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:

Impaired fasting glucose
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	HbA_1c*** 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.

***HbA_1c

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 HbA_1cwill be present in the blood.
HbA_1cmeasures 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 HbA_1c 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 HbA_1clevels 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 HbA_1clevel 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 HbA_1c 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 HbA_1c 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 (HbA_1c) 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)

Pregnancy (Patients who are diabetic)

Screening for pregnancy intention at every clinical encounter is suggested in patients with type 1 or type 2 diabetes mellitus who are of childbearing potential. For those who do not wish to become pregnant, contraception is suggested.
Discontinuation of a glucagonlike peptide-1 receptor agonist before conception rather than during the first trimester of pregnancy is suggested for patients with type 2 diabetes.
The routine addition of metformin to the regimen of pregnant patients with type 2 diabetes who are receiving insulin is not suggested.
Either a carbohydrate-restricted (<175 g/d) or usual (>175 g/d) diet is suggested for pregnant patients with diabetes; however, low or high extremes of carbohydrate intake should be avoided.
Either continuous glucose monitoring (CGM) or self-monitoring of blood glucose is suggested for pregnant patients with type 2 diabetes. For patients who are using CGM, the standard of care pregnancy glucose targets for fasting (<95 mg/dL), 1 hour postprandial (<140 mg/dL), and 2 hours postprandial (<120 mg/dL) are suggested rather than a single 24-hour target of <140 mg/dL.
For pregnant patients with type 1 diabetes, a hybrid closed-loop insulin delivery system is suggested instead of separate noncommunicating pump and CGM devices or multiple daily injections.

Medscape

Guidelines on the management of preexisting diabetes in pregnancy were published in August 2025 by the Endocrine Society and the European Society of Endocrinology in the Journal of Clinical Endocrinology and Metabolism.

Wyckoff JA, Lapolla A, Asias-Dinh BD, et al. Preexisting diabetes and pregnancy: an Endocrine Society and European Society of Endocrinology joint clinical practice guideline. J Clin Endocrinol Metab. 2025 Aug 7;110(9):2405-52. PMID: 40652453. https://academic.oup.com/jcem/article/110/9/2405/8196670

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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