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Diabetes Disease OrganizationsMany organizations provide support to patients and medical professionals. Diabetes develops when the body doesn’t make enough insulin or is not able to use insulin effectively, or both.
Over time, high blood glucose damages nerves and blood vessels, leading to complications such as heart disease, stroke, kidney disease, blindness, dental disease, and amputations. Islets within the pancreas contain beta cells, which make insulin and release it into the blood.
Type 1 diabetes, formerly called juvenile diabetes, is usually first diagnosed in children, teenagers, and young adults. Type 2 diabetes, formerly called adult-onset diabetes, is the most common type of diabetes. More information about gestational diabetes is provided in the NIDDK health topic, What I need to know about Gestational Diabetes, or by calling 1–800–860–8747. Many other types of diabetes exist, and a person can exhibit characteristics of more than one type. More information about other types of diabetes is provided in the NIDDK health topic, Causes of Diabetes, or by calling 1–800–860–8747. Prediabetes is when blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes.
However, modest weight loss and moderate physical activity can help people with prediabetes delay or prevent type 2 diabetes. Blood tests are used to diagnosis diabetes and prediabetes because early in the disease type 2 diabetes may have no symptoms.
Testing enables health care providers to find and treat diabetes before complications occur and to find and treat prediabetes, which can delay or prevent type 2 diabetes from developing. Another blood test, the random plasma glucose (RPG) test, is sometimes used to diagnose diabetes during a regular health checkup. Other symptoms can include fatigue, blurred vision, increased hunger, and sores that do not heal. Any test used to diagnose diabetes requires confirmation with a second measurement unless clear symptoms of diabetes exist. The following table provides the blood test levels for diagnosis of diabetes for nonpregnant adults and diagnosis of prediabetes. The A1C test is used to detect type 2 diabetes and prediabetes but is not recommended for diagnosis of type 1 diabetes or gestational diabetes. False A1C test results may also occur in people with other problems that affect their blood or hemoglobin such as chronic kidney disease, liver disease, or anemia. More information about limitations of the A1C test and different forms of sickle cell anemia is provided in the NIDDK health topic, For People of African, Mediterranean, or Southeast Asian Heritage: Important Information about Diabetes Blood Tests, or by calling 1–800–860–8747.
More information about the A1C test is provided in the NIDDK health topic, The A1C Test and Diabetes, or by calling 1–800–860–8747. Although all these tests can be used to indicate diabetes, in some people one test will indicate a diagnosis of diabetes when another test does not. Health care providers take all these variations into account when considering test results and repeat laboratory tests for confirmation. More information about variation among diabetes blood test results is provided in the NIDDK health topic, The A1C Test and Diabetes, or by calling 1–800–860–8747. Many studies have shown that gestational diabetes can cause complications for the mother and baby. Based on the results of the HAPO study, new guidelines for diagnosis of gestational diabetes were recommended by the International Association of the Diabetes and Pregnancy Study Groups in 2011. Both ADA and ACOG guidelines for using the OGTT in diagnosing gestational diabetes are shown in the following tables. Test women with risk factors for diabetes using standard testing for diagnosis of type 2 diabetes.Women found to have diabetes at this time should be diagnosed with type 2 diabetes, not gestational diabetes.
Adults, pregnant women, children, and teens should be tested for diabetes and prediabetes according to their risk factors.
All pregnant women with risk factors for type 2 diabetes should be tested using standard diabetes blood tests during their first visit to the health care provider during pregnancy to see if they had undiagnosed diabetes before becoming pregnant. Women who develop gestational diabetes should also have follow-up testing 6 to 12 weeks after the baby is born to find out if they have type 2 diabetes or prediabetes.
Body mass index is a measurement of body weight relative to height for adults age 20 or older. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. The Economic Impact of Healthcare Reform on Small BusinessesThesis: In the face of new healthcare mandates created by the Small Business Health OptionsProgram (SHOP) Act of 2009, the costs of providing required medical care will force smallbusinesses to make employee healthcare coverage choices which will impact job growth. Clipping is a handy way to collect and organize the most important slides from a presentation.


