Across the UK, almost 5 million people are living with diabetes. Of these, approximately 90% of people have a diagnosis of Type 2 diabetes, with a further 8% of people living with Type 1 diabetes.
A much smaller number of people have one of the rarer forms of diabetes, including gestational diabetes, which affects women during pregnancy.
You may wonder how is diabetes diagnosed in the UK and specifically, how people are tested for this condition.
What is Diabetes?
Simply put, diabetes is the name given to a condition where the blood sugar levels in the body are too high.
This causes various symptoms, including ongoing thirst even after drinking, urinating more frequently than normal, feeling tired, and losing weight unintentionally.
On top of this, some diabetes patients experience episodes of blurred vision, frequent infections, or cuts that take longer to heal.
First Signs of Diabetes
Type 1 diabetes typically starts in childhood or young adulthood, while Type 2 diabetes can begin at any time, but develops more slowly. It’s really important to visit your doctor if you notice you, or your child, have been peeing much more than normal, or drinking excessively – or if there’s been a significant weight loss.
How is diabetes diagnosed in the UK?
The GP will ask some questions about how much liquid you have been drinking, how often you visit the toilet, and whether you have lost any weight recently without trying to. They may also ask questions about your energy levels, and whether you or your child have been feeling more tired than usual.
If they have any suspicions that diabetes may be the cause of your symptoms, they’ll carry out a simple finger prick test. This almost painless test will allow them to test a drop or two of blood to see whether it is high in glucose – another term for sugar.
The doctor might also feel that it would be a good idea to test a urine sample while you’re there. A urine sample can give a good indication of anything in the urine that suggests a problem. They’ll be looking for glucose levels, as well as ketones and protein in the urine, which can detect not only high blood sugars, but also rule out a medical emergency called diabetic ketoacidosis. A urine test can also be used to make sure there is no early kidney damage.
Next Steps
If either the finger prick test or the urine test show any causes for concern, the GP will likely refer you to a specialist in a hospital. While it might feel alarming at first, they will try to get you an appointment with this diabetes specialist on the same day. This isn’t because it’s an acute emergency, but because it is better to work out the treatment plan and get it started as soon as possible.
Hospital Tests – How is Diabetes Diagnosed in the UK?
Next, let’s take a look at some of the NHS diabetes tests which are undertaken in a hospital setting – such as a specialist diabetes clinic. These NHS diabetes tests are more specific than those taken in general practice, and can give a more detailed picture of your diabetes. They will be done when you are first diagnosed, and at least annually – this gives a clear indication to your specialist team as to how well your diabetes is being managed.
NHS Diabetes Tests – HbA1c Test
This is the main test used to determine whether someone has Type 2 diabetes. A very small amount of blood is required, and usually taken from the arm. This test will show your blood sugar level average for the previous two to three months. Results usually take a couple of days to come back. A level of 48mmol/mol or higher indicates diabetes, while scores of 42 to 47 mmol/mol indicate prediabetes – a state where the person is at high risk of developing diabetes within the foreseeable future.
Fasting Blood Test
An HbA1c test doesn’t require any preparation, but a Fasting Blood Test is slightly different and requires the patient to avoid having anything to eat or drink for eight hours beforehand. For this reason, tests are often conducted in the early morning. Again, blood is taken from the arm, and the results can indicate whether diabetes is present.
Glucose Tolerance Test
Another test, called a Glucose Tolerance Test or GTT, can indicate whether the body is having a difficult time processing the sugar acquired when you consume various foods and drinks. This is commonly used for women who are suspected of having gestational diabetes during their pregnancy.
This type of test begins with a fasting blood test as described above. Once that’s done, the patient will need to consume a sugary drink, and two hours later, the test will be repeated again. This test will indicate how well the body can maintain a normal blood sugar level.
Annual Checks
People with diabetes have an annual review to make sure that it’s well controlled. In people with Type 2 diabetes, it can often be managed, or even reversed, with healthy lifestyle changes, such as cutting out processed food, eating more fruits, vegetables and whole grains, and quitting smoking. However, medication is usually necessary in Type 1 diabetes to control your blood sugar levels. It’s therefore important to attend the annual check up, and it’s also a good opportunity to ask any questions you might have about your diabetes.
