In order to diagnose diabetes, health care providers conduct a fasting glucose test, an oral glucose tolerance test (OGTT)13 or very recently a haemoglobin A1c test. All involve taking blood, the first two after an overnight fast.

In January 2010 the American Diabetes Association (ADA) published revised recommendations for the screening and diagnosis of diabetes14 .

Fasting blood glucose
Glucose level indication
From 70 to 99 mg/dL (3.9 to 5.5 mmol/L) Normal fasting glucose
From 100 to 125 mg/dL (5.6 to 6.9 mmol/L) Pre diabetes (impaired fasting glucose and or impaired glucose tolerance)
126 mg/dL (7.0 mmol/L) and above on more than on testing occasion Diabetes
Source: table based on American Diabetes Association (2010) Standards of Medical Care in Diabetes – 2010. Diabetes Care, 33:S11-S61

The 2010 revised ADA recommendations include the use of haemoglobin A1c (HbA1c) for the first time to diagnose diabetes and to identify people at risk of developing diabetes in the future (aka pre diabetes).

The revised ADA recommendations help doctors and patients interpret HbA1c test results.

Haemoglobin A1c ( HbA1c)
HbA1c level (%) indication
5.0 – 5.5 % Normal
5.5 – 6.0 % Pre diabetes: Increased risk for developing diabetes in the next 5 years, appropriate level for initiating preventive measures
5.7 – 6.4 % Very high risk of developing diabetes over 5 years
≥ 6.5 %  (confirmed by repeat testing)

Source: table based on American Diabetes Association (2010) Standards of Medical Care in Diabetes – 2010. Diabetes Care, 33:S11-S61 and

According to the ADA, HbA1c has several advantages over fasting glucose tests including:

  • Convenience as fasting not required
  • Less day to day fluctuation
  • Less affected by stress and illness

Diabetes and pre diabetes often goes undiagnosed because there may be no symptoms or many of its symptoms seem so harmless. Early detection and treatment can lower your risk of developing both diabetes and its often debilitating complications.

If you find out you have pre diabetes or diabetes, you can take steps to treat it and prevent complications.

13In the OGTT test, a person’s blood glucose level is measured after a fast and two hours after drinking a glucose rich beverage.140-200 mg/dL (7.8 – 11.1 mmol/L indicated pre diabetes. Over 200 mg/dL (11.1 mmol/L) on more than once testing occasion indicates diabetes.
14American Diabetes Association (2010) Standards of Medical Care in Diabetes – 2010. Diabetes Care, 33:S11-S61

Lisa Fouladi Balance Ur Bod Nutrition Consultancy

Lisa, principle consultant and founder of balance ur bod nutrition consultancy is a qualified nutrition therapist (dip.ION), a Nutrition Therapy Council registered practitioner, and a current member of the British Association of Applied Nutrition and Nutrition Therapy (BANT) and is bound by their codes of ethics and practice. She is fully insured, and dedicated to continuous study of current research and industry developments through Continued Professional Development (CPD).

In keeping with her quest for knowledge, Lisa is currently enrolled in yet another degree program, an MSc at the University of London (London School of Hygiene and Tropical Medicine) which she hopes to complete someday.

Although based in Zürich, Switzerland, she sees clients in the Geneva area, in Germany (Münster area) and in the UK (London and Windsor areas).

Lisa conducts one to one consultations with clients, advising on all aspects of nutrition and the effect food and lifestyle choices have on health and well being. Lisa works closely with her clients, assessing and identifying imbalances and individual needs, and supporting them in making the necessary dietary and lifestyle changes. She is deeply committed to supporting her client’s health through nutrition and stays at their side throughout the process.