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Diagnosing Diabetes
Pre-diabetes
Impaired Fasting Glucose (IFG)
Impaired Fasting Glucose is a pre-diabetes condition diagnosed when the fasting* blood glucose level is higher than the normal or non-diabetic range, but not high enough to be diagnosed as Type 2 diabetes.
Impaired Glucose Tolerance (IGT)
Impaired Glucose Tolerance is a pre-diabetes condition in which blood glucose levels are higher than normal after an oral glucose tolerance test. It is diagnosed when the blood glucose rises abnormally after having a sweet glucose drink, but not high enough to be diagnosed as Type 2 diabetes.
* ‘Fasting’ means having nothing to eat for 8 hours before the test.
Type 1 Diabetes
For children thought to have Type 1 diabetes the doctor will ‘dip-stick’ test the urine. If the child has Type 1 diabetes the test will show large amounts of sugar and ketones (the waste product passed out of the body after the body has been using fat and muscle for energy, not glucose). A blood test will confirm the high blood glucose (sugar). A a glucose tolerance test is not necessary and may be dangerous if the blood glucose is already very high. Other tests are also usually done to check for other conditions that occur more frequently in people with type 1 diabetes.
Type 1 diabetes in older adults may take longer to reveal itself. This means it may be misdiagnosed as Type 2 diabetes. A person who has a high blood sugar level in the diabetes range yet does not have a family history of Type 2 diabetes, is lean, and for whom changes in lifestyle and/or taking tablets for diabetes does not bring blood glucose levels down, should be checked for Type 1 diabetes. In adults this will mean taking blood to check for certain proteins in the blood, which if present indicate an autoimmune process in the pancreas which will lead to the pancreas not producing insulin.
Type 2 Diabetes
The diagnosis of Type 2 diabetes is made in one of the following three ways:
- Symptoms of diabetes and a non-fasting blood glucose level of 11 mmol/l or higher
- A blood glucose level, taken after fasting for 8 hours of 7.0 mmol/l or more. The test should be repeated on a second occasion to confirm the diagnosis.
- A 2-hour blood glucose level of 11 mmol/l or more taken during an oral glucose tolerance test (OGTT)
Gestational Diabetes
Most women are diagnosed with Gestational Diabetes after a special test where they have a sweet drink, with a blood test taken afterwards.
There are two tests. One is only a screening test used to determine which women are more likely to have high blood glucose. It is called a Glucose Challenge Test (GCT), where blood is taken for a glucose measurement one hour after having a sweet drink.
The other is an Oral Glucose Tolerance Test (OGTT), which is a diagnostic test, in which a blood sample is taken before and two hours after the sweet drink. A diagnosis of diabetes is based on the results of the OGTT. These tests are performed when the woman is about 6 months pregnant.