How to test at home? - frustrated finding basic info....

[johnthomas]

I am finding it remarkably difficult to find basic information as to how to test for potential type 2 diabetes at home with finger prick tests.

Even on this site - it indicates a target of 4-7 before meals and in the morning....but then describes this as "These are blood sugar level targets for adults with type 1 and type 2 diabetes" ....well - what are the targets *without* diabetes?!

Can anyone suggest a reasonable strategy for self home diagnosis?

At this point I am not interested in getting diagnosed elsewhere, so please don't suggest that.

thanks very much-
JT.

 

[Docb]

Hi @johnthomas. Formally you get a diagnosis of diabetes if your HbA1c level is over 48 mmol/mol and a diagnosis of "At risk of diabetes" if it is over 42 mmol/mol. That can only be measured by a laboratory test on a sample of blood taken by syringe. There are meters which purport to be able to make home measurements of HbA1c but they are expensive and not considered reliable.

You can get an estimate of your HbA1c from taking a lot of finger prick measurements covering all times of day and night and looking at the average value. If the average is above 8 mmol/l then it indicates an HbA1c of greater than 48 mmol/mol. If it is between 7 mmol/l and 8 mmol/l then that indicates an HbA1c of greater than 42 mmol/mol.

That route would give you a pointer as to whether you have or at risk of developing diabetes, but I would not offer it as a strategy for "self home diagnosis".

 

[grovesy]

Hi @johnthomas. Formally you get a diagnosis of diabetes if your HbA1c level is over 48 mmol/mol and a diagnosis of "At risk of diabetes" if it is over 42 mmol/mol. That can only be measured by a laboratory test on a sample of blood taken by syringe. There are meters which purport to be able to make home measurements of HbA1c but they are expensive and not considered reliable.

You can get an estimate of your HbA1c from taking a lot of finger prick measurements covering all times of day and night and looking at the average value. If the average is above 8 mmol/l then it indicates an HbA1c of greater than 48 mmol/mol. If it is between 7 mmol/l and 8 mmol/l then that indicates an HbA1c of greater than 42 mmol/mol.

That route would give you a pointer as to whether you have or at risk of developing diabetes, but I would not offer it as a strategy for "self home diagnosis".

Another thing to point out this strategy could work out expensive as test strips are not cheap they cost anything between £8 to £30 a pot of 50 strips, depending on the brand and the strips are brand/meter specific.

 

[Kaylz]

You say not to suggest getting diagnosed elsewhere but I'm afraid only professionals who know what they are doing can diagnosis something like diabetes and also if it is you may need treatment, how do you suppose you get that without an official diagnosis?

 

[Inka]

Hi @johnthomas The blood glucose meters you can buy are for people who already have diabetes to monitor their blood glucose. They are not for diagnostic purposes. As @Docb says, the diagnostic test for Type 2 is an HbA1C blood test from your arm.

The target levels you see on this site are, as you said, aimed at people with diabetes.

In the past, it was sometimes said that two random fingerprick blood tests over 11.1mmol would indicate diabetes, so you could try that if you can’t see a doctor.

Do you have any symptoms that make you think you might have Type 2 diabetes?

 

[Ralph-YK]

well - what are the targets *without* diabetes?!

Non diabetics wouldn't have targets. I believe they'd get readings from 3 to 11 or more. Depending on what they eat and when.

Can anyone suggest a reasonable strategy for self home diagnosis?

No. Persistantly high readings, from a finger prick test, can give an indication. However, you do need to a professional and get a "real" diagnoses. I think self diagnosis, for lots of things, is a bad idea. People so often get it completely wrong.

 

[karloc]

Like many have said, doctors is the way to go.

I my view Normal, At risk, Type 2 is just a slope on a graph, so if you suspect that you are anything except Normal (what ever that may be) then why not make life style changes. The life style changes needed for Type 2 Diabetics are all healthy things anyway so wont cause harm. Stay at a healthy weight, Excercise the correct amount, Reduce the amount of carbs consumed espically 'bad' carbs.

The only other test I am aware of would be the glucose test that could be done at home with a BG meter but it would still only be a snap shot of how you are able to cope with the glucose at that moment in time.

As a side note, the one thing I have never been able to discover is what is the ideal (normal) fasting BG level - it maybe such a thing just does not exist and I know it's never quite that simple thou.

 

[Anitram]

As a side note, the one thing I have never been able to discover is what is the ideal (normal) fasting BG level - it maybe such a thing just does not exist and I know it's never quite that simple thou.

