Diabetes mellitus has become a worldwide epidemic, thanks to changing lifestyles and increasing obesity. Type 2 diabetes affects approximately 13% of the population of the United States. The worldwide prevalence of diabetes is estimated to be around 463 million people. Type 2 diabetes accounts for over 90% of patients with diabetes.
The earliest symptoms of diabetes are as follows:
- Fatigue: It is feeling exhausted all the time despite adequate sleep.
- Polyphagia: You may feel hungry despite regular meals. You may also feel irritable if you skip a meal.
- Weight loss: A weight loss of around four to eight kg for no apparent reason is another symptom of high blood sugar levels.
- Yeast infections: Vaginal thrush presenting as curdy white vaginal discharge in women and balanitis or itching at the tip of the penis in men may be an early marker of diabetes.
- Feeling thirsty: It is an increased amount of thirst despite drinking adequate water.
- Increased urination: Peeing often, especially at night, is a warning sign of diabetes.
- Tingling and numbness in the legs: If you have constant pins- and needle-like sensation or burning sensation in your soles, your high sugars may be the culprit.
Always remember that diabetes may present without signs and symptoms for a long time. Hence, routine screening of your blood sugars, in case you have risk factors, is very important.
What are the screening tests for diabetes?
If left untreated, undiagnosed diabetes can lead to severe and irreversible complications. If you have signs and symptoms of or risk factors for diabetes, your doctor may recommend you to go for screening tests. Screening tests let you know if you have diabetes or if you are predisposed to diabetes in the near future. The screening tests for diabetes include blood tests such as:
- Fasting blood glucose is more than 126 mg/dL (7.0 mmol/L). Fasting is defined as no caloric intake for at least eight hours.
- HbA1C level of more than 6.5%.
- Two-hour plasma glucose ≥200 mg/dL (11.1 mmol/L) during an oral glucose tolerance test. The test should be performed as advised by the World Health Organization, using a glucose load containing the equivalent of 75-g anhydrous glucose dissolved in water (This is mostly done to diagnose the diabetes of pregnancy).
- A random blood sugar of 200 mg/dL or more in presence of increased thirst, increased hunger, and increased urination.
If the screening test for diabetes is negative but you have risk factors, your doctor will still ask you to repeat the screening after six months or a year. They may order additional tests to confirm whether you have diabetes. To decrease your risk of diabetes, keep your weight, blood pressure, and lipid levels under check. You can achieve this by following a healthy diet and exercising regularly.
If the screening test for diabetes is positive, your doctor may recommend further testing such as kidney function tests, urine tests, cholesterol, and so on. These tests will let the doctor know if you have developed any complications from diabetes.
Depending upon the blood sugar levels, your doctor will devise an appropriate treatment plan for you. If your blood sugar levels are not so high, your doctor may recommend making certain dietary modifications, lifestyle changes, and mild-to-moderate physical activities such as brisk walking, jogging, and cycling. Anti-diabetic medications will be prescribed looking at the changes in blood sugar levels brought about by the lifestyle recommendations.
Who needs screening tests for diabetes?
According to the American Diabetes Association (ADA), everyone who is 45 years and above should be screened for diabetes regularly. This screening is especially important for those who are overweight or obese. ADA recommends repeat screening every three years, but it may be required more frequently in some individuals.
What puts you at a risk of diabetes?
Not everyone ends up developing diabetes. However, various factors increase your risk of diabetes. These include:
- Having a close relative with diabetes
- African Americans
- Hispanic Americans
- Native Americans
- Asian Americans
- Pacific Islanders
- Being overweight
- Lack of physical activity
- History of gestational diabetes
- Increased blood glucose levels in the past
- Hypertension (high blood pressure)
- Abnormal lipids levels (low levels of good or high-density lipoprotein [HDL] cholesterol, high triglycerides)
- Polycystic ovary syndrome (PCOS)
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Pippitt K, et al. Diabetes Mellitus: Screening and Diagnosis. Am Fam Physician. 2016 Jan 15;93(2):103-9.
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