- Glycated hemoglobin (A1C) test – this is a blood test that indicates the average blood sugar level for the past two/three months. The test measures the percentage of blood sugar attached to hemoglobin, also called glycated. Hemoglobin is a protein that can be found in red blood cells and it carries oxygen from the lungs to the cells. If your blood sugar levels are high you will have more hemoglobin with glucose attached. A result of 6.5% or more on two repeated tests indicates diabetes. Once you have been diagnosed and treated, this test is particularly useful to understand how well is your treatment working. The American Diabetes Association suggests an A1C of 7%, but a more or less stringent glycemic goals may be appropriate for each individual.
- Fasting blood sugar test – Consists of taking a blood sample after an overnight fast. A fasting blood sugar level between 100 and 125 mg/dL (5.6 and 6.9 mmol/L) is considered prediabetes. If it’s 126 mg/dL (7 mmol/L) or higher on two separate tests, you’ll be diagnosed with diabetes.
- Oral glucose tolerance test – For this test a blood sample is taken after you fast for at least eight hours or overnight. Then you drink a sugary solution and your blood sugar level is measured again after two hours. A blood sugar level less than 140 mg/dL (7.8 mmol/L) is normal. A blood sugar level from 140 to 199 mg/dL (7.8 to 11 mmol/L) is considered pre-diabetes.
Home Blood Glucose Testing
Testing blood glucose level is very important. The point is that even if you feel you know when it is increasing this is not always true. The way you feel is not as accurate as monitoring, and it is reliable only when blood sugar level is very high, therefore you may already be at risk.
Home blood glucose testing is the most accurate way to know the blood glucose level at the moment of the test. The test involves picking the side of your finger with a finger-pricking device and putting a drop of blood on a testing strip. Finally a blood glucose meter will read the strip and give you the result . The frequency of testing and the right tool for you should be decided with your healthcare provider. It is always advisable to keep a diary with the results, in order to keep track and, if need be, adjust the treatment with your doctor.
Urine testing can be done at home with test strips. The test strip should be under a stream of urine for a few seconds. After that the color of the strip will change. This color has to be compared with the instructions of the box of strips. The test measures the percentage of glucose in the urine. The ideal level is 0%. The best moment to make this test is in the morning, before having breakfast. The test could be done even two or three hours after a meal, at this time the blood glucose will be at the highest level.
Urine testing is not as accurate as blood testing, but your doctor may still advise you to take it. Less accuracy is given by the fact that normally there is no glucose in the urine, unless you have already a quite high blood sugar level (10 mmol/l). Therefore it is impossible to understand from the urine if the blood sugar level is too low, which is also really important to know especially if you are taking insulin.
What do the results mean?
Self-monitoring blood sugar level is very beneficial, especially for you as a self-manager. As with any other chronic condition, becoming able to self-manage will be beneficial for many aspects of your health condition. Measuring blood sugar levels can become part of your daily routine, informing you on the best lifestyle and treatment choices. It can as well help you monitor for symptoms of hypoglycemia or hyperglycemia.
Self-monitoring is the key tool for good self-management. Therefore it is important to become able to interpret the results correctly and to make strategic decisions based on them.
You should aim at having a glucose level as close as possible to normal levels, which means the levels of a person who doesn’t have diabetes. These levels are:
- 3.5–5.5mmol/l* before meals
- less than 8mmol/l, 2 hours after meals.
There are different opinions about the what is the ideal range you should aim for. The target should be personalized for the individual and decided on with your healthcare professional.
Here are some indications on target levels. These are not absolute and have just to be considered as a guide.
Children with Type 1 diabetes
- Before meals: 4-8mmol/l
- Two hours after meals: less than 10mmol/l
Adults with Type 1 diabetes
- Before meals: 4- 7mmol/l
- 2 hours after meals: less than 9mmol/l
Type 2 diabetes
- Before meals: 4-7mmol/l
- Two hours after meals: less than 8.5mmol/l
*millimoles per litre: a measurement of the concentration of a substance in a given amount of liquid