Getting tested for, monitoring and managing Diabetes

Getting tested for Diabetes is a process. The same goes for monitoring it after diagnosis.

Testing and monitoring your blood sugar levels.

Finding out you’re Diabetic is a journey. Diabetes presents itself in different ways, but once you’re diagnosed, it’s critical to regularly monitor your blood sugar levels. This article focuses on how to tell if you need to be tested for Diabetes, what to expect from Diabetes tests and then how to monitor your condition and effectively manage it as you progress through life.

How to tell if you need a Diabetes test:

Diabetes symptoms tend to appear over time, the length of which depends on the type and severity of each person’s situation. If you experience any of these symptoms, we encourage you to get tested for Diabetes by your doctor, nurse or clinic team:

  • Excessive thirst over a prolonged period
  • Need to urinate frequently
  • Significant weight loss or gain
  • Regular fatigue and irritability
  • Wounds, cuts, and boils take a long time to heal
  • Blurred vision
  • Tingling sensations in your hands and feet.

How to test for Diabetes?

To confirm you are Diabetic, your doctor or clinic sister will conduct a series of blood sugar/blood glucose tests. These may include:

  • A random blood sugar/glucose test.
  • A fasting blood sugar/glucose test, where you’ll need to fast for 8 to 12 hours before having blood taken. This means you won’t be able to eat for between 8 to 12 hours before you have your blood taken.
  • An oral glucose tolerance test, whereby you fast for 8 to 12 hours, and then drink a sugary liquid.
  • A glycated haemoglobin (HbA1c) test, that measures your blood sugar/glucose level over the past few months.

What are Blood Glucose Levels?

Your blood glucose level is the amount of glucose molecules in your blood. It indicates how well your body processes sugar, and can be affected by various factors. These factors include activity levels, stress, types of food, infection and/or illness.

Your portion sizes and how much time you leave between your meals also impact your blood glucose levels. Usually, the lowest reading is observed after overnight fasting or if you haven’t eaten in at least eight hours. The highest reading is normally observed within an hour of eating foods high in carbohydrate concentration (eg. potatoes, chocolate, bread, rice, pasta).

How a blood glucose test works:

Blood glucose levels are measured in two ways: molar concentrations, measured in mmol/L (millimoles per litre) and mass concentration which is measured in mg/dL (milligrams per decilitre).In South Africa, we measure blood glucose levels in millimoles per litre (mmol/l). The normal range for non-Diabetic people is 4-6 mmol/l.

You’re considered to be Diabetic if your fasted blood glucose (before eating breakfast) is over 7 mmol/l, or your non-fasted level is over 11 mmol/l. This test is useful for managing daily nutritional intake, and is highly recommended for Diabetics using insulin.

What is HbA1c?

HbA1c is the measure of the percentage of haemoglobin attached to red blood cells that have glucose bound to them. It’s an average measurement of blood glucose over two to three months.

Haemoglobin binds and transports oxygen in red blood cells. Depending on how high or low your blood glucose level is, more or less glucose is bound to the haemoglobin during the red blood cells’ lifespan.

How often should you check your HbA1c level?

Monitored at regular intervals, your HbA1c reading summarises how effective your overall effort is, in managing your Diabetes. It also acts as an early warning sign of potential complications related to Diabetes. Your doctor, nurse or clinician will likely recommend you test your HbA1c every three to six months.

If your HbA1c level is elevated, your medical practitioner will advise you on a course of action to address this. Your HbA1c level may be monitored more closely thereafter, even monthly, to assess the efficacy of the adjusted treatment plan. You should aim to keep your HbA1c levels below 8%.

The following HbA1c level guideline is taken from the South African Diabetes Association’s suggestions:

  • 4 – 6% Non-Diabetic range.
  • < 7% Well-controlled Diabetic.
  • 7% – 8% Acceptable Diabetic control.
  • > 8% Poor diabetic control; needs attention.

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The difference between HbA1c and blood glucose:

Blood glucose is the amount of glucose in your blood at any one point in time, determined through a blood glucose test. HbA1c refers to how much glucose has bonded to your red blood cells over several months, and is determined through a more comprehensive HbA1c blood test. Although these two tests are similar, they are carried out for different reasons. To confirm your diagnosis as Diabetic, your doctor or clinic team will have to conduct an HbA1c test.

Your HbA1c test results are the most accurate indicator regarding Diabetes and provide an early warning of potential future complications.

How to monitor your own blood glucose levels:

You can monitor and record your blood glucose levels at home, or visit a clinic to have them taken. To measure your glucose, you’ll need to obtain a small drop of blood. This is then placed onto a blood glucose strip to be tested.

Your doctor, nurse or clinic team will advise you what levels to aim for, but it’s generally accepted that keeping your blood glucose levels between 4-8mmol/l will greatly reduce your risk of Diabetic complications.

Why is it important to monitor blood glucose levels?

