What is a random glucose test?
A random glucose test is one method for measuring the amount of glucose or sugar circulating in a person’s blood.
Doctors carry out this test and use the result to determine whether a person is likely to have diabetes. While other tests may be necessary to confirm a full diagnosis,
This article will look at what a random glucose test is, why a doctor may recommend it, and what the results can mean.
What is random glucose testing?
Random glucose testing measures the levels of glucose in the blood at any given point in the day.
Many blood tests for diabetes involve either fasting or continuous monitoring, but this test does not.
It is useful for people who need a speedy diagnosis, such as those with type 1 diabetes who require supplementary insulin as a matter of emergency.
How does the test work?
Glucose is a form of sugar and comes from the foods people eat.
It is the body’s primary energy source and fuels every cell, including those in the brain, heart, and muscles.
The body works continuously to keep the amount of blood glucose at optimum levels. It produces a hormone called insulin to achieve this, which helps glucose get into the cells that need it for energy.
People with type 1 diabetes do not produce insulin because their immune systems attack and destroy the cells in the pancreas that make insulin.
People with type 2 diabetes either do not produce enough insulin or their body does not respond to it appropriately.
When a person does not make insulin correctly, glucose remains in the blood. Hyperglycemia occurs when levels remain consistently high and hypoglycemia when they are too low.
Random glucose testing is one way of checking the levels of glucose in the blood. Doctors may carry out a random glucose test at any time of the day.
If the result indicates that a person has higher than expected glucose levels, the doctor will usually order a follow-up test to confirm the diagnosis, including the following:
Fasting glucose test. This test measures blood glucose levels after the person has had nothing to eat or drink for 8 hours.
Doctors usually perform this test in the morning before breakfast.
Oral glucose tolerance test (OGTT). People with diabetes can sometimes demonstrate normal results in the fasting or random glucose tests yet still have diabetes.
If a doctor still suspects that a person has diabetes, they may recommend an OGTT. This test also requires a person not to eat or drink for 8 hours.
After giving the first blood sample, the individual drinks a liquid containing glucose. The doctor then takes more blood samples hourly over the next 2 hours.
Reasons for testing
A doctor may recommend a random blood glucose test if a person shows symptoms of diabetes, such as:
- urinating more often
- feeling extremely thirsty
- feeling very hungry despite eating enough
- unexplained weight loss
- extreme fatigue or tiredness
- blurred vision
- slow healing of cuts and bruises
Type 2 diabetes can often develop slowly, which might make symptoms difficult to detect at first.
People with diabetes may also experience a sensation of tingling or numbness in the hands or feet, or diabetic neuropathy. This is more likely to occur if a person does not control blood glucose for extended periods.
A random glucose test is a quick test that a doctor or nurse can carry out at short notice in their office or clinic. The person does not need to fast beforehand.
The test requires a small sample of blood that the doctor or nurse will take using a needle, often from the finger.
Doctors measure the amount of glucose in a person’s blood in milligrams per deciliter (mg/dL).
For a random glucose test, a result of 200 mg/dL or above indicates that a person may have diabetes. However, for a more reliable diagnosis, the doctor will usually repeat the test on another day.
To help confirm the diagnosis, the doctor may also order a different type of test, such as a fasting glucose test or an OGTT.
For a fasting glucose test:
- less than 100 mg/dL is normal
- 100 to 125 mg/dL indicates prediabetes
- 126 mg/dL or above indicates diabetes
For an OGTT:
- less than 140 mg/dL is normal
- 140 to 199 mg/dL indicates prediabetes
- 200 mg/dL or above indicates diabetes
One suggests that one random glucose test that shows a reading of over 100 mg/dL is a greater risk factor for diabetes than traditional factors, such as obesity.
Prediabetes means that a person’s blood glucose levels are higher than usual, but doctors do not yet consider that they have diabetes. Doctors sometimes call this impaired glucose tolerance (IGT) or impaired fasting glucose (IFG).
People with prediabetes are at increased risk of developing diabetes. Lifestyle modifications, such as weight loss and exercise, and certain medications can help reduce this risk.
