Type 2 Diabetes Diagnosis & Treatment Type 2 Diabetes Guide Type 2 Diabetes Guide Symptoms Causes Diagnosis Treatment Coping Diet Complications How Type 2 Diabetes Is Diagnosed By Debra Manzella, RN linkedin Debra Manzella, MS, RN, is a corporate clinical educator at Catholic Health System in New York with extensive experience in diabetes care. Learn about our editorial process Debra Manzella, RN Medically reviewed by Medically reviewed by Ana Maria Kausel, MD on September 18, 2020 facebook twitter Ana Maria Kausel, MD, is double board-certified in internal medicine and endocrinology/diabetes and metabolism. She works in private practice and is affiliated with Mount Sinai St. Luke's/Mount Sinai West. Learn about our Medical Review Board Ana Maria Kausel, MD Updated on July 07, 2021 Print John FedeleBlend Image / Getty Table of Contents View All Table of Contents Self-checks/At-Home Testing Labs and Tests Differential Diagnoses Frequently Asked Questions Next in Type 2 Diabetes Guide From Diet to Drugs: Treating Type 2 Diabetes Diagnosing type 2 diabetes requires a series of lab tests looking for markers of elevated glucose, or blood sugar. Such tests are necessary, as type 2 diabetes may or may not have noticeable symptoms, or symptoms may crossover with other conditions. The diagnosis often is made during an annual physical or checkup. Your doctor may order a hemoglobin A1C test, a fasting blood sugar (FBS) test, or an oral glucose tolerance test (OGTT) as part of regular screening to check blood sugar levels and to help determine if you have diabetes. Alex Dos Diaz / Verywell Self-Checks/At-Home Testing According to the latest data available from the Centers for Disease Control and Prevention (CDC), more than 34 million Americans, or about 10% of the population, has diabetes. An additional 88 million American adults, or approximately 33% of the population, has prediabetes. Despite increased awareness efforts, many people with diabetes or prediabetes continue to be unaware of their condition. While symptoms of diabetes may be hard to pinpoint, there are several signs that frequently coincide with high blood sugar and may be indicative of diabetes, such as: Frequent urination Frequent thirst Excessive hunger Extreme fatigue Nerve tingling Blurry vision Cuts and bruises that are slow to heal A buildup of blood sugar may also result in skin conditions associated with diabetes—in particular: Skin tags: Small, harmless, polyp-type growths typically appearing on the eyelids, neck, and armpits Acanthosis nigricans: Dark, velvety patch of skin in skin folds such as the back of the neck, armpits, elbow creases, hands, knees, and groin. Both conditions are thought to be related to insulin resistance. If you think you might have diabetes, it's important to consult with your doctor and get a confirmed diagnosis. Do not attempt to diagnose yourself by using over-the-counter testing equipment, such as a glucose monitor. Labs and Tests Routine screenings for type 2 diabetes are recommended for most people every two years after age 45, especially for those who may be overweight. Routine screenings may be recommended by your physician if you're under 45 but have certain high-risk factors, like a family history of the disease, heart disease, high blood pressure, gestational diabetes, and/or a sedentary lifestyle. Type 2 diabetes usually is diagnosed with the hemoglobin A1C test, but if that test isn't available or you have a hemoglobin variant that makes testing difficult, your doctor will need to order another blood glucose test. Your doctor may also perform additional tests to rule out type 1 diabetes, as elevated blood glucose levels can be present initially in both type 1 and type 2. Hemoglobin A1C Test The hemoglobin A1C test looks at the percentage of glucose that is attached to hemoglobin, a protein that makes up part of your red blood cells. The test gives a glimpse of your average blood sugar levels over the past two to three months, which is the approximate lifespan of red blood cells. One advantage of this test is that it does not require fasting. A1C Result Meaning Less than 5.7% Normal 5.7% to 6.4% Prediabetes 6.5% or higher Diabetes A1C Results and Meanings Some people of African, Mediterranean, or Southeast Asian descent may have a genetic variation in their hemoglobin that could give falsely high or falsely low results. Random Plasma Glucose Test (RPG) A random blood sugar test looks at blood glucose levels regardless of when you've last eaten for a snapshot of your blood sugar status. This test is usually performed when healthcare professionals want to take a look at your blood sugar without having to wait for you to fast and so it can be performed at any time. While a diagnosis of diabetes can be made with the help of this test, it is not usually used to diagnose prediabetes. RPG Results Meaning Less than 200 mg/dl Normal 200 mg/dl or higher Diabetes RPG Results and Meanings Fasting Plasma Glucose (FPG) The FPG test looks at fasted blood glucose levels at a single point in time. A fasting test means you can't eat for eight to 10 hours before you have your blood drawn. Most doctors recommend getting tested first thing in the morning after fasting all night. FPG Results Meaning 99 mg/dl or below Normal 100 mg/dl to 125 mg/dl Prediabetes 126 mg/dl or higher Diabetes FPG Results and Meanings Fasting glucose higher than 126 mg/dL indicates type 2 diabetes. Your doctor will likely repeat the fasting blood sugar test on two separate occasions to confirm the diagnosis. Oral Glucose Tolerance Test (OGTT) The OGTT is a glucose challenge test. Fasting blood glucose is usually taken first to establish a baseline level. Then you are given a drink that contains 75 grams of glucose (sugar). Two hours later another blood sample is