November is Diabetes Awareness Month and the perfect opportunity to get educated about your personal diabetes risk. One important piece of the puzzle is knowing your blood sugar numbers.
How is Blood Sugar Tested?
There are many ways to test blood sugar that give you an idea of how well your body is keeping glucose in range. At-home glucometers and continuous glucose monitors (CGM) are tools that can be used at home to check blood sugar at a specific point in time. These are useful tools for understanding how your body reacts to certain foods, illness and stress but are not recommended for everyone. If your provider thinks this would be beneficial for you, they will have you monitor for a month or so but will provide clinical oversight so you can accurately interpret results.
Routine bloodwork completed at a lab often includes a fasting glucose test, which measures your blood sugar at a specific moment in time after you have not eaten anything in eight hours or more. This is an effective measurement to determine risk.
Another lab test often used is a Hemoglobin A1C (A1C). This blood test measures an average of your blood sugar over a two-to-three-month period, giving your provider critical information about a pattern of blood sugar management.
A third diagnostic test is called the Oral Glucose Tolerance Test (OGTT). This test is given to women during pregnancy to check for gestational diabetes but is also sometimes used to diagnose prediabetes and Type 2 diabetes. For this test, you fast for 8-12 hours prior, then drink a sugary solution that contains 75 grams of glucose. Your blood sugar is tested before you drink the solution and again two hours later, when blood sugar tends to be at its highest after ingestion.
What Are Current Screening Guidelines?
Screening guidelines are based on age, risk factors and personal history. The 2025 American Diabetes Association (ADA) Standards of Care recommends the following groups should be screened for prediabetes and Type 2 diabetes:
1. For adults who are overweight or obese and have any of the following risk factors:
• First-degree relative with diabetes
• High-risk race, ethnicity and ancestry (African American, Latino, Native American, Asian American)
• History of cardiovascular disease
• High blood pressure
• Low HDL cholesterol or high triglyceride levels
• Polycystic Ovary Syndrome (PCOS)
• Physical inactivity
• Other clinical conditions associated with insulin resistance
2. People with prediabetes should be tested annually.
3. Women diagnosed with gestational diabetes should be checked every one to three years.
4. For all others, testing should begin at age 35.
5. With normal results, testing should be repeated at least every three years, or more often with additional risk factors and personal history.
6. Individuals in other high-risk groups should be closely monitored (people with HIV, exposure to high-risk medicines, evidence of periodontal disease, history of pancreatitis).
How to Help Manage Blood Sugar
While some factors are out of our control, there are many ways we can help regulate blood sugar through general lifestyle and wellness practices. If your tests come back in the prediabetes range, ask your provider about a referral to the Diabetes Prevention Program (DPP) to learn how to best prevent prediabetes from becoming Type 2 diabetes. Some of the lifestyle factors you can address in the meantime include:
• Maintain a healthy body weight.
• Exercise 150+ minutes per week at moderate intensity.
• Choose high-fiber, minimally processed foods.
• Manage stress.
• Sleep seven to nine hours per night.
• Manage blood pressure and cholesterol levels.
Warning Signs to Seek Prompt Medical Attention
While screening is helpful to see a pattern of blood sugars and if they are heading in the wrong direction, if you or a loved one experiences any of these symptoms, seek the advice of a professional for prompt screening and treatment:
• The “3 P’s”: Increased urination (polyuria), increased thirst (polydipsia), increased hunger (polyphagia).
• Unexplained weight loss (especially rapid weight loss) – happens more often in Type 1 but can also occur in Type 2 diabetes.
• Extreme fatigue, blurred vision, slow-healing sores or infections or numbness/tingling in hands and/or feet (neuropathy).
• Symptoms of diabetic ketoacidosis (DKA) – Nausea, vomiting, abdominal pain, rapid breathing, confusion and fruity breath. This is an emergency most commonly seen in Type 1 diabetes (but can also be seen in Type 2) and requires immediate care. Can sometimes be the reason people seek medical intervention, resulting in a diabetes diagnosis.
This month, check in with yourself. Complete a risk assessment HERE to determine your risk factors. If you haven’t been screened lately, talk to your provider about whether it’s time for you to be screened. If you are aware once you have developed pre-diabetes, you can take steps towards effective blood sugar management and help prevent future complications.
