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Diabetes – what is it?
Diabetes is a long-lasting (chronic) condition that affects how your body turns food into energy. People with diabetes have to take care with what they eat and measure their blood sugar levels every day.
If blood sugars (known as glucose levels) are not kept in check, there are side effects of diabetes which can be severe. The complications associated with long term high body glucose levels include:
- Neuropathy
- Heart disease
- Nephropathy
- Diabetic retinopathy
These conditions are mainly connected to major organs, like the heart, eyes and kidneys. Research evidence suggests that these conditions occur when the blood vessels and nerves that serve these organs become damaged by high levels of sugar in the blood.
Monitoring blood sugar levels
You can take blood glucose measurements, quite simply, by using a blood glucose meter. These machines, while small, give accurate and real-time blood glucose readings. Blood glucose meters can be bought in most good pharmacies or from online retailers.
There are many different types of blood glucose meters available in the UK and it’s worth finding the right one for you. You will need to also supply the blood test strips but you might be able to get these on prescription from your GP. Essentially, all the different types of blood glucose meters measure the sugar in your blood.
Blood Glucose Levels
The guidelines set out below have been provided by NICE (National Institute for Health and Care Excellence), apart from the guidelines for non-diabetic levels. The body’s blood glucose level is measured in millimoles per litre.
While people with type 2 diabetes can measure their own blood glucose levels, it’s not always the right thing to do for the patient. There is evidence to suggest that it can raise levels of depression within self-monitoring patients. Furthermore, studies show that self-measurement and monitoring doesn’t actually lead to improved glycaemic control, when compared to type 2 diabetes patients who are measured and monitored by the NHS.
There are several tests that a GP can use to diagnose diabetes. These tests include:
- Oral glucose tolerance test (OGTT)
- Random plasma glucose test
- Fasting plasma glucose test
- HbA1c test
Oral Glucose Tolerance Test (OGTT)
An OGTT is used to support the diagnosis of diabetes or insulin resistance. The OGTT includes taking blood samples at various times and drinking a sugary glucose drink. The first blood test is a fasting test, which is done before taking the drink.
Blood tests may then be carried out every 30 minutes or the blood test might be given 2 hours after taking the glucose drink. An OGTT can last for up to 3 hours and is more involved than a finger prick test.
Random Plasma Glucose Test
The Random Plasma Glucose Test is used to diagnose type 1 diabetes. Unlike other diabetes tests, it does not require fasting and can be taken at any time.
Fasting Plasma Glucose Test
A Fasting Plasma Glucose Test can be used to test for type 2 diabetes or for a condition that’s viewed as a precursor to diabetes, known as prediabetes. With a Fasting Plasma Glucose Test, a blood test is typically given 8 hours after the patient ate a meal. This means that they are often carried out first thing in the morning. The results of this test can highlight an impaired fasting glucose level, which is also considered to be an indicator of prediabetes.
The threshold for prediabetes is blood glucose levels that are above normal but still fall below diabetic parameters. A prediabetes diagnosis is considered to show that the patient has a higher risk of developing diabetes, although it is not a given that they will develop diabetes.
The HbA1c Test for Diabetes
The HbA1c test is a straightforward blood test that measures the amount of glucose that is bound to haemoglobin in the red blood cells. This is known as HbA1c.
The HbA1c can indicate how well sugar levels have been controlled in the previous 3 months and give an average figure for the glucose in your blood. Traditionally, the test has been used to give an average reading but the World Health Organisation are now recommending the HbA1c test as a test for diagnosing type 2 diabetes, particularly in people who are unaware that they may have it.
Haemoglobin is a protein and it is responsible for carrying oxygen around the body.
The level of HbA1c formed is directly proportional to the average concentration of glucose in your blood. With blood cells living for up to 3 months, it means that the amount of HbA1c present can be averaged over this time.
HbA1c Test Results
In order to reduce your risk of complications stemming from diabetes, it is important to reduce your levels of HbA1c. A study, carried out in 2000, showed that even a minimal reduction to levels could reduce diabetic-related deaths from complications, including cardiovascular disease.