If not effectively managed, your blood glucose levels can result in hyperglycaemia or hypoglycaemia. Both conditions can damage different parts of your body if not swiftly attended to, and nobody wants to be in this position.

What is hypoglycaemia?

Hypoglycemia occurs when Diabetics over-control their medication or do not eat for extended periods of time. It’s a condition in which blood glucose levels drop too low (generally below 3.5mmol/l).
Symptoms include:

  • Irritability
  • Numbness in the arms and hands
  • Sweating
  • Confusion
  • Extreme hunger
  • Shakiness or dizziness.

It should be treated immediately, by eating or drinking a simple sugar. A simple sugar could be a glucose sweet, or a sugary cold drink. You’ll need to follow that up with a sandwich or other form of carbohydrate. If left untreated, Hypoglycaemia can become severe and lead to unconsciousness.

What is hyperglycaemia?

Hyperglycaemia, the converse of hypoglycaemia, occurs when food, activity and insulin and/or other medication are not balanced. High blood glucose may happen when you’re ill, pregnant or under stress.

Symptoms include:

  • Thirst and/or dry mouth
  • Glucose in the urine
  • Large urine volumes and more frequent urination
  • Weakness and lethargy
  • Blurred vision
  • Weight loss

Best ways to monitor and manage Diabetes:

Depending on the Type and the intensity of your Diabetes, your doctor, nurse or clinic team may recommend a schedule for you to self-check your blood glucose levels. Because everyone’s body is different, it’s important that you speak to your consulting doctor, nurse or clinic team if you have any questions about which machine or testing strips to use, or where to draw your drop of blood from when you self-test.

There are more ways through which you can effectively manage your Diabetes:

  • Adjust your eating and drinking habits
  • Manage your stress levels from day to day
  • Seek laughter more often
  • Get enough sleep, regularly
  • Move more – even casual strolls count
  • Learn more about Diabetes, and ask your doctor, nurse or clinic team about your body in particular

Sources:

Cunha, JP. 2019. Diabetes early symptoms and signs. MedicineNet. 7 August. Available at: https://www.medicinenet.com/diabetes_symptoms_in_men/article.htm [Accessed 9 September 2019].

Galan, N. 2018. What are the early signs of type 2 diabetes?. 26 September. Available at: https://www.medicalnewstoday.com/articles/323185.php [Accessed 9 September 2019].

Mayoclinic. 2019. Diabetes Diagnosis. Available at: https://www.mayoclinic.org/diseases-conditions/diabetes/diagnosis-treatment/drc-20371451 [Accessed 9 September 2019].

MedicalNewsToday. 2019. Diet And Insulin Resistance: Foods To Eat And Diet Tips. Available at: https://www.medicalnewstoday.com/articles/316569.php [Accessed 9 September 2019].

NHSInform. 2019. Diabetes. 1 August. Available at: https://www.nhsinform.scot/illnesses-and-conditions/diabetes/diabetes [Accessed 9 September 2019].

Volpe, Kd. 2017. Who should be tested for diabetes, and how is diabetes diagnosed?. EndocrineWeb. Available at: https://www.endocrineweb.com/conditions/diabetes/who-should-be-tested-diabetes-how-diabetes-diagnosed [Accessed 9 September 2019].

WebMD. 2019. Early Signs and Symptoms of Diabetes. Available at: https://www.webmd.com/diabetes/guide/understanding-diabetes-symptoms#1 [Accessed 9 September 2019].

We all have questions.

Below are some of the answers to the most common questions that you need to know.

Which is worse – Type 1 or Type 2 Diabetes?

“Worse” is a harsh comparison. The difference between these two types of Diabetes is that Type 1 requires insulin, and it never goes away. Type 2 requires consistent effort and can be managed over your lifetime.

What is the normal HbA1C level?

It is generally accepted that you should maintain HbA1C below 8%. The following guidelines are suggested by the South African Diabetes Association:

 

  • 4 – 6% Non-Diabetic range. 
  • < 7% Well-controlled Diabetic 7% – 8% Acceptable Diabetic control > 8% 
  • Poor Diabetic control needs attention.

What is the main cause of Diabetes?

Diabetes (Type 1) is usually a predisposed or genetically inherited condition. Diabetes (Type 2) is caused by lifestyle choices. Gestational Diabetes can be caused by either genetics or lifestyle choices.

What are the first signs of Diabetes?

  • Excessive thirst over a prolonged period.
  • Increased frequency in the need to urinate.
  • Significant weight loss or gain.
  • You find yourself fatigued, tired, and irritable, on a regular basis.
  • Open or ruptured wounds take a long time to heal.
  • Blurred vision.
  • Tingling sensations in your hands and feet.

Can you get life insurance if you have Diabetes?

Yes. AllLife can help you get up to R10million life insurance, as either a Type 1 or Type 2 Diabetic.

Can I test myself for Diabetes?

Although you can easily test your own blood glucose levels at any time, only your doctor, nurse, or clinic team can confirm a Diabetes diagnosis. This is because a series of specific tests are required for diagnosis.

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