In a person without classic symptoms of hyperglycaemia, diabetes is confirmed by two abnormal results: either two different tests from the same sample, such as HbA1c and fasting glucose, or the same test repeated on another day. A random glucose of 200 mg/dL or more with typical symptoms is enough on its own.
The point of confirming is not delay. Book the repeat test when you see the first result, so the diagnosis is settled at the next visit and treatment is not lost in between. Remember that anaemia, haemoglobin variants and recent blood loss can make HbA1c misleading, which is relevant in many Indian patients.
- Confirm an abnormal HbA1c or fasting glucose with a second test if the patient has no symptoms
- Book the confirmatory test at the moment you read the first result
- Use glucose-based tests when anaemia or a haemoglobin variant may distort HbA1c
- Record the diagnosis in the notes once confirmed so it follows the patient
Why it matters
Confirmation is where many diagnoses stall, as today's practice-changer shows.
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