People with diabetes have high blood glucose, also called high blood sugar or hyperglycemia. The digestive tract breaks down carbohydrates—sugars and starches found in many foods—into glucose, a form of sugar that enters the bloodstream. As a result, glucose builds up in the blood instead of being absorbed by cells in the body. Other complications of diabetes may include increased susceptibility to other diseases, loss of mobility with aging, depression, and pregnancy problems.
In this type of diabetes, the beta cells of the pancreas no longer make insulin because the body’s immune system has attacked and destroyed them. About 90 to 95 percent of people with diabetes have type 2.1 People can develop type 2 diabetes at any age, even during childhood, but this type of diabetes is most often associated with older age.
The hormones produced during pregnancy increase the amount of insulin needed to control blood glucose levels. Shortly after pregnancy, 5 to 10 percent of women with gestational diabetes continue to have high blood glucose levels and are diagnosed as having diabetes, usually type 2.1 Research has shown that lifestyle changes and the diabetes medication, metformin, can reduce or delay the risk of type 2 diabetes in these women.
For example, in latent autoimmune diabetes in adults, people show signs of both type 1 and type 2 diabetes. Prediabetes means a person is at increased risk for developing type 2 diabetes, as well as for heart disease and stroke. All diabetes blood tests involve drawing blood at a health care provider’s office or commercial facility and sending the sample to a lab for analysis. If the RPG measures 200 milligrams per deciliter or above, and the individual also shows symptoms of diabetes, then a health care provider may diagnose diabetes. The A1C test is a blood test that reflects the average of a person’s blood glucose levels over the past 3 months and does not show daily fluctuations. When the A1C test is used for diagnosis, the blood sample must be sent to a laboratory using a method that is certified by the NGSP to ensure the results are standardized. The A1C test can be unreliable for diagnosing or monitoring diabetes in people with certain conditions known to interfere with the results. International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes.
The FPG test has been the most common test used for diagnosing diabetes because it is more convenient than the OGTT and less expensive. Research has shown that the OGTT is more sensitive than the FPG test, but it is less convenient to administer.
A person’s blood glucose levels normally move up and down depending on meals, exercise, sickness, and stress. Even when the same blood sample is repeatedly measured in the same laboratory, the results may vary due to small changes in temperature, equipment, or sample handling.
People with differing test results may be in an early stage of the disease, where blood glucose levels have not risen high enough to show on every test.
Diabetes develops over time, so even with variations in test results, health care providers can tell when overall blood glucose levels are becoming too high.
Women may be tested during their first visit to the health care provider after becoming pregnant or between 24 to 28 weeks of pregnancy depending on their risk factors and symptoms. An international, multicenter study, the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study, showed that the higher a pregnant woman’s blood glucose is, the higher her risk of pregnancy complications. So far, the new guidelines have been adopted by the American Diabetes Association (ADA)3 but not by the American College of Obstetricians and Gynecologists (ACOG)4 or other medical organizations. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. More information about treating gestational diabetes is provided in the NIDDK health topic, What I need to know about Gestational Diabetes, or by calling 1–800–860–8747. A waist measurement of 40 inches or more for men and 35 inches or more for women is linked to insulin resistance and increases a person’s risk for type 2 diabetes. Health care providers may recommend more frequent testing depending on initial results and risk status.
After that, pregnant women should be tested for gestational diabetes between 24 and 28 weeks of their pregnancy using the OGTT. The words above the BMI number indicate whether the person is normal weight, overweight, or obese. The BMI may overestimate body fat in athletes and others who have a muscular build and underestimate body fat in older adults and others who have lost muscle.
With the help of the hormone insulin, cells throughout the body absorb glucose and use it for energy. Type 2 diabetes is also associated with excess weight, physical inactivity, family history of diabetes, previous history of gestational diabetes, and certain ethnicities. If the body can’t meet this increased need for insulin, women can develop gestational diabetes during the late stages of pregnancy.


