The growing concern with increase in Diabetes
Diabetes is a chronic disease that causes high levels of sugar in the blood. In 2011, about 62.4 million people in India were type 2 diabetic (up from 50.8 million from previous year) and this number is expected to touch around 100 million by 2030, according to the International diabetes Federation and the Madras diabetes research foundation. Diabetes can go undetected without the individual experiencing any symptoms until a complication has already developed. There are two main classifications of diabetes, namely Type 1 and Type 2 diabetes. Type 1 diabetes usually begins during childhood while Type 2 diabetes is more common in adults. There is also another type called gestational diabetes which occurs in pregnant women. Diabetes can be managed through medication, proper diet, and blood sugar level monitoring.
A hormone called insulin is produced in the pancreas and is necessary for blood sugar control. Diabetes can occur as a result of insufficient insulin production or insulin resistance. When food is digested by the body, carbohydrates are broken down into glucose, a simple form of sugar. Glucose serves as the body’s fuel and enters the bloodstream upon digestion. Insulin is needed to move glucose into the cells of the body where it can be utilized for energy. When the pancreas does not produce enough insulin, glucose cannot get into the cells and stay in the bloodstream. The same thing happens when the cells fail to respond to insulin properly.
One of the important aspects of diabetes management is blood sugar level monitoring. Keeping one’s blood sugar within normal range is important to avoid diabetes symptoms and complications such as nerve damage, eye problems, kidney failure, and heart disease. There are several tests that measure the amount of glucose in the blood which can be helpful in the diagnosis and monitoring of diabetes.
Blood Sugar Testing
Blood sugar level monitoring provides information that can be useful for managing diabetes. It helps determine the effects of diabetes medications on your blood sugar and can also help assess how successful you are in reaching the treatment goals. Blood sugar tests can also reveal information on the effects of exercise, diet, or stress on your blood sugar levels.
Blood sugar levels of type 1 diabetes patients are usually tested at least three times per day. This can be done before or after a meal or before and after exercise. Type 1 diabetes patients may also need to check their blood sugar more frequently if there is a new medication being taken. For type 2 diabetes, patients taking insulin as part of their care plan may need to check their blood sugar at least once a day usually before meals or after fasting for 8 hours. For patients who do not take insulin for type 2 diabetes, daily blood sugar testing may not be necessary.
Types of Tests for Blood Sugar
- Random Blood Sugar
Random blood sugar test is done any time and involves numerous measurements throughout the day. Random testing is not used to diagnose diabetes but can indicate if there is an underlying problem since sugar levels in blood should not vary greatly.
- Fasting Blood Sugar
Fasting blood sugar is done to assess for pre-diabetes and diabetes. Blood sugar level is measured after an individual has refrained from eating and drinking (except water) for 8 hours.
- 2-Hour Postprandial Blood Sugar
2-Hour postprandial blood sugar is taken two hours after a meal. In people without diabetes, blood sugar levels should be back to normal by this time. Postprandial blood sugar test is usually done together with the fasting blood sugar to evaluate the body’s ability to metabolize carbohydrates and produce insulin.
- Oral Glucose Tolerance Test
Oral glucose tolerance test involves drinking a sweet drink that contains glucose then blood sugar measurements are taken after 2 hours. It is commonly used in the diagnosis of diabetes in pregnant women which is also known as gestational diabetes and for diagnosing type 2 diabetes.
- Glycated Hemoglobin (HBA1c) Test
HBA1c is a lab test that serves as an indication of the average blood sugar levels in the last 3 months. This is very useful to know if the person’s blood sugar levels have been in control in the preceding months. Sometimes, the current blood sugar level may look normal, but the HBA1c test conclusively proves if the blood sugar levels have remained well within control in the preceding months. Although this test is usually done on diabetes patients to determine the diabetic control of a patient, it is now routinely included even for normal persons to determine how well their blood sugar levels have been in the preceding months. It is commonly done every 3 months and involves a measure of glucose that attaches to red blood cells.
Importance of HBA1c Test
The result of HBA1c test indicates the overall effectiveness of diabetes management. The patient and the doctor usually agree on a target level for the HBA1c, usually between 6.5-7.5%. If the result of HBA1c test is higher than the target level, it may mean that the patient is not adhering to the diabetes management plan or the treatment plan is ineffective and some modifications need to be made.