Diabetes co UK (not this site, the other one) says this about fasting levels:-

• Normal: 3.9 to 5.4 mmols/l
• Prediabetes or Impaired Glucose Tolerance: 5.5 to 6.9 mmol/l
• Diagnosis of diabetes: 7.0 mmol/l or above

I've seen other sites say 4.0 to 5.6 for Normal.

Martin

 

[karloc]

Diabetes co UK (not this site, the other one) says this about fasting levels:-

• Normal: 3.9 to 5.4 mmols/l
• Prediabetes or Impaired Glucose Tolerance: 5.5 to 6.9 mmol/l
• Diagnosis of diabetes: 7.0 mmol/l or above

I've seen other sites say 4.0 to 5.6 for Normal.

Martin

I think 3.9 to 5.4 is Normal - I am wanting to know what Ideal for that perfect Human (that does not exist) should be. I may be wrong but I think Normal is just not Pre or Diabetic rather than Ideal.
In my mind 4 to 4.5 is what I am aiming for.

 

[johnthomas]

thanks very much everybody - especially for the figures quoted etc.

@Docb - I'm not sure about HbA1c as surely that is just measuring elevated blood sugar over time - ...I'm a bit of an alcoholic, so am expecting blood sugar to be high even if my body is still coping with that ok(ish).

@Kaylz - how am I expecting to get treatment? - seems best to me to go Keto (high fat carnivore suits me) - I will do that when I have to!

@Inka - symptoms? - last week I developed an odd neuropathy - not defo sugar related, but might be. After 2 days of zero carb my blood sugar was 4.8 this morning which is very encouraging - though I did take a morning reading using a dodgy cheap strip that was 7.4.

@Anitram - thanks very much - that's just the sort of answer I was looking for - though of course I take on board all the above comments.

 

[Inka]

@johnthomas It depends on how much you like definite information. If it was me, I’d want an HbA1C as that’s solid diagnostic info. You can then see exactly where you are on the scale. I think fasting blood sugar can contribute to the overall picture, but I know my own GP only uses the HbA1C test for diagnosis. I don’t think they’re alone in doing that.

If you were to be diagnosed with Type 2, you’d then qualify for things like the special eye test, kidney tests, foot checks, etc so that’s a benefit too even if you would want to use diet rather than medication to try to get your blood sugar down.

 

[Docb]

@Docb - I'm not sure about HbA1c as surely that is just measuring elevated blood sugar over time - ...I'm a bit of an alcoholic, so am expecting blood sugar to be high even if my body is still coping with that ok(ish).

If you think about it, diabetes is the inability of the body to control blood glucose at healthy levels automatically, no matter what the cause. Because blood glucose varies naturally an average blood glucose is as good a measure of that control as any. That is what the HbA1c gives you because it evens out all the other factors in one result. Any other approach, like that I suggested, requires a lot of interpretation. It is why HbA1c is central to the NICE guidelines on diagnosing and treating diabetes.

I would comment on the ranges quoted by Anitram - you cannot measure blood glucose as accurately as implied by the numbers quoted and in any case, the results would depend what was meant by "fasting".

Not wanting to get a test done is fair enough, but the downside is that you cannot get a proper diagnosis without it.

 

[johnthomas]

If you think about it, diabetes is the inability of the body to control blood glucose at healthy levels automatically, no matter what the cause. Because blood glucose varies naturally an average blood glucose is as good a measure of that control as any. That is what the HbA1c gives you because it evens out all the other factors in one result. Any other approach, like that I suggested, requires a lot of interpretation. It is why HbA1c is central to the NICE guidelines on diagnosing and treating diabetes.

I would comment on the ranges quoted by Anitram - you cannot measure blood glucose as accurately as implied by the numbers quoted and in any case, the results would depend what was meant by "fasting".

Not wanting to get a test done is fair enough, but the downside is that you cannot get a proper diagnosis without it.

..I am skeptical of HbA1c as I tend to drink pretty heavily - so my blood sugar will defo be high even measured over the long term- I'm not sure how I can determine that my body is coping with it or not - or perhaps we just look for extreme numbers.

 

[helli]

I have not read anywhere that alcohol causes higher blood sugars.
For those of us with Type 1, treated with injected insulin, alcohol can lower blood sugars, not raise it.

For someone with a healthy pancreas, whatever you eat or drink, your body will create enough insulin to keep your blood sugars "in range".
If you blood sugars are higher after drinking, it will be the carbs in the drink which your body in unable to process because your pancreas is struggling.

