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Type 1 Diabetes: Diagnosis

Type 1 diabetes is often diagnosed in a hospital or emergency room after extremely high blood glucose of undetected diabetes causes severe illness. In other cases, chronic infection or other initial symptoms raise the suspicion of diabetes, and testing occurs in a doctor’s office or outpatient lab.

The preferred blood test for diagnosing type 1 diabetes is the plasma glucose test. The test requires an eight-hour fast (no food or drink except water), after which a blood draw is performed. It is usually done in the morning. Other accepted tests for type 1 diagnosis include a random plasma glucose test (a blood draw taken at any time of the day) and an An oral glucose tolerance test (OGTT; blood draws taken at intervals up to three hours after a patient consumes a drink of 75 grams of glucose).

The following lab values are the American Diabetes Association practice guidelines for the diagnosis of diabetes:

  • A random plasma glucose value of 200 mg/dl (11.11 mmol/L) or more (in the presence of diabetes symptoms).
  • A plasma glucose value of 126 mg/dl (7 mmol/L) or more.
  • An oral glucose plasma glucose value of 200 mg/dl (11.11 mmol/L) or higher at 2 hours post-glucose load.

    A definitive diabetes diagnosis requires a second positive test performed on a different day. If symptoms of high blood glucose are extreme (e.g., diabetic ketoacidosis) and blood glucose levels are significantly elevated, your doctor may not require a second follow-up test.

    In some cases, especially in those where it’s unclear whether type 1 or type 2 diabetes is present, a physician may also prescribe additional blood tests. These may include a c-peptide test (which measures levels of this protein associated with insulin production) or tests for islet cell antibodies (ICA), insulin auto-antibodies (IAA), and/or glutamic acid decarboxylase (a beta cell protein known as GAD).

  • SOURCES:

    1 - National Diabetes Information Clearinghouse. Diabetes Overview. (Accessed 2/19/08).
     

    Last Modified Date: March 20, 2008


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