What can affect the result?
Blood glucose levels change throughout the day, depending on a range of factors.
These might include a person’s food intake, as well as the duration and intensity of any exercise or physical activity that day. However, the blood glucose levels of people without diabetes tends to stay within the normal range.
The following factors may increase a person’s blood glucose levels:
- eating too much food
- low levels of physical activity
- medication side effects
The following factors may decrease a person’s blood glucose levels:
- eating little or no food
- drinking alcohol
- medication side effects
- intense physical activity or exercise
Diagnosis with any chronic condition can be distressing, and, without treatment, diabetes can lead to serious health problems and complications, including:
However, with effective treatment and management, people with diabetes can enjoy a long and active life.
Doctors usually diagnose type 1 diabetes in children and young adults. People with type 1 diabetes need to take insulin daily and regularly monitor their blood sugar levels for the rest of their lives.
Type 2 diabetes often develops later in life. A person can sometimes manage type 2 diabetes using only diet and exercise. Other people may need medication or even insulin so that they can keep their blood sugar levels within healthy levels.
Anyone with symptoms of diabetes should see their doctor for an evaluation.
What are Normal Blood Glucose Levels?
The amount of glucose (“sugar”, measured in mg/dL) in your blood changes throughout the day and night. Your levels will change depending upon when, what and how much you have eaten, and whether or not you have exercised.
Normal Blood Sugars
- A normal fasting (no food for eight hours) blood sugar level is between 70 and 99 mg/dL
- A normal blood sugar level two hours after eating is less than 140 mg/dL
Diabetes is diagnosed by any one of the following:
- Two consecutive fasting blood glucose tests that are equal to or greater than 126 mg/dL
- Any random blood glucose that is greater than 200 mg/dL
- An A1c test that is equal to or greater than 6.5 percent. A1c is an easy blood test that gives a three month average of blood sugars
- A two-hour oral glucose tolerance test with any value over 200 mg/dL
Sometimes you may have symptoms of fatigue, excessive urination or thirst, or unplanned weight loss. However, often people have no symptoms of high blood glucose and find a diabetes diagnosis surprising.
My doctor says I have pre-diabetes. What is that?
- You are at high risk of developing diabetes. You can prevent or delay diabetes by increasing physical activity, eating healthful foods, and maintaining or losing weight
- Pre-diabetes is also called impaired fasting glucose (IFG)
Pre-diabetes is diagnosed by any one of the following:
- A fasting blood glucose in between 100-125 mg/dL
- An A1c between 5.7 - 6.4 percent
- Any value between 140 mg/dL and 199 mg/dL during a two-hour 75g oral glucose tolerance test
To Make an Appointment
To talk with someone about an appointment, or to contact an endocrinologist or certified diabetes educator, please call the Endocrinology and Diabetes clinic at (206) 223-6627.
Learn more at one of Virginia Mason’s diabetes classes.
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What Is a Normal Range of Mg/Dl for Blood Glucose?
Vegetables have low impact on blood sugar.
Image Credit: Jupiterimages/Creatas/Getty Images
Glucose is an important energy source for your brain and body. Your body converts carbohydrates and simple sugars in your diet to glucose for fuel usage. Your pancreas releases a hormone called insulin to regulate blood glucose levels. According to the American Diabetes Association, a normal fasting blood glucose level is between 70 to 100 milligrams per deciliter and the recommendation is to aim for 70 to 130 milligrams per deciliter when fasting and less than 180 milligrams per deciliter after meals.
Low Blood Glucose
Low blood glucose, or hypoglycemia, occurs when your blood glucose drops too low. Blood glucose can drop if you missed a meal or waited too long to eat. Rigorous exercise also decreases blood glucose, as well as drinking alcoholic beverages. Some medications can cause blood glucose to drop. You can prevent hypoglycemia by eating regularly. If you experience low blood sugar, eating a few pieces of hard candy, drinking an 8-ounce cup of milk or drinking 1/2 cup of fruit juice can quickly raise levels.
