Glucose Test - Medtick
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Glucose Test

What is it?

Pre-diabetes

They are not classed diabetic but still have high glucose blood levels hence usually show no symptoms hence it is more important to have regular check ups.

To check if one has these conditions one should test their sugar levels using a diabetes blood glucose device or visit their local pharmacy and/or diabetic clinic to see if they provide this service.

 

There are two main forms of pre-diabetes:

  1. Impaired fasting glucose
  2. Impaired glucose tolerance
  • A person with impaired fasting glucose and impaired glucose tolerance indicates that they may be on the ‘borderline’ to develop diabetes, the development to diabetes occurs between 3-10 years.
  • Impaired fasting glucose is normally is connected liver insulin resistance and near normal muscle insulin sensitivity.
  • Impaired glucose tolerance is connected with muscle insulin resistance and malfunction of insulin being released and is also more connected with obesity and age.
  • It also has a higher risk of heart conditions and metabolic syndrome than impaired glucose tolerance.

Measurement guidelines

 The guidelines on results are indicated below from blood glucose devices.

  Fasting glucose * mmol/L 2 hours post glucose load** mmol/L HbA1c***

mmol/mol
Normal       3.6-6.0      < 7.8       20-41
Impaired Fasting Glucose  5.6 in (USA) 6.1-6.9              42-<48
Impaired Glucose Tolerance       7.8-11.0       42-<48
Diabetes        >7.0             >11.0       ≥ 48

*Fasting glucose means one has not had any food or drink (except water) for at least 12 hours, this test is more accurate if done in the morning.

**A 2 hours post glucose load means one has done a fasting glucose test and the results were not clear. A measurement is then taken two hours after eating a 75g glucose load.

***HbA1c

  • In the blood stream are the red blood cells, which are made of a molecule, haemoglobin. Glucose sticks to the haemoglobin to make a ‘glycosylated haemoglobin’ molecule, called haemoglobin HbA
  • The more glucose in the blood, the more haemoglobin HbA1c will be present in the blood.
  • HbA1c measures the average blood glucose over a period of 8-12 weeks in the blood because red blood cells only live that long before being replaced.
  • While HbA1c reflects the exposure of haemoglobin to glucose over 120 days, it does not indicate the variation in blood glucose levels in response to activity, diet or insulin therapy.
  • It hence gives us a reading over a period of time and It requires no food or drink fasting.
  • These tests are done with a blood sample in a hospital or clinic.
  • For diabetics the main aim is to get your HbA1c levels below 53 mmol/mol.

Roche Accu-Chek 2010

The International Diabetes Federation and World Health Organization diagnostic criteria for type 2 diabetes mellitus

Presence of diabetes symptoms (e.g. frequent urination, thirst, unexplained weight loss) and one of the following abnormal test results:

  • A fasting plasma glucose concentration of ≥7.0mmol/L;
  • A random venous plasma glucose concentration of ≥11.1mmol/L;
  • A plasma glucose concentration of ≥11.1mmol/L two hours after 75g anhydrous glucose in an oral glucose tolerance test;
  • An HbA1c level of ≥48mmol/mol (6.5%).

In the absence of diabetes symptoms, two abnormal test results are required for confirmation (preferably the same test).

Source: International Diabetes Federation

International Diabetes Federation. IDF clinical practice recommendations for managing type 2 diabetes in primary care. 2017. Available at: 

https://www.idf.org/e-library/guidelines/128-idf-clinical-practice-recommendations-for-managing-type-2-diabetes-in-primary-care.html (accessed September 2019)

However, there are patient groups in whom HbA1c is inappropriate for diagnosis, including:

  • Children;
  • Pregnant women;
  • People who are taking medicines that can cause an acute glucose rise (e.g. steroids, anti-psychotics, progesterone oral contraceptives);
  • People with acute pancreatic damage;
  • People with haematological conditions that may influence HbA1c and its measurement (e.g. haemoglobinopathies, decreased erythropoiesis/administration of erythropoietin, erythrocyte destruction, alcoholism, chronic kidney disease and chronic opioid use).
  • Urinary glucose should not be used as a diagnostic test owing to its low sensitivity

 World Health Organization. Use of glycated haemoglobin (HbA1c) in the diagnosis of diabetes mellitus: abbreviated report of a WHO Consultation. 2011. Available at: 

https://www.who.int/diabetes/publications
/report-hba1c_2011.pdf?ua=1 
(accessed September 2019)

 Diabetes UK. Diagnostic criteria for diabetes. 2014. Available at:

 https://www.diabetes.org.uk/professionals
/position-statements-reports
/diagnosis-ongoing-management-monitoring/
new_diagnostic_criteria_for_diabetes
(accessed September 2019)

Complications /Information to beware of/General tips:

Please talk to your healthcare professional (i.e. Medical Doctor/Pharmacist) for further advice

Detailed Information

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