Women who have had a history of gestational diabetes, or the delivery of an infant over 9 pounds, are also at higher risk for diabetes and subsequently hypertension. The screening tests used are a quick dip stick evaluating protein in the urine or a blood pressure measurement. Patients who are spilling protein in their urine have a greater chance of having renal damage which can have resulted from either diabetes or hypertension.
A fasting blood sugar is the standard test for diabetes. This is a simple blood test which is taken after eight hours of complete fasting. Most individuals are told to stop eating after midnight and the blood tests is taken sometime after 8 a.m. the next morning, prior to breakfast, coffee or any other intake. This test is reliable but it does require a follow-up test if the test indicates that there is a problem with elevated blood sugar. (3)
A more extensive test to evaluate the diagnosis of diabetes is called the oral glucose tolerance test. During this test the patient is asked to drink a product that contains 75 g of glucose after having fasted for eight hours. Patients should be cautious when drinking this material since many find themselves vomiting after introducing something with this high sugar content into their stomachs after having eaten nothing else. (4)
Blood samples are then taken every half-hour and the urine is also tested every hour. This test is a measurement of the body’s response to a high load of glucose. The results of this test will help the physician determine a diagnosis of diabetes as well as give a good indication of how much insulin or oral hypoglycemic the individual should start with.
If an individual already has the diagnosis of diabetes then a glycosylated hemoglobin, or hemoglobin A1 C, is drawn to determine the severity of the diabetes over a period of time. This test is usually drawn every six months to get an accurate picture of the previous six months of glucose control. (5)
Screening for hypertension is much simpler and involves only doing a blood pressure test while sitting or standing. At the same time the individual may be screened for heart disease that can include a blood test for cholesterol, an EKG and chest x-ray.
These screenings for diabetes and hypertension can successfully be done at health fairs and doctors offices. It is especially important for individuals who have risk factors to understand those factors and how lifestyle choices may help prevent illness.
References:
(1) American Diabetes Association: Diabetes Basics
http://www.diabetes.org/diabetes-basics/diabetes-statistics/
(2) American Family Physician: Controlling Hypertension in Patients with Diabetes
http://www.aafp.org/afp/2002/1001/p1209.html
(3) Medline Plus: Glucose Test- Blood
http://www.nlm.nih.gov/medlineplus/ency/article/003482.htm
(4) MayoClinic.com: Glucose Tolerance Test
http://www.mayoclinic.com/health/glucose-tolerance-test/MY00145
(5) American Diabetes Association: Living with Diabetes: A1C
http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/a1c/
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