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Diagnostic testing is performed not only to establish the diagnosis of diabetes, but also to detect any complications due to the disease. There are two primary tests to establish the presence of elevated glucose:

• Fasting Plasma Glucose Test (FPG) - This test is recommended by The American Diabetes Association because it is easier, faster, and less expensive to perform. With the FPG test, a fasting blood glucose level between 100 and 125 mg/dL signals pre-diabetes. A person with a fasting blood glucose level of 126 mg/dL or higher has diabetes.

• Oral Glucose Tolerance Test (OGTT) - In the OGTT test, a person's blood glucose level is measured after a fast and again two hours after drinking a glucose-rich beverage. If the two-hour blood glucose level is between 140 and 199 mg/dL, the person has pre-diabetes. If the two-hour blood glucose level is at 200 mg/dL or higher, the person has diabetes.

Laboratory evaluation for diabetes may also include:

• Random nlood glucose
• Glycosolated hemoglobin (HbA1c) - reflects blood glucose levels for the previous 2-3 months
• Blood urea nitrogen and creatinine levels (tests of kidney function)
• Metalloproteinase-9 - a blood test that may help predict early kidney damage
• Cholesterol and lipid levels
• Thyroid function tests
• Urinalysis
• Urinary microalbumin
• Electrocardiogram (EKG) may be performed to assess the function of the heart.

Fingerstick Blood Glucose Monitoring

Fingerstick testing is the common method to monitor blood sugars at home. This procedure is easy to learn and takes just minutes to perform. A drop of blood is placed on a test strip and inserted into a small, handheld machine that provides a digital readout of the current blood sugar level. Glucose monitoring machines and test strips are readily available at most pharmacies.

Newer meters can measure glucose from blood taken from sites other than the traditional fingertip test, such as the forearm, however, due to some fluctuations in reliability, the fingertip remains the recommended test site.

The frequency of glucose monitoring depends on how well the person's blood sugar levels are controlled. People with type 1 diabetes, or those with poorly controlled disease, with wide fluctuations in results, may need to perform testing 4 or more times per day (usually before meals and at bedtime). These higher frequencies may also be necessary at times of medication adjustment, illness, or stress in people with type 2 diabetes.