drawn to check your glucose level. OGTT Results Meanings 139 mg/dl or below Normal 140 mg/dl to 199 mg/dl Prediabetes 200 mg/dl or higher Diabetes OGTT Results and Meanings If your glucose is over 200 mg/dl, then a diagnosis of type 2 diabetes is likely. Again, your doctor will usually perform this test on two different occasions before a confirmed diagnosis is made. Differential Diagnoses Beyond type 2 diabetes, there are several other conditions that may be at play and could result in similar symptoms or even possibly blood work showing elevated glucose levels: Prediabetes Insulin resistance or impaired glucose tolerance may be affecting how your body processes and metabolizes glucose, but you may not be in the midst of full-blown type 2 diabetes just yet. If you have prediabetes, your doctor can help you craft a treatment plan to make lifestyle changes in order to prevent the disease from progressing. Type 1 Diabetes or Latent Autoimmune Diabetes in Adults Symptoms of type 1 diabetes may appear very similar to type 2 diabetes, though they tend to come on all at once in a short time span. Blood work may also still show glucose elevation when standard tests are performed, but your doctor should be able to add on additional testing to confirm whether you have type 1 (which may be latent autoimmune diabetes in adults or LADA) by looking at certain antibodies and proteins in your blood. Metabolic Syndrome Elevated blood sugar is just one piece of the constellation of factors contributing to metabolic syndrome, which is thought to be linked to insulin resistance. Other criteria for the diagnosis of metabolic syndrome include three out of five of the following factors: Waist circumference over 35 inches for women or 40 inches for men Triglyceride level above 150 mg/dl High-density lipoprotein (HDL) cholesterol below 40 mg/dl Blood pressure above 130/85 mm/Hg Fasting blood glucose level above 100 mg/dl Treatment for metabolic syndrome includes modification of many lifestyle factors including diet, exercise, and stress, but risk factors usually decrease with positive changes. Hyperthyroidism Mild hyperglycemia (high glucose levels) and symptoms such as fatigue, tingling, anxiety, and weight loss may be associated with hyperthyroidism or overactivity of the thyroid gland and overproduction of thyroxine. Your doctor may perform additional testing to check for sufficient thyroid function before ruling out this diagnosis. Frequently Asked Questions How is type 2 diabetes diagnosed? Type 2 diabetes is diagnosed by measuring blood glucose levels. If your doctor suspects you have diabetes, the first step is usually an in-office finger stick for a test called a random blood glucose level, followed by other blood tests to check your fasting glucose levels and A1c. What symptoms indicate testing for diabetes? Frequent urination, frequent thirst, excessive hunger, extreme fatigue, tingling in feet or hands, blurry vision, and cuts and bruises that are slow to heal are symptoms of diabetes that warrant testing. Who should be screened for diabetes? The American Diabetes Association recommends being screened starting at age 45. If results are normal, screening should be done every three years. Those with risk factors including a family history of type 2 diabetes, heart disease, high blood pressure, kidney disease, previous gestational diabetes, obesity, or a sedentary lifestyle may be advised to undergo screening for diabetes at an earlier age or more frequently. How can you test for diabetes at home? If you have a family member or friend who has diabetes and a glucose meter, you can ask to use their meter to test your blood sugar (just be sure to use a fresh lancet) or you can purchase one at your local pharmacy. If your reading is over 200, contact your doctor to be tested for diabetes. A Word From Verywell If you're diagnosed with diabetes, there's a lot you can do to prevent it from worsening, starting with losing weight: According to the American Diabetes Association, overweight and obese people with diabetes can benefit greatly from losing just 5% of their total body weight; a loss of 15% or more is the most effective. People with prediabetes can prevent it from progressing to diabetes by shedding just 7% to 10% of body weight. This doesn't mean you'll need to dramatically cut back on your eating: Your healthcare team can help you create a weight loss plan that includes not only a healthy and satisfying diet, but also moderate exercise (brisk walking, swimming, or cycling for 30 minutes, five days per week) along with medication if necessary, supplements, and stress-management practices. In some ways, while obviously unwelcome, a diabetes diagnosis can mean positive changes in your health and well-being you may not have made otherwise. Type 2 Diabetes Doctor Discussion Guide Get our printable guide for your next doctor's appointment to help you ask the right questions. Download PDF Email the Guide Send to yourself or a loved one. Sign Up This Doctor Discussion Guide has been sent to {{form.email}}. There was an error. Please try again. Was this page helpful? Thanks for your feedback! We know healthy eating is key to help manage diabetes, but that doesn't make it easy. Our free nutrition guide is here to help. Sign up and receive your free copy! Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Centers for Disease Control and Prevention. National diabetes statistics report, 2020. Last reviewed February 11, 2020. Centers for Disease Control and Prevention. Diabetes symptoms. Last reviewed March 24, 2020. American Diabetes Association. Skin complications. 2019. American Diabetes Association. 2. Classification and diagnosis of diabetes: Standards of medical care in diabetes-2020. 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