Screening test for diabetes advised

DEAR DR. ROACH

» Recently my mom was diagnosed with diabetes. Two of her 12 siblings were diabetic. While I don’t have anything that I would call a red flag symptom, would it be wise for me to get tested? Can I go to my doctor and have them run a test without having any major symptoms, or would that be a waste of time? I am a fairly healthy 35-year-old male. I don’t smoke, have an occasional drink, run 2030 miles a week and have a physically active job in landscaping. The worst part is my diet, which isn’t always the best due to working long hours in the summer, coming home and eating prior to going to bed. Sometimes that can include sweets and/or carbs.

— M.D.F.

DEAR READER » People with a family history of diabetes (parents or siblings) should absolutely receive screening tests for diabetes. A screening test is done on a person with no symptoms at all.

If you were to develop symptoms, such as excess thirst or urination, blurry vision or unintended weight loss, you should be seen right away and evaluated solely on the basis of your symptoms. Otherwise, a screening test with your routine wellness visit is appropriate.

Most doctors use the hemoglobin A1C test, which looks at the blood sugar over the past couple of months, rather than a fasting blood glucose, which will not become abnormal until the diabetes is considerably more advanced. The most sensitive test is a two-hour glucose tolerance test, which I use when my suspicion is very high, even if the A1C is normal.

Given your family history, it is particularly important for you to avoid processed foods, refined starches and simple sugars. Whole fruits, whole grains, vegetables, seeds and nuts are much better choices. You should also avoid eating right before bed. Try keeping a healthier snack with you to eat in the late afternoon or evening to keep you from getting so hungry that you make unwise choices at night.