Type 2 Diabetes Fasting Glucose

The Risks Of Intermittent Fasting

Low blood sugar, a.k.a. hypoglycemia, can cause a rapid heart rate, sweating, shakiness, and other symptoms. If severe, it can induce weakness, seizures, or even death. People with Type 2 diabetes are at increased risk for hypoglycemiaespecially if they go long periods without eatingand this was one of the first dangers experts looked at when assessing the safety of intermittent fasting. If you are taking medications that are aimed at reducing the amount of glucose in your blood, together with fasting these can cause potentially fatal hypoglycemia, Horne says. Its not a minor safety risk.

For people who arent taking drugs to lower their blood sugar, Horne says the risk of hypoglycemia seems to be very low. People should still consult with someone who treats diabetesa physician such as an endocrinologist, or at least a nutritionist who is trained in diabetes treatment, he says. Like Corley, he says even people on blood-sugar medications could attempt intermittent fasting so long as they are working with an expert. Its not so much should they or shouldnt they. Its more the degree to which they should be monitored, he says.

Aside from hypoglycemia, a second major concern is dehydration. High blood glucose causes general dehydration in the body, and people with Type 2 diabetes are already at elevated risk. Intermittent fasting may further increase these risks if people are drinking or eating less than they normally would.

Key Messages For People With Diabetes

• Try to keep your blood glucose as close to your target range as possible. This will help to delay or prevent complications of diabetes.
• Target ranges for blood glucose and A1C can vary and depend on a persons medical conditions and other risk factors. Work with your diabetes health-care team to determine your target A1C and blood glucose target range .

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What Is The A1c Test

The A1C test is a simple blood test that measures your average blood sugar levels over the past 2 or 3 months. The test is done at a lab or your doctors office in addition tonot instead ofregular blood sugar testing you do yourself.

A1C testing is part of the ABCs of diabetesimportant steps you can take to prevent or delay health complications down the road:

• A: Get a regular A1C test.
• B: Try to keep your blood pressure below 140/90 mm Hg .
• C: Manage your cholesterol levels.
• s: Stop smoking or dont start.

The A1C goal for most adults with diabetes is between 7% and 8%, but your goal may be different depending on your age, other health conditions, medicines youre taking, and other factors. Work with your doctor to establish a personal A1C goal for you.

Tips For Intermittent Fasting When You Have Diabetes

If you have diabetes and are thinking of trying intermittent fasting, here are some tips:

• Talk with your healthcare provider about adjusting medication or insulin dosages. You may need to change your diabetes treatment when trying a diet that could affect your blood sugar levels.
• Monitor your blood sugar levels. Long periods without eating can cause blood sugar to go too low, so check you glucose levels often.
• Check in on your mood. Many people find that restricting food intake can really affect their mood. Watch for signs like irritability, increased anxiety, and difficulty coping with stress.
• Monitor energy levels. Fasting can make you feel fatigued something you might want to keep in mind if youre driving or operating equipment.
• Balance your carbohydrates. Your body breaks down carbohydrates into glucose, which can lead to a spike in blood sugar. When youre not fasting, try to balance starchy carbohydrates in your meals with vegetables and protein to avoid high blood sugar.

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Testing For Type 2 Diabetes And Prediabetes In Asymptomatic Adults

Prediabetes and type 2 diabetes meet criteria for conditions in which early detection is appropriate. Both conditions are common and impose significant clinical and public health burdens. There is often a long presymptomatic phase before the diagnosis of type 2 diabetes. Simple tests to detect preclinical disease are readily available. The duration of glycemic burden is a strong predictor of adverse outcomes. There are effective interventions that prevent progression from prediabetes to diabetes and reduce the risk of diabetes complications .

Approximately one-quarter of people with diabetes in the U.S. and nearly half of Asian and Hispanic Americans with diabetes are undiagnosed . Although screening of asymptomatic individuals to identify those with prediabetes or diabetes might seem reasonable, rigorous clinical trials to prove the effectiveness of such screening have not been conducted and are unlikely to occur.

