Blood sugar or HbA1C levels: routinely tested or when needed/asked?

When people go to their doctor for a check-up, is blood sugar or HbA1C levels routinely tested or is it only done at the patient’s request or based on the patient’s health, individual health history, or family health history?

WRS

It should only be tested to determine how well a known diabetic’s blood sugar control is. The standard recommendation is every 3 months for type I diabetics and every 3 to 6 months for type II diabetics, depending on how well they’re controlled.

The HbA1C is not a screening test to determine if one has diabetes. Many people with early diabetes will still have normal HbA1C levels. The best way to screen for diabetes is either with fasting blood sugars, or on occasion the glucose tolerance test. Frankly I favor the fasting sugars for screening myself.

As always, QtM is correct.

I’ll add that the HbA1c level is probably diagnostic of diabetes if it’s elevated (i.e. it’s specific for diabetes), but a normal HbA1c level does not rule it out (i.e. it’s not a sensitive test for diabetes - just as Dr. Qad said).

Here’s a formal statement on the use of HbA1c as a screening test for diabetes:

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At my routine annual physical in 1999, which was the last one I had before being diagnosed with type 2 diabetes a couple years later, they did a random blood sugar check along with all the other stuff they were checking. As I recall, it came back highlighted as “impaired glucose tolerance” but my nurse practitioner didn’t make a big deal about it. I kind of wish she had, in retrospect.

I did mark on my paperwork that I had a family history of diabetes, so I don’t know if they would have included the blood sugar check anyway or not. They definitely did not do an A1C.

Nor should they have done the A1C. But a 2nd fasting glucose is standard when the first is in the “glucose intolerany” range. If the second is in that range too, then perhaps a glucose challenge test is needed.

Someone identified as glucose intolerant should get counselled on diet and exercise routines which may stave off developing full blown diabetes (for a while at least) and be closely followed up to ensure that if the person does tip over into diabetes, it’s identified.

Thanks for the additional input, KarlGauss, along with the props.

But I ain’t always right, you know. I am frequently sure (even if incorrect), and I always have an opinion (even if it’s uninformed), but I ain’t always on the money.
:smiley:

Oh, definitely, I didn’t mean to imply that I felt they should have done an A1C at that point. However, the diet and exercise counseling you mentioned sure would have been helpful. My nurse practitioner basically just shrugged it off and said it wasn’t a big deal and I should “avoid sugary foods” and come back to get checked again in a year.

Thanks, y’all!

Your answers help me lots. :slight_smile:

I hope you will indulge me in this thread now.

WRS