Why get a diabetes screening? We’ll give you five good reasons—namely, elevated risk of heart attack, stroke, blindness, kidney failure, and loss of limb. Diabetes is hitting the U.S. harder than ever, with nearly 10 percent of Americans dealing with its symptoms and risks. And an estimated one in three U.S. adults has prediabetes, meaning they have an increased chance of developing diabetes over the next five years.
A diabetes screening is really just a simple tool to see what your current risk looks like. And that’s important, because one in four people who has diabetes doesn’t even know it.
Here’s what you need to know about what diabetes is, what your risk factors might be, and how to get tested:
The Difference Between Type 1 and Type 2
You may have heard about different types of diabetes. Type 1 diabetes is an autoimmune disease in which the pancreas stops producing insulin—a hormone that regulates glucose (blood sugar). Type 1 can begin in childhood or adulthood. Type 1 is manageable with lifestyle changes and therapies, but once Type 1 diabetes is underway, it’s rare for the pancreas to start making insulin again.
Type 2 diabetes, on the other hand, is a progressive disease in which gradually higher insulin resistance causes higher-than-normal glucose—and type 2 diabetes can be prevented, slowed, and even reversed, depending on the individual and the state of the disease. People with prediabetes are at risk of developing type 2 diabetes but might still avoid it through lifestyle changes—such as healthy eating and increased physical activity.
Diabetes Risk Factors
Since the symptoms of type 2 diabetes come on gradually, the American Diabetes Association advises that any person with any of the following risk factors get a diabetes screening:
- Anyone with a body mass index (BMI) of 25 or higher (23 for Asian Americans), regardless of age, who has additional risk factors should have an initial blood screening, and then follow up based on the results. Additional risk factors may include: high blood pressure, abnormal cholesterol levels, a sedentary lifestyle, or a history of heart disease; women with a history of polycystic ovary disease; and those having a close relative with diabetes.
- Anyone older than age 45 should get an initial blood screening and, if the results are normal, follow up every three years.
- Any woman who has had gestational diabetes (a high blood sugar complication during pregnancy) should be screened every three years.
- Anyone who has been diagnosed with prediabetes should get a screening once a year.
Types of Diabetes Screenings
The simplest type of diabetes screening, an A1C test, measures your average blood sugar level, relative to the hemoglobin in your red blood cells, over the past two to three months. There’s no fasting required. A result above 6.5% indicates diabetes, 5.7% to 6.5% indicates prediabetes, and below 5.7% is considered normal.
The A1C test can’t account for fluctuations in your blood sugar levels or may not be reliable for other reasons. In such cases, your doctor may recommend a fasting blood sugar test, a random blood sugar test, or a glucose tolerance test for more reliable results.
If your glucose indicates diabetes or prediabetes, your doctor will advise you about lifestyle changes and treatments that can reduce further risk or help slow the onset.