What is the type 2 diabetes diagnosis criteria?
The American Diabetes Association (ADA) has established the following diagnostic criteria for type 2 diabetes diagnosis and treatment.
- A fasting plasma glucose (FPG) level of 126 mg/dL (7.0 mmol/L) or higher, or
- A 75-g oral glucose tolerance test (OGTT) with a 2-hour plasma glucose level of 200 mg/dL (11.1 mmol/L) or above, or
- A random plasma glucose of 200 mg/dL (11.1 mmol/L) or higher in a patient with classic symptoms of hyperglycemia or hyperglycemic crisis, or
- A HbA1c test level of 6.5% (48 mmol/mol) or higher.
How is a type 2 diabetes diagnosis made?
Type 2 diabetes is diagnosed with specific blood tests. A glycated haemoglobin (A1C) test indicates your average blood sugar level for the past two to three months. The results interpretation is as follows:
- Below 5.7% is normal.
- 5.7% to 6.4% are diagnosed with prediabetes.
- 6.5% or higher on two repeat tests indicates diabetes.
If the HbA1c test isn’t available, or if you have certain conditions that interfere with an HbA1c test, your health care provider may use the following tests to diagnose diabetes:
Random blood sugar test: Regardless of when you last ate, a level of 200 mg/dL (11.1 mmol/L) or higher suggests diabetes and is clinically correlated. The units of measurement for blood sugar are millimoles of sugar per litre (mmol/L) or milligrammes of sugar per decilitre (mg/dL).
Fasting blood sugar test: You fast for the entire night before having a blood sample obtained. The findings are interpreted in this way:
- Less than 100 mg/dL (5.6 mmol/L) is considered healthy.
- 100 to 125 mg/dL (5.6 to 6.9 mmol/L) shows prediabetes.
- 126 mg/dL (7 mmol/L) or higher on two repeat tests is diagnosed as diabetes.
Oral glucose tolerance test: With the exception of pregnancy, this test is not as frequently used as the others. You’ll need to fast for about eight hours and then drink a sugary liquid. Blood sugar levels are then tested periodically for two hours. The results are interpreted as follows:
- Less than 140 mg/dL (7.8 mmol/L) after two hours is considered healthy.
- 140 to 199 mg/dL (7.8 mmol/L and 11.0 mmol/L) means prediabetes.
- 200 mg/dL (11.1 mmol/L) or higher after two hours confirms diabetes.
What are the symptoms of type 2 diabetes?
Symptoms of type 2 diabetes often develop slowly. It is possible to have type 2 diabetes for years without realising it. If symptoms are evident, they could include increased thirst, frequent urination, increased hunger, unintended weight loss, fatigue, blurred vision, slow-healing sores, frequent infections, tingling or numbness in the hands or feet, as well as darker skin patches, typically on the neck and armpits.
Are there any medications to treat type 2 diabetes?
Yes, there are several classes of oral medications that may be prescribed to manage blood sugar levels in type 2 diabetes. These include metformin, sulfonylureas, meglitinides, thiazolidinediones, DPP-4 inhibitors, SGLT2 inhibitors, and GLP-1 receptor agonists. The choice of medication depends on various factors, such as the patient’s overall health, kidney function, and, most importantly, the discernment of the treating physician.
Some people with type 2 diabetes may eventually require insulin therapy. This, in case, oral medications are not sufficient to control blood sugar levels. Insulin can be administered through injections or insulin pumps, and the dosage regimen is tailored to individual needs.
Education about diabetes management, including self-care practices, nutrition, exercise, medication adherence, and monitoring, is crucial for patients and their families. Support from healthcare providers, diabetes educators, dietitians, and support groups can help individuals navigate the challenges of living with diabetes and stay motivated to manage their condition effectively.
What preventive measures can be taken to manage type 2 diabetes?
Type 2 diabetes diagnosis and treatment includes a combination of lifestyle changes and medication. In fact, you may be able to reach your target blood sugar levels with diet and exercise alone.
Weight loss by dropping extra kilos can help. While losing 5% of your body weight is good, losing at least 7% and keeping it off seems to be ideal. Though weight loss can seem overwhelming, portion control and eating healthy foods are a good place to start. A registered dietitian can educate you about carbs and help you make a meal plan and portion size you can stick with. The focus is more on eating fewer calories, cutting back on refined carbs, especially sweets, and adding veggies and fruits to your diet to get more fibre.
Exercise for 30 to 60 minutes every day. Any exercise that increases heart rate, such as riding, walking, or swimming, is suitable. Combine that with weightlifting or yoga for strength training. Food may be necessary before an exercise session if you take medicine that decreases blood sugar.
Depending on your treatment plan, especially if you’re on insulin, your doctor will tell you if you need to test your blood sugar levels and how often to do it. Periodic monitoring of other parameters such as blood pressure, cholesterol levels, kidney function, and eye health is also important. This is to prevent or detect complications associated with diabetes.
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