Diabetes Diagnosis

2023 Author: Wallace Forman | [email protected]. Last modified: 2023-08-25 11:04

Diabetes: diagnosis

When diagnosing diabetes mellitus, the doctor will clarify risk factors and symptoms with you and possibly check your current blood sugar level with a finger prick. In order to clarify a suspicion more precisely, a venous blood sample is taken and the blood sugar level is determined.

A single examination is not enough to reliably diagnose diabetes and determine the stage of the disease. Multiple examinations are often required and follow-up examinations are necessary.

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How is the diagnosis made?

In order to be able to make a reliable diagnosis, the doctor will carry out one or more tests. The following test procedures are available for this:

Determination of occasional glucose (non-fasting glucose)

Sometimes other tests happen to show that your blood sugar levels are high. Regardless of the time of day of the measurement and the time of food intake, the following applies: If the blood sugar level is 200 mg / dl or more, diabetes mellitus is suspected. Even if there are no additional clinical symptoms of diabetes mellitus, the doctor will carry out further examinations. Fasting blood sugar measurements or, if necessary, an oral glucose tolerance test are used to make a reliable diagnosis.

Determination of the fasting blood sugar

The measurement of the fasting blood sugar takes place after a previous food waiver of at least eight hours. With a blood glucose concentration in the plasma of 126 mg / dl or more, diabetes mellitus is assumed. Further examinations are then carried out or the test is repeated for at least one further day. If the result is confirmed, it is considered manifest diabetes mellitus. At values between 100 and 126 mg / dl one speaks of disturbed fasting glucose, which means an increased risk of diabetes.

Oral glucose tolerance test (oGTT)

The oGTT is usually used when the findings are unclear, when gestational diabetes is suspected or to clarify impaired glucose tolerance. To do this, the fasting blood sugar is first determined in the morning. The patient is not allowed to eat anything for eight to 14 hours beforehand and should refrain from alcohol, coffee or tea. After this first blood sample, a solution containing glucose is drunk. This causes blood sugar to rise, but it should quickly return to normal. In the case of impaired glucose tolerance or diabetes, it remains elevated. Therefore, two hours after ingestion of the glucose solution, the sugar concentration in the blood (venous plasma) is measured again:

• If the value is between 140 and 199 mg / dl, one speaks of impaired glucose tolerance. In this case, the blood sugar level is too high after eating, but there is no (yet) diabetes.
• If the doctor determines a sugar level of 200 mg / dl or more after the two hours, diabetes mellitus is present.

Determination of hemoglobin A1c (HbA1c)

The HbA1c value reflects the blood sugar level for the previous six to eight weeks. If the HbA1c is ≥ 6.5 percent (48 mmol / mol), one speaks of manifest diabetes mellitus. An HbA1c ≤ 6.5 percent does not rule out diabetes! Further diagnostics using fasting glucose or oGTT is required.

Whom can I ask?

You can contact the following offices to clarify a suspected diabetes:

• General practitioner
• Specialist in internal medicine.

There you can have the necessary blood tests carried out or you will be forwarded to an appropriate point (e.g. to a medical laboratory).

How are the costs going to be covered?

All necessary and appropriate diagnostic measures are taken over by the health insurance carriers. Basically, your doctor or the outpatient clinic will settle accounts directly with your health insurance provider. With certain health insurance providers, however, you may have to pay a deductible (BVAEB, SVS, SVS, BVAEB). However, you can also use a doctor of your choice (ie doctor without a health insurance contract) or a private outpatient clinic. For certain examinations (e.g. MRI), a doctor's approval may be required. For more information, see Costs and Deductibles. For information on the respective provisions, please contact your health insurance provider, which you can find on the social security website.