High Blood Glucose
According to the National Diabetes Information Clearinghouse, high blood sugar means either you do not have enough insulin in your body or your insulin sensitivity is decreased and your body is not responding properly. Diet and lack of exercise are factors in high blood glucose. Having an infection can also increase blood glucose, as can some medications. If you are on diabetes medications and miss a dose, your blood glucose levels can rise.
Maintaining Healthy Blood Sugar Levels
Physical activity increases insulin sensitivity, which helps maintain healthy blood glucose levels, so it is important to engage in at least 30 minutes of physical exercise daily. Eating healthy fruits, vegetables and lean meats such as poultry and fish reduces your risk of developing high glucose. Limiting high-sugar foods such as ice cream, cake, candy bars and pastries helps reduce the glycemic load on your body. Glycemic load refers to how much insulin your pancreas produces after a meal.
Diabetes occurs when your body doesn't make enough insulin or does not use it properly. There are two types of diabetes. In Type 1, the pancreas fails to produce sufficient insulin. In Type 2, the pancreas either does not produce enough insulin or the body's cells ignore it. According to FamilyDoctor.org, between 90 to 95 percent of individuals diagnosed have Type 2 diabetes. Type 1 diabetes requires lifelong insulin replacement. Type 2 diabetes is usually managed through diet and lifestyle changes.
Blood sugar test
A blood sugar test measures the amount of a sugar called glucose in a sample of your blood.
Glucose is a major source of energy for most cells of the body, including brain cells. Glucose is a building block for carbohydrates. Carbohydrates are found in fruit, cereal, bread, pasta, and rice. Carbohydrates are quickly turned into glucose in your body. This can raise your blood glucose level.
Hormones made in the body help control blood glucose level.
A blood sample is needed.
The test may be done in the following ways:
- After you have not eaten anything for at least 8 hours (fasting)
- At any time of the day (random)
- Two hours after you drink a certain amount of glucose (oral glucose tolerance test)
When the needle is inserted to draw blood, some people feel moderate pain. Others feel only a prick or stinging. Afterward, there may be some throbbing or slight bruising. This soon goes away.
Your health care provider may order this test if you have signs of diabetes. More than likely, the provider will order a fasting blood sugar test.
The blood glucose test is also used to monitor people who already have diabetes.
The test may also be done if you have:
- An increase in how often you need to urinate
- Recently gained a lot of weight
- Blurred vision
- Confusion or a change in the way you normally talk or behave
- Fainting spells
- Seizures (for the first time)
- Unconsciousness or coma
SCREENING FOR DIABETES
This test may also be used to screen a person for diabetes.
High blood sugar and diabetes may not cause symptoms in the early stages. A fasting blood sugar test is almost always done to screen for diabetes.
If you are over age 45 and have no diabetes risk factors, you should be tested every 3 years.
If you're overweight or obese (body mass index, or BMI, of 25 or higher), you should be screened for prediabetes or type 2 diabetes starting at age 35.
If you're overweight and have any of the other risk factors below, ask your provider about getting tested at an earlier age and more often:
- High blood sugar level on a previous test
- Blood pressure of 140/90 mm Hg or higher, or unhealthy cholesterol levels
- History of heart disease
- Member of a high-risk ethnic group (African American, Latino, Native American, Asian American, or Pacific Islander)
- Woman who has been previously diagnosed with gestational diabetes
- Polycystic ovary disease (condition in which a woman has an imbalance of female sex hormones causing cysts in the ovaries)
- Close relative with diabetes (such as a parent, brother, or sister)
- Not physically active
Children age 10 and older who are overweight and have at least two of the risk factors listed above should be tested for type 2 diabetes every 3 years, even if they have no symptoms.
If you had a fasting blood glucose test, a level between 70 and 100 mg/dL (3.9 and 5.6 mmol/L) is considered normal.
If you had a random blood glucose test, a normal result depends on when you last ate. Most of the time, the blood glucose level will be 125 mg/dL (6.9 mmol/L) or lower.