Additional considerations regarding testing for type 2 diabetes and prediabetes in asymptomatic patients include the following:

Age

Testing recommendations for diabetes in asymptomatic adults are listed in . Age is a major risk factor for diabetes. Testing should begin at age 45 years for all patients.

BMI and Ethnicity

Medications

Certain medications, such as glucocorticoids, thiazide diuretics, and atypical antipsychotics , are known to increase the risk of diabetes and should be considered when ascertaining a diagnosis.

Diagnostic Tests

Testing Interval

Diagnostic Tests For Diabetes

Diabetes may be diagnosed based on the plasma glucose criteria, either the fasting plasma glucose or the 2-h plasma glucose value after a 75-g oral glucose tolerance test or the A1C criteria .

Criteria for the diagnosis of diabetes

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Testing For Type 2 Diabetes And Prediabetes In Children And Adolescents

In the last decade, the incidence and prevalence of type 2 diabetes in adolescents has increased dramatically, especially in ethnic populations . Recent studies question the validity of A1C in the pediatric population, especially among certain ethnicities, and suggest OGTT or FPG as more suitable diagnostic tests . However, many of these studies do not recognize that diabetes diagnostic criteria are based on long-term health outcomes, and validations are not currently available in the pediatric population . The ADA acknowledges the limited data supporting A1C for diagnosing type 2 diabetes in children and adolescents. Although A1C is not recommended for diagnosis of diabetes in children with cystic fibrosis or symptoms suggestive of acute onset of type 1 diabetes and only A1C assays without interference are appropriate for children with hemoglobinopathies, the ADA continues to recommend A1C for diagnosis of type 2 diabetes in this cohort . The modified recommendations of the ADA consensus report Type 2 Diabetes in Children and Adolescents are summarized in .

Why The Test Is Performed

Your doctor may order this test if you have signs of diabetes . More than likely, the doctor will order a fasting blood sugar test.

The blood glucose test is also used to monitor people who already have diabetes.

The test may also be done if you have:

• An increase in how often you need to urinate
• Recently gained a lot of weight

SCREENING FOR DIABETES

This test may also be used to screen a person for diabetes.

High blood sugar and diabetes may not cause symptoms in the early stages. A fasting blood sugar test is almost always done to screen for diabetes.

If you are over age 45, you should be tested every 3 years.

If you’re overweight and have any of the risk factors below, ask your health care provider about getting tested at an earlier age and more often:

• High blood sugar level on a previous test
• Blood pressure of 140/90 mm Hg or higher, or unhealthy cholesterol levels
• History of heart disease
• Member of a high-risk ethnic group
• Woman who has been diagnosed with gestational diabetes
• Polycystic ovary disease
• Close relative with diabetes
• Not physically active

Children age 10 and older who are overweight and have at least two of the risk factors listed above should be tested for type 2 diabetes every 3 years, even if they have no symptoms.

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How Does Blood Glucose Work

Blood sugar, or glucose, is the main sugar found in your blood. When you eat or drink, your body breaks down carbohydrates in the food or liquid into sugar for energy.

Then your pancreas produces a hormone called insulin, which helps blood sugar enter your bodys cells. It also helps your body store blood sugar for later use. As the cells use the blood sugar, glucose and insulin levels in the blood decrease.

But with diabetes, your body has trouble regulating glucose. Either your pancreas doesnt make enough insulin, or your body doesnt process insulin effectively. Therefore, the amount of sugar in your blood is higher than normal. And a lot of glucose in your blood is bad for your body.

A fasting blood glucose test measures the amount of glucose in your blood when it should be at its lowest. That happens in the morning and when you havent had anything to eat or drink for a while.

Recommended Target Blood Glucose Level Ranges

The NICE recommended target blood glucose levels are stated below for adults with type 1 diabetes, type 2 diabetes and children with type 1 diabetes.

In addition, the International Diabetes Federations target ranges for people without diabetes is stated.

The table provides general guidance. An individual target set by your healthcare team is the one you should aim for.

*The non-diabetic figures are provided for information but are not part of NICE guidelines.

