Friday, April 27, 2012

How does my doctor confirm the diagnosis of diabetes?

Your doctor will perform one of the standard meas- urements  for the diagnosis of diabetes approved by the accepted authoritative body in whichever part of the world you live. In the United States, this is gen- erally  set  by  the  America Diabetes  Association (ADA) and is accepted by most practitioners, insur- ers, and health providers as valid. The  most  current ADA criteria for the diagnosis of diabetes are shown in Table 1 (see Question 9). Your doctor may or may not ask you to fast prior to measuring the blood glu- cose or he or she may perform a standard 2-hour test known as the oral glucose tolerance test. Unless they are clearly and indisputably  abnormal, or accompa- nied by typical symptoms of diabetes  (discussed in Question  4), the  results should be confirmed  on a different day, since the diagnosis of diabetes carries many implications and necessitates lifelong monitor- ing and treatment. Very soon, the test that measures the average blood glucose over the past 3 months (the Hemoglobin  A1c  or  HbA1c  test)  is  also likely to become a standard test for detection and diagnosis of diabetes.

Different diagnostic procedures are used for pregnant women,  most  of whom  should  be screened for the presence of  diabetes  of pregnancy (gestational dia- betes”) during the 24th to 28th week of pregnancy or earlier if they are at high risk or  had diabetes in a previous pregnancy. This involves an initial  1-hour screening test for which fasting is not required. If the  screening  test  is  positive, it  is  followed by  a more detailed 3-hour test for which prior fasting is necessary.

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