Do you have insulin resistance or pre-diabetes?

Anyone 45 years or older should consider getting tested for diabetes. If you are overweight and aged 45 or older, it is strongly recommended that you get tested. You should consider getting tested if you are younger than 45, overweight, and have one or more of the following risk factors:

• family history of diabetes
  
  
• low HDL cholesterol and high triglycerides
  
  
• high blood pressure
  
  
• history of gestational diabetes (diabetes during pregnancy) or gave birth to a baby weighing more than 9 pounds
  
  
• minority group background (African American, American Indian, Hispanic American/Latino, or Asian American/Pacific Islander)

Diabetes and pre-diabetes can be detected with one of the following tests:

A fasting glucose test measures your blood glucose after you have gone overnight without eating. This test is most reliable when done in the morning. Fasting glucose levels of 100 to 125 mg/dL are above normal but not high enough to be called diabetes. This condition is called pre-diabetes or impaired fasting glucose, and it suggests that you have probably had insulin resistance for some time. IFG is considered a pre-diabetic state, meaning that you are more likely to develop diabetes but do not have it yet.

A glucose tolerance test measures your blood glucose after an overnight fast and 2 hours after you drink a sweet liquid provided by the doctor or laboratory. If your blood glucose falls between 140 and 199 mg/dL 2 hours after drinking the liquid, your glucose tolerance is above normal but not high enough for diabetes. This condition, also a form of pre-diabetes, is called impaired glucose tolerance and, like IFG, it points toward a history of insulin resistance and a risk for developing diabetes.

These tests give only indirect evidence of insulin resistance. The test that most accurately measures insulin resistance is too complicated and expensive to use as a screening tool in most doctors' offices. The test, called the euglycemic clamp, is a research tool that helps scientists learn more about sugar metabolism problems. Insulin resistance can also be assessed with measurement of fasting insulin. If conventional tests show that you have IFG or IGT, your doctor may suggest changes in diet and exercise to reduce your risk of developing diabetes.

If your blood glucose is higher than normal but lower than the diabetes range, have your blood glucose checked in 1 to 2 years.

Lab Tests and What They Show

• Blood glucose. High blood glucose may be a sign that your body does not have enough insulin or does not use it well. However, a fasting measurement or oral glucose tolerance test gives more precise information.
  
  
• Insulin. An insulin measurement helps determine whether a high blood glucose reading is the result of insufficient insulin or poor use of insulin.
  
  
• Fasting glucose. Your blood glucose level should be lower after several hours without eating. After an overnight fast, the normal level is below 100 mg/dL. If it is in the 100 to 125 mg/dL range, you have impaired fasting glucose or pre-diabetes. A result of 126 or higher, if confirmed on a repeat test, indicates diabetes.
  
  
• Glucose tolerance. Your blood glucose level will be higher after drinking a sugar solution, but it should still be below 140 mg/dL 2 hours after the drink. If it is higher than normal (in the 140 to 199 mg/dL range) 2 hours after drinking the solution, you have IGT or pre-diabetes, which is another strong indication that your body has trouble using glucose. A level of 200 or higher, if confirmed, means diabetes is already present.

source: http://diabetes.niddk.nih.gov/dm/pubs/insulinresistance/index.htm