- Have symptoms of diabetes (increased thirst, increased urination, and unexplained weight loss) and a blood sugar level equal to or greater than 11.1 millimoles per litre (mmol/L). The blood sugar test is done at any time, without regard for when you last ate (random plasma glucose test or random blood sugar test).
- Have a fasting blood sugar level that is equal to or greater than 7.0 mmol/L. A fasting blood sugar test (fasting plasma glucose) is done after not eating or drinking anything but water for 8 hours.
- Have a 2-hour oral glucose tolerance test (OGTT) result that is equal to or greater than 11.1 mmol/L.
- Have a hemoglobin A1c that is 6.5% or higher. (This test is most reliable for adults. Some experts recommend using one of the other tests to diagnose diabetes in children.)footnote 2 This test may not be appropriate for everyone because many things can affect the lifespan of red blood cells, such as the second or third trimester of pregnancy, a recent blood loss or a blood transfusion, sickle cell disease, hemodialysis, or erythropoietin (ESA) medicine.
Two tests are used to confirm the diagnosis of diabetes.
If the results of your fasting blood sugar test are between 6.1 to 6.9 mmol/L, your OGTT result is between 7.8 to 11.0 mmol/L (2 hours after the beginning of the test), or your hemoglobin A1c is 6.0% to 6.4%, you have prediabetes. This means that your blood sugar is above normal but not high enough to be diabetes. Discuss with your doctor how often you need to be tested.footnote 1
There are different types of diabetes. Sometimes it's hard to diagnose the type of diabetes you have because the symptoms are different or the normal treatments don't work well. Your doctor may do a C-peptide test or test for autoantibodies. These tests can help diagnose type 1 diabetes or a slowly developing form of type 1 diabetes called latent autoimmune diabetes in adults (LADA). Another form of diabetes, maturity onset diabetes of the young (MODY), is an inherited disease caused by a change (mutation) in a gene. There are many types of MODY depending on the gene that is affected. Genetic testing can help you and your doctor decide how to treat MODY.
- Diabetes Canada Clinical Practice Guidelines Expert Committee, et al. (2018). Definition, classification and diagnosis of diabetes, prediabetes and metabolic syndrome. Canadian Journal of Diabetes, 42(Suppl 1): S10–S15. DOI: 10.1016/j.jcjd.2017.10.003. Accessed October 15, 2018.
- Diabetes Canada Clinical Practice Guidelines Expert Committee, et al. (2018). Type 2 diabetes in children and adolescents. Canadian Journal of Diabetes, 42(Suppl 1): S247–S254. DOI: 10.1016/j.jcjd.2017.10.037. Accessed October 15, 2018.
Current as of: August 31, 2020
Author: Healthwise Staff
Medical Review: E. Gregory Thompson MD - Internal Medicine
Anne C. Poinier MD - Internal Medicine
Kathleen Romito MD - Family Medicine
Adam Husney MD - Family Medicine
David C.W. Lau MD, PhD, FRCPC - Endocrinology
Matthew I. Kim MD - Endocrinology
Current as of: August 31, 2020