The examples above show the common measurements for results of these tests. Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or may test different specimens. Talk to your provider about the meaning of your specific test results.
Blood glucose measured by a blood test from a vein is considered more accurate than blood glucose measured from a fingerstick with a blood glucose meter, or blood glucose measured by a continuous glucose monitor.
If you had a fasting blood glucose test:
- A level of 100 to 125 mg/dL (5.6 to 6.9 mmol/L) means you have impaired fasting glucose, a type of prediabetes. This increases your risk of developing type 2 diabetes.
- A level of 126 mg/dL (7 mmol/L) or higher usually means you have diabetes.
If you had a random blood glucose test:
- A level of 200 mg/dL (11 mmol/L) or higher often means you have diabetes.
- Your provider will order a fasting blood glucose, A1C test, or glucose tolerance test, depending on your random blood glucose test result.
- In someone who has diabetes, an abnormal result on the random blood glucose test may mean that the diabetes is not well controlled. Talk with your provider about your blood glucose goals if you have diabetes.
Other medical problems can also cause a higher-than-normal blood glucose level, including:
A lower-than-normal blood glucose level (hypoglycemia) may be due to:
- Hypopituitarism (a pituitary gland disorder)
- Underactive thyroid gland or adrenal gland
- Tumor in the pancreas (insulinoma - very rare)
- Too little food
- Too much insulin or other diabetes medicines
- Liver or kidney disease
- Weight loss after weight loss surgery
- Vigorous exercise
Some medicines can raise or lower your blood glucose level. Before having the test, tell your provider about all the medicines you are taking.
For some thin young women, a fasting blood sugar level below 70 mg/dL (3.9 mmol/L) may be normal.
There is little risk involved with having your blood taken. Veins and arteries vary in size from one person to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.
Other risks associated with having blood drawn are slight, but may include:
- Excessive bleeding
- Fainting or feeling lightheaded
- Multiple punctures to locate veins
- Hematoma (blood accumulating under the skin)
- Infection (a slight risk any time the skin is broken)
Random blood sugar; Blood sugar level; Fasting blood sugar; Glucose test; Diabetic screening - blood sugar test; Diabetes - blood sugar test
American Diabetes Association. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2021. Diabetes Care. 2021 Jan;44(Suppl 1):S15-S33. PMID: 33298413 pubmed.ncbi.nlm.nih.gov/33298413/.
Chernecky CC, Berger BJ. Glucose, 2-hour postprandial - serum norm. In: Chernecky CC, Berger BJ, eds. Laboratory Tests and Diagnostic Procedures. 6th ed. St Louis, MO: Elsevier Saunders; 2013:585.
Chernecky CC, Berger BJ. Glucose tolerance test (GTT, OGTT) - blood norm. In: Chernecky CC, Berger BJ, eds. Laboratory Tests and Diagnostic Procedures. 6th ed. St Louis, MO: Elsevier Saunders; 2013:591-593.
US Preventive Services Task Force, Davidson KW, Barry MJ, Mangione CM, et al. Screening for prediabetes and type 2 diabetes: US Preventive Services Task Force recommendation statement. JAMA. 2021;326(8):736-743. PMID: 34427594 pubmed.ncbi.nlm.nih.gov/34427594/.
Updated by: Brent Wisse, MD, board certified in Metabolism/Endocrinology, Seattle, WA. Internal review and update on 06/03/2021 by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 09/03/2021.
What You Should Know About Managing Glucose Levels
What are blood glucose levels?
If you have diabetes, managing your blood glucose level is an important part of managing your condition. That’s because high blood sugar levels can cause long-term complications.
When you have diabetes, your body isn’t able to get the sugar from blood into cells, or make enough, or any, insulin. This causes high levels of blood sugar, or high glucose levels. The carbohydrates in food cause blood sugar levels to go up after meals.
When you eat foods that contain carbohydrates, the digestion process turns them into sugars. These sugars are released into the blood and transported to the cells. The pancreas, a small organ in the abdomen, releases a hormone called insulin to meet the sugar at the cell.
