:
If an individual is found to have an impaired fasting glucose level, then this is an indication of prediabetes.
Prediabetes is defined as having blood glucose levels which are above normal but below the diabetic parameters. Therefore, an individual is at a greater risk of developing diabetes if they are prediabetic, although it doesn’t necessarily mean they will go on to develop the condition.
Oral Glucose Tolerance Test (OGTT)
The OGTT can be used to help diagnose diabetes or insulin resistance. The test involves a fasting blood glucose test being carried out prior to drinking a very sweet glucose drink.
Further blood tests may be taken at 30-minute intervals or alternatively a sample will be taken 2 hours after drinking the glucose drink. The test can last for up to 3 hours and is more rigorous than a simple finger prick test.
The HbA1c Test for Diabetes
A further test which can be carried out is the HbA1c which can show how well diabetes or sugar levels have been controlled over a period of up to 3 months.
Basically, the test will give an average figure of glucose in your blood over that period. In the past, the test was used in this way but more recently the World Health Organisation has recommended the use of the test to diagnose type 2 diabetes in people who may not have been known to have it.
The test is a simple blood test and measures the amount of glucose bound to haemoglobin in the red blood cells, known as HbA1c.
Haemoglobin is the protein essential for transporting oxygen around the body. The amount of HbA1c which is formed is proportional to the average glucose concentration in your blood and as blood cells live for up to 3 months, the amount of HbA1c can be averaged over this time.
HbA1c Test Results
Reducing HbA1c levels can reduce the risk of diabetic complications. A study by Stratton et al., (2000) showed how even minimal reductions could reduce deaths related to diabetic complications such as cardiovascular and cerebrovascular disease.