Diabetes symptoms: don’t wait for them, get tested for diabetes

India is often referred to as the ‘diabetes capital of the world’ and still people do not get tested for diabetes! Even the more aware of us may search for signs and symptoms of diabetes or look up the risk calculators to find out whether we have diabetes

But type 2 diabetes (the adult version of diabetes) is a silent disease, until it develops complications. The symptoms of diabetes itself, classically described as increased thirst, appetite and micturition ( called polyphagia, polydipsia and polyuria respectively) are not present in most of diabetics. Often the first presentations are of the complications of diabetes . By the time these symptoms develop, the golden window of opportunity to control diabetes and avoid complications is closed!

A lot of us, including some doctors and health workers in India, believe that one should get tested for diabetes at the age of forty. But that erroneous information can harm so many people by delaying the diagnosis and potentially allowing complications to develop

Diabetes screening: recommendations

The Indian (ICMR) and international (ADA,WHO) guidelines suggest the following criteria for getting tested for diabetes

For adults: 

  • Overweight (BMI>23) or has abdominal obesity (Waist Circumference more than 90 cms or 35.4 inches for men and more than 80 cms or 31. 4 inches for women)
  • Has sedentary lifestyle
  • Family history of diabetes is there
  • Has high blood pressure, high blood cholesterol or triglycerides or fatty liver
  • Woman having a history of GDM (Gestational Diabetes Mellitus) or have had a big baby (>3.5 kg weight at birth)
  • Any adult over 30, even without the above mentioned conditions

Early screening tests can impact your health significantly, not only by detection of diabetes but also by prevention. If you get picked up to be having ‘prediabetes’ and modify your lifestyle, you can prevent developing diabetes, or  delay it.  Read ‘Can diabetes be prevented?’

For children: 

Children who are overweight ( BMI or ‘Weight For Height’ > 85th percentile for age) AND  have one of the following conditions:

  • Symptoms suggestive of diabetes
  • Mother had Gestational Diabetes Mellitus (GDM) while carrying the child or the child was SGA (Small for Gestational Age)
  • There are first or second degree relatives having diabetes
  • Child having high BP or high blood cholesterol

These children should first undergo screening tests for diabetes at the age of 8-10 years

Routine blood tests for diabetes 

  • Fasting Blood Sugar or FBG (At least eight hours of fasting) is the best test for diabetes screening . A fasting blood sugar of more than 126 mg/dL is diagnostic of diabetes, but lower levels could still mean you have prediabetes
  • The blood tests for diabetes in non fasting state are the following:
    • Random blood sugar (blood sugar test agnostic of your last meal time) of more than 200 mg/dL  blood sugar alone is useful in people having symptoms of diabetes (increased thirst, increased appetite, frequent micturition,weight loss). But this test is not diagnostic, FBG is still needed to confirm the diagnosis
    • HbA1c blood test has an advantage over FBG that it does not need to be done in fasting. It is increasingly being accepted as a diagnostic test for diabetes
  • OGTT (Oral Glucose Tolerance Test) is a test in which blood sugar levels are checked in fasting state and two hours after intake of a specific sugar load. It is used especially in diagnosis of GDM (Gestational Diabetes Mellitus)

In fact we would recommend that rather than just getting tested for diabetes, you should get all the relevant screening tests done in one go. Check out FHI Health Check List for Adults and FHI Health Check List for Children, which include not only blood tests but offer a comprehensive health check up package including body measurements, cancer screening and heart risk calculation

CHECK OUT: FWI references for preventive health checks