Type 1 diabetes is a chronic autoimmune condition in which the pancreas makes very little or no insulin. Without insulin, the amount of glucose in the blood (or, blood sugar) builds up and the levels become too high. Over time, high blood sugar levels can damage the kidneys, eyes, heart, and nerves.
There are different ways to screen for and diagnose type 1
diabetes. Many of these tests involve measuring your body’s blood sugar
levels. Testing is simple and you can expect your results to be available
quickly. Blood sugar tests cannot be used to tell if you type 1 or
type 2 diabetes.
Your treatment
plan will be based on the type of diabetes, so it’s important
for your healthcare provider (usually an endocrinologist, or a doctor who
specializes in the glands of the endocrine system, including the pancreas) to
identify the type. If they suspect type 1 diabetes, you may also undergo an
autoantibody blood test and a ketone blood or urine test. Results from these
two tests will help them confirm a type 1 diabetes diagnosis.
Medical History
Your healthcare provider will take your medical history to learn
about your symptoms and when they started. Type 1 diabetes is diagnosed at any
age, but symptoms tend to present between ages five to around puberty.
Type 1 diabetes tends to run in families, so your healthcare
provider will want to know if you have a family history of the condition.
In addition to blood tests, symptoms are an important part of
the type 1 diabetes diagnosis. Your healthcare provider will ask about your
symptoms and when they first began. Most signs and symptoms of type 1 diabetes
indicate high blood sugar levels (hyperglycemia).
They include:
- Excessive
thirst (polydipsia)
- Needing to
urinate frequently (polyuria)
- Feeling
tired or fatigued
- Losing
weight without trying
- Slowly
healing wounds
Some people experience a delay in getting a type 1 diabetes
diagnosis. As a result, the first symptoms they present with are signs of a
diabetes complication called diabetic
ketoacidosis (DKA). In addition to symptoms of high blood sugar, you
may have DKA symptoms such as:
- Fruity odor
on your breath
- Nausea,
vomiting, or stomach pain
- Rapid
breathing
- Feeling
sluggish
- Trouble
paying attention or feeling confused
DKA is a very serious complication, and can sometimes lead to a
coma. It is a medical emergency, so seek care immediately to prevent
long-lasting damage.
Glucose Blood Test
If your healthcare provider suspects diabetes based on your
symptoms, they will have you take one or
more blood tests to help confirm a diagnosis. There are different types of
glucose blood tests and each serves a specific purpose. A glucose blood test
requires a blood sample, usually taken as a blood drawn from a vein or a finger
stick.
A1C Test
The A1C test (also known as hemoglobin A1C or HbA1c test) is commonly
used to diagnose diabetes. Glucose is a type of sugar your body uses to make
energy. When sugar enters the bloodstream, it attaches to the protein
hemoglobin in red blood cells.
It is normal to have some sugar attached to hemoglobin. However,
people with higher blood sugar levels have more sugar attached to hemoglobin.
An A1C test reveals what percentage of red blood cells have
sugar-coated hemoglobin. Since red blood cells turn over every three months, an
A1C test gives an average measure of glucose levels over the last 90 days.
Results from testing are:
- Normal (no diabetes): Less
than 5.7%
- Prediabetes: 5.7% to 6.4%
- Diabetes: 6.5% or higher
Fasting Blood Sugar Test
A fasting blood sugar test measures your blood sugar after an
overnight fast (not eating). To ensure accurate results, you must not eat or
drink eight hours before the test. Other names for this test include blood
glucose test or fasting blood glucose.
The purpose of a fasting blood sugar test is to see if your
blood sugar levels are within a healthy range. If needed, the test may be
repeated to confirm a diabetes diagnosis. Results from testing are:
- Normal
(no diabetes): 99 milligrams per deciliter (mg/dL) or
lower
- Prediabetes: 100 to 125
mg/dL
- Diabetes: 126
mg/dL or higher
Random Blood Sugar Test
A random blood sugar test measures your blood sugar at the time
you’re tested. This blood test can be taken at any time. You do not need to
fast (not eat) before having your blood drawn. A blood sugar level of 200 mg/dL
or higher indicates a diabetes diagnosis.
Ketone Test
When our body can’t get the glucose it needs to make energy, the
body begins to burn fat instead. The liver converts fat into energy at an
extremely fast rate, producing ketones during the process. When ketones are
released into the blood too quickly, it makes the blood acidic.
This condition is known as diabetic ketoacidosis. Diabetic
ketoacidosis is most common in people living with type 1 diabetes. It can
develop in people with type 2 diabetes but is less common and less severe.
A ketone test is done using a urine or blood sample. This test
detects the levels of ketone bodies produced through ketoacidosis.
Autoantibody Testing
Glucose blood tests are used to confirm a diabetes diagnosis,
but they aren’t helpful in identifying what type of diabetes you may have. Once
your glucose test results indicate diabetes, your healthcare provider may order
antibody testing that is specific to type 1 diabetes.
With type 1 diabetes, the immune system attacks and destroys
healthy insulin-producing beta cells in the pancreas. As
this is happening, the body produces pancreatic autoantibodies.
These antibodies are proteins created by our immune system. They
indicate that the immune system has started to destroy beta cells. Pancreatic
autoantibodies are present in type 1 diabetes, but not in type 2 diabetes.
Results from autoantibody and glucose tests, along with your
symptoms, help your healthcare provider form a type 1 diabetes diagnosis.
A Quick Review
Identifying symptoms is an important first step when seeking a
type 1 diabetes diagnosis. Symptoms
of type 1 diabetes include excessive thirst, frequent urination, and losing
weight without trying.
Based on these symptoms, your healthcare provider will order
glucose blood tests such as A1C, fasting blood sugar, or random blood sugar.
Repeat testing may be needed.
Blood sugar tests do not indicate what type of diabetes a person
is living with. Your healthcare provider may order additional tests that are
specific to type 1 diabetes. This may include a ketone urine or blood test or
an autoantibody test.
If you notice symptoms of type 1 diabetes in yourself or your
child, it’s a good idea to get tested. Keep a list of symptoms and share them
with your healthcare provider. An early diagnosis can help you get started on a
treatment plan that works best for you and your lifestyle.
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