Insulin acts as a “bridge,” allowing the sugar to go from the blood into the cell. When the cell uses the sugar for energy, blood sugar levels go down.
If you have diabetes, there’s either a problem with the pancreas producing insulin, or the cells using insulin, or both.
The different types of diabetes and diabetes-related conditions include:
Type 1 diabetesis when the body stops making insulin.
Keep reading to learn more about checking and managing your glucose levels.
When to check blood glucose levels
Talk to your doctor or healthcare providers about the best times to check your blood glucose. Optimal times vary for each person.
Some options include:
- after fasting (after waking or not eating for eight to 12 hours), or before meals
- before and after meals, to see the impact that the meal had on your blood sugar
- before all meals, to decide how much insulin to inject
- at bedtime
Bring a record of your blood sugar results to appointments with your doctor so you can review it and make changes to your treatment if necessary.
How to check
You will need to take a blood sample to check your blood glucose levels. You can do this at home using a blood glucose monitor. The most common type of blood glucose monitor uses a lancet to prick the side tip of your finger to draw a small drop of blood. Then you place this drop of blood on a disposable testing strip.
You insert the testing strip into an electronic blood glucose meter before or after the blood is applied. The meter measures the level of glucose in the sample and returns a number on a digital readout.
Another option is a continuous glucose monitor. A small wire is inserted beneath the skin of your abdomen. Every five minutes, the wire will measure blood glucose levels and deliver the results to a monitor device worn on your clothing or in a pocket. This allows you and your doctor to keep a real time reading of your blood glucose levels.
What should I do if my glucose levels are too high?
You should establish a treatment plan with your doctor. You may be able to manage your glucose levels through diet and other lifestyle changes, like weight loss. Exercise can also help lower your glucose levels.
Medications may be added to your treatment if needed. Most people with type 2 diabetes will start on metformin as their first medication. There are many different types of diabetes medications that act in different ways.
Injecting insulin is one way to quickly reduce your glucose levels. Your doctor may prescribe insulin if you need help managing your glucose levels. Your doctor will determine your dosage and go over with you how to inject it, and when.
Let your doctor know if your glucose levels are consistently high. This could mean you need to take regular medication or make other changes to your diabetes treatment plan. Working with your doctor to get your glucose levels under control is important. Consistently high levels can lead to serious complications, like diabetic neuropathy or kidney failure.
Diabetes eating plan
The foods you eat can have a big impact on your glucose levels.
Don’t skip meals. Irregular eating patterns can cause spikes and dips in your blood glucose and make it difficult to stabilize.
Include healthy carbohydrates, fiber-rich foods, and lean proteins in your diet. Healthy carbohydrates include:
- whole grains
- beans and other legumes
Manage the amount of healthy carbohydrates you eat at meals and snacks. Add protein and fat to slow digestion and avoid blood sugar spikes.
Limit foods high in saturated and trans fats, cholesterol, and sodium. Instead, eat healthy fats, which are important to a balanced diet. They include:
- olive oil
Limit your consumption of processed foods. They often digest quickly and spike blood sugar levels. These foods can be high in:
- trans fats
Cook healthy foods in bulk and then store them in single serving size containers in the refrigerator or freezer. Having easy-to-grab, healthy choices can help you avoid choosing less healthy options when you’re in a hurry or really hungry.
In addition to eating healthy foods, remember to include regular exercise in your daily routine. If you’re new to exercise, check with your doctor before starting. Then start slowly and work your way up to more vigorous routines.
You can also add more exercise through small changes, including:
- taking stairs instead of an elevator
- walking around the block or your office during breaks
- parking further from store entrances when shopping
Over time, these small changes can add up to big wins for your health.
Monitoring your blood glucose levels is an important step in managing your diabetes. Knowing your numbers will also help inform your doctor about changes you may need to make to your treatment plan.
Following a healthy and balanced diet, exercising, and taking medicines as prescribed should help you to maintain normal glucose levels. Talk to your doctor if you need help coming up with a diet or exercise plan, or if you are unclear about how to take medications.
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