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How To Pick The Right Type 2 Diabetes Diet

A diabetic diet need not be bland, boring or considered a punishment. Let us look at how you can pick the right diet that you will enjoy eating while still maintaining blood glucose levels. Irrespective of which diet you choose, there are a few pointers that should be followed:

• The right diet for you should be easy to follow, thus ensuring that you will stick to it for a long time.
• It should be a well-balanced plate of food, ensuring that all nutritional needs are met.

What Is Diabetic Ketoacidosis

If you think you may have low blood sugar, check it even if you dont have symptoms.

When too many ketones are produced too fast, they can build up in your body and cause diabetic ketoacidosis, or DKA. DKA is very serious and can cause a coma or even death. Common symptoms of DKA include:

• Fast, deep breathing.
• Nausea and vomiting.

If you think you may have DKA, test your urine for ketones. Follow the test kit directions, checking the color of the test strip against the color chart in the kit to see your ketone level. If your ketones are high, . DKA requires treatment in a hospital.

DKA happens most in people with type 1 diabetes and is sometimes the first sign of type 1 in people who havent yet been diagnosed. People with type 2 diabetes can also develop DKA, but its less common.

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Blood Sugar Chart: Summary

The fasting blood sugar, 2-hour post-meal blood sugar, and HbA1C tests are important ways to diagnose prediabetes and diabetes, as well as indicate how well a persons diabetes is being managed. If you think you have diabetes, its important to not try and diagnose yourself by doing a finger-stick with a home blood glucose meter. There are strict standards and procedures that laboratories use for diagnosing diabetes therefore, you should get tested at your doctors office or at a laboratory.

Its also important to talk with your doctor to make sure you understand a) how often you should have certain tests, such as a fasting blood glucose or HbA1C test b) what your results mean and c) what your blood sugar and HbA1C targets are.

If you have not been previously diagnosed with prediabetes or diabetes but your results are above normal, your doctor may recommend other tests and should discuss a plan of treatment with you. Treatment may include lifestyle changes, such as weight loss, a healthy eating plan, and regular physical activity. You may need to start taking diabetes medications, including insulin. If you are diagnosed with diabetes, its recommended that you learn how to check your blood sugars with a meter so that you and your health care team can determine how your treatment plan is working for you.

Fasting Blood Sugar Test

A fasting blood sugar test provides a snapshot of your blood sugar level before you have eaten. The doctor measures the amount of sugar in your blood after youve fasted for at least eight hoursusually overnight.

A fasting blood sugar level of 100 to 125 milligrams per deciliter indicates that you have prediabetes. A blood sugar level of 126 milligrams per deciliter or higher on two separate tests means you have diabetes.

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The Oral Glucose Tolerance Test For Diabetes

The oral glucose tolerance test is yet another method used to detect diabetes, but it is usually only done during pregnancy to diagnose gestational diabetes or for someone who is suspected of having type 2 diabetes yet has a normal fasting glucose level. It can also be performed to diagnose prediabetes.

The Casual Plasma Glucose Test For Diabetes

The casual plasma glucose test is another method of diagnosing diabetes. During the test, blood sugar is tested without regard to the time since the person’s last meal. You are not required to abstain from eating prior to the test.

A glucose level greater than 200 mg/dL may indicate diabetes, especially if the test is repeated at a later time and shows similar results.

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Living With Type 1 Diabetes:

Life with type 1 diabetes poses lifelong challenges for every member of the family.

People with type 1 diabetes should:

• Test blood glucose levels three or more times per day and adjust their insulin through injections or an insulin pump.
• Ensure insulin doses are balanced with food intake and level of daily activity. People with type 1 diabetes may experience low and high blood sugar levels, which should be carefully monitored and managed.

While living with type 1 diabetes requires a certain amount of daily structure, newer pumps and insulin products have provided more flexibility in the management of this condition.

A healthcare provider can provide advice to help properly manage blood glucose levels.

Classification And Diagnosis Of Diabetes

American Diabetes Association 2. Classification and Diagnosis of Diabetes. Diabetes Care 1 January 2016 39 : S13S22.

Diabetes can be classified into the following general categories:

This section reviews most common forms of diabetes but is not comprehensive. For additional information, see the American Diabetes Association position statement Diagnosis and Classification of Diabetes Mellitus .

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