Babies born to mothers who had gestational diabetes are also more likely to develop obesity and type 2 diabetes as they grow up.
Other types of diabetes include those caused by genetic defects, diseases of the pancreas, excess amounts of certain hormones resulting from some medical conditions, medications that reduce insulin action, chemicals that destroy beta cells, infections, rare autoimmune disorders, and genetic syndromes associated with diabetes.
The A1C test is more convenient for patients than the traditional glucose tests because it does not require fasting and can be performed at any time of the day. People with an A1C below 5.7 percent maystill be at risk for diabetes, depending on the presence of other characteristics that put them at risk, also known as risk factors.
Blood samples analyzed in a health care provider’s office, known as point-of-care tests, are not standardized for diagnosing diabetes. Interference should be suspected when A1C results seem very different from the results of a blood glucose test.
The FPG test measures blood glucose in a person who has fasted for at least 8 hours and is most reliable when given in the morning.
When used to test for diabetes or prediabetes, the OGTT measures blood glucose after a person fasts for at least 8 hours and 2 hours after the person drinks a liquid containing 75 grams of glucose dissolved in water. Women found to have diabetes at the first visit to the health care provider after becoming pregnant may be diagnosed with type 2 diabetes.
The HAPO researchers found that pregnancy complications can occur at blood glucose levels that were once considered to be normal.
People whose test results indicate they have prediabetes may be tested again in 1 year and should take steps to prevent or delay type 2 diabetes. Blood glucose tests, rather than the A1C test, should be used for testing within 12 weeks of delivery.
People who are overweight or obese should consider talking with a health care provider about ways to lose weight and reduce the risk of diabetes. Small businesses must weigh the difference between the cost to offer coverage and the government fine for non-compliance.
Type 2 diabetes usually begins with insulin resistance, a condition linked to excess weight in which muscle, liver, and fat cells do not use insulin properly.
Glucose measuring devices used in a health care provider’s office, such as finger-stick devices, are not accurate enough for diagnosis but may be used as a quick indicator of high blood glucose. People with an A1C above 6.0 percent should be considered at very high risk of developing diabetes. People of African, Mediterranean, or Southeast Asian descent or people with family members with sickle cell anemia or a thalassemia are particularly at risk of interference.
The app also provides links to information about steps people can take to bring their BMI into a healthy range. As the blood glucose level rises after a meal, the pancreas is triggered to release insulin.
As a result, the body needs more insulin to help glucose enter cells to be used for energy. Small businesses who offer coverage must cover no less than 72.5% of the cheapest health plan offered for individuals, and no less than 65% for families. Within the pancreas, clusters of cells called islets contain beta cells, which make the insulin and release it into the blood. But in time, the pancreas loses its ability to produce enough insulin in response to meals, and blood glucose levels rise. In addition, employers must automatically enroll every employee in a health plan with the lowest employee premium - unless they opt out. Small businesses who do not offer coverage must pay the Health Choices Commissioner (SHOP Plan) 8% of average wages paid during a predefined period.
Small businesses that fail to provide coverage or pay SHOP fees will be fined $100 per violation day. Fewer incentives for entrepreneurs to grow their business will have a negative impact on hiring and productivity gains in the United States. Small businesses that employ less than 50 people (one of the thresholds in the legislation for tax penalties and compliance requirements) are holding off on hiring any new employees until they can get a better handle on what their costs is going to be under the new legislation. Small business owners may decide not to grow their human capital merely to stay below the 50 employees to avoid the mandate.
If small businesses dont expand, the economy could be impacted with lower expansion and growth, which will trickle down to lower hiring rates and GDP growth. Driving growth and innovation, small businesses play an important role in the United States economy.
Small businesses are now faced with healthcare coverage decisions that will not be helpful to the current employment situation in the country.



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