Type 2 Diabetes

Diagnosis

To diagnose diabetes, your doctor will take your medical history and conduct a physical examination. Your doctor will check your height, weight, and blood pressure, and will look for evidence of nerve damage. Your doctor will also do an eye exam to look for a complication that results when blood vessels supplying the retina are damaged (retinopathy). The doctor will also examine your mouth, heart, skin, and feet (people with diabetes sometimes lose sensation in their feet, and may not notice sores that have been caused by trauma).

Your doctor will run blood tests to confirm a diagnosis of diabetes. Your blood sugar level will help determine whether or not you have diabetes.Your doctor may do a random blood test, or may ask you to fast before coming to your appointment. A glucose concentration of 200 mg/dL or above with symptoms of diabetes on a random sample and one of 126 mg/dL or above on a fasting sample reveals diabetes. If your fasting level falls between 110 and 125 mg/dL, your doctor may wish to do another test (glucose tolerance test), which involves drinking a 75-g glucose solution and having your blood collected at one and two hours. At 2 hours, a glucose concentration of 200 mg/dL or higher is diagnostic of diabetes. If you have a fasting blood glucose between 110 and 125, you are considered to have impaired fasting glucose (IFG). If you have a two-hour value on a glucose tolerance test between 140 and 199 mg/dL, you are considered to have impaired glucose tolerance (IGT). Both IFG and IGT are risk factors for future diabetes and cardiovascular disease.

Your doctor may also do a blood test called the hemoglobin A1C test (also referred to as glycohemoglobin or glycosylated hemoglobin test). This is a measure of blood sugar control over time (the preceding three months), and is the standard for predicting the risk of developing long-term complications. According to the American Diabetes Association, a hemoglobin A1C level of <7% in diabetics is the target value for blood sugar control.

Prevention and Screening

You should be screened for type 2 diabetes every three years starting at age 45. If you are younger than 45 but have risk factors for diabetes, you should be screened more frequently.

Get regular exercise. Research is showing that exercise appears to lower your chance of getting diabetes. In one study, middle-aged men who did at least 40 minutes of brisk walking daily, slow swimming, bicycling, or other moderate-intensity physical activity had half the risk for developing Type 2 diabetes than did men who exercised less. If you have a family history of diabetes, the benefits of exercise for preventing diabetes are even greater. Regular exercise also helps to control weight and blood lipid (fat) levels.

Pay close attention to your diet, and lose weight if you are overweight [Figure 2]. Leading a sedentary lifestyle and eating a nutrient-poor diet high in sugar, calories, and fat contributes to obesity, which is a major risk factor for diabetes. Getting exercise and eating a balanced diet can help you lose weight and prevent diabetes.

Figure 2. Body mass index (BMI)

Your body mass index determines whether or not you are at a healthy weight for your height.

A BMI between 18.5 and 25 is considered to be normal. Anything between 25 and 30 is considered to be overweight. A BMI over 30 indicates obesity. In Asian-Americans a BMI of 18.5 to 23 is considered normal, and 23 to 30 is considered overweight