At least that is how I understand it.

 

[Inka]

I’ve just found this:

“There are three main ways drinking alcohol to excess can be a factor in causing diabetes:

1. Heavy drinking can reduce the body’s sensitivity to insulin, which can trigger type 2 diabetes.
2. Diabetes is a common side effect of chronic pancreatitis, which can be caused by heavy drinking.
3. Alcoholic drinks often contain a lot of calories – So drinking can also increase your chance of becoming overweight which raises your risk of developing type 2 diabetes”

Edited to add that hypoglycaemia ie low blood sugar is also associated with heavy drinking.

 

[Inka]

..I am skeptical of HbA1c as I tend to drink pretty heavily - so my blood sugar will defo be high even measured over the long term- I'm not sure how I can determine that my body is coping with it or not - or perhaps we just look for extreme numbers.

What do you mean exactly? Coping with what - the alcohol or raised blood sugar?

The HbA1C will show if your blood sugar has been high enough to put you in the diabetes range. It doesn’t matter so much why that’s happened, just whether your body is now in that range or not.

If you’re talking about the alcohol, then I’d imagine a liver function test will be the answer to that.

 

[rebrascora]

I agree with @helli and @Inka
It doesn't matter if your glucose levels come from carbs in beer or carbs in sugar or carbs in bread, pasta and potatoes, your pancreas should be able to deal with them by producing insulin. If that system is impaired sufficiently then you are diabetic and the HbA1c is the only real way to assess that. Individual BG spot tests, even many taken at random times and averaged are not guaranteed to pick it up. Having said that, the propensity of alcohol to lower BG might mean that the HbA1c is actually skewed towards being less likely to pick it up.... in the same way as Type 1 diabetic can have a good HbA1c but not have good Blood Glucose management because they are getting peaks and troughs which cancel each other out to produce a better overall HbA1c result than their individual BG readings would indicate.

 

[Anitram]

I would comment on the ranges quoted by Anitram - you cannot measure blood glucose as accurately as implied by the numbers quoted and in any case, the results would depend what was meant by "fasting".

Those numbers are lifted from the Diabetes UK (.co.uk) webpage.

I think the value in self-testing is less to do with the actual numbers but with being able to see trends. A daily test on waking, maybe (in my case) as much as10-12 hours since last eating, must be a reasonably good definition of fasting. My average fasting level is currently flat, in the range 5.0 - 5.8 for November, 5.4 on average. I averaged 5.2 in October and 5.4 in September, so on the basis of those numbers I can feel comfortable that I'm managing things well.

Martin

 

[trophywench]

Alcohol lowers blood sugar, full stop.

So in the 1960s before I was diabetic, on Saturday nights when I was a teenager we'd go out with friends which usually comprised visiting one if not several pubs and having a drink in each, then getting on for closing time we'd start getting the munchies so where were we going next - Indian, Chinese, chip shop, back to one set of parents for coffee and a sandwich or what? This was bog standard behaviour and completely normal at the time - the reason why the munchies always happened was purely because of lowered blood sugar so when that happens the body is designed so that the liver just pumps out some of its natural stores and increases the blood glucose but tonight, the liver's function has been inhibited by the alcohol so the brain takes over and gets the stomach to instruct you to give it food instead.

If the liver's natural function is more permanently banjaxed cos it's damaged whether by overconsumption of alcohol or in an accident, then frankly a lot more bits of the body are likely to fail than just the blood glucose regulating functions of it.

 

[Ralph-YK]

I tend to drink pretty heavily - so my blood sugar will defo be high even measured over the long term

I have not read anywhere that alcohol causes higher blood sugars.
For those of us with Type 1, treated with injected insulin, alcohol can lower blood sugars, not raise it.

Alcoholic drinks have sugar, which might raise BG. However, as Helli says, alcohol can lower BG. (Something to do with the body having to deal with alcohol & not working as normal.) So they cancel out, or give you a drop. Those on insulin have to check their BG carefully after drinking, in case they go too low (so I understand).
[Edit] And as @trophywench says. (Took so long crafting my post Trophywench posted inbetween).

It doesn't matter if your glucose levels come from carbs in beer or carbs in sugar or carbs in bread, pasta and potatoes, your pancreas should be able to deal with them by producing insulin. If that system is impaired sufficiently then you are diabetic and the HbA1c

I'd also say this is pretty much true.
So being a drinker isn't likely to give a false positive on a HbA1c.