the patient came in for a general check feeling perfectly well. Her fasting blood sugar came back at 10.2 mmol/L — nearly double the upper limit of normal. Her HbA1c showed she had had elevated sugar for at least 3 months. She had Type 2 diabetes and had not known it.
Trader, Ojota. Attended for a general wellness check — no specific complaints. Had not tested blood sugar in 5 years. Family history: mother had diabetes. Mildly overweight (BMI 28.4). Fasting blood glucose: 10.2 mmol/L. HbA1c: 8.4%.
Fasting Blood Sugar + HbA1cthe patient had last checked her blood sugar at a church health fair 5 years earlier. That result had been normal — 4.8 mmol/L. She had felt reassured and not thought about it since. Her mother had developed diabetes in her 60s, but the patient was only 52 and felt healthy. She was tired sometimes, but she ran a busy market stall. Who wasn't tired?
She came to Mascot Healthcare for what she described as "a general check — my daughter said I should come in once a year." The doctor took a history: occasional increased thirst, nocturia once or twice a night, a skin wound on her left calf that had been slow to heal for 6 weeks. Each symptom, alone, had seemed explainable. Together, they formed a pattern.
The fasting blood sugar result came back: 10.2 mmol/L. The HbA1c, collected at the same visit: 8.4%. "the patient," the doctor said carefully, "your blood sugar is significantly elevated. Based on these results, you have Type 2 diabetes."
Blood sugar tests measure the concentration of glucose in the blood. Different tests capture different aspects of glucose control — a fasting test gives the baseline level, while HbA1c reflects average blood sugar over the preceding 2–3 months.
Blood glucose after at least 8 hours without food. Normal: < 5.6 mmol/L. Prediabetes: 5.6–6.9. Diabetes: ≥ 7.0 mmol/L.
Reflects average blood glucose over 2–3 months. Normal < 5.7%. Prediabetes: 5.7–6.4%. Diabetes: ≥ 6.5%. the patient's was 8.4%.
Blood glucose at any time regardless of meals. ≥ 11.1 mmol/L with symptoms = diabetes.
Helps distinguish Type 1 (low/absent insulin) from Type 2 (insulin present but tissues resistant). Not always required at diagnosis.
Diabetes is the leading cause of kidney disease — baseline renal function is checked at diagnosis and monitored annually.
the patient had all the risk factors for Type 2 diabetes: age over 45, family history (mother diabetic), mild overweight, African ethnicity. Annual blood sugar testing was indicated — and had not happened for five years.
During those five years, her blood sugar had been rising. The slow-healing wound on her calf was a sign of microvascular disease that had likely been developing for months or years. Five years of undetected elevated blood sugar increases the risk of diabetic nerve damage, eye disease, and kidney disease — most of which is preventable with early treatment.
The diagnosis of Type 2 diabetes was confirmed on the basis of two abnormal results (fasting glucose 10.2 mmol/L + HbA1c 8.4%). Additional tests: full blood count (normal), kidney function (creatinine 74 μmol/L — normal), lipid profile (LDL 3.8 mmol/L — elevated), liver function (normal), urine albumin-to-creatinine ratio (18 mg/g — normal, no proteinuria yet).
The HbA1c of 8.4% indicated poor glucose control over the preceding 3 months — consistent with a diagnosis that had been present undetected for at least 6–12 months. An ophthalmology referral was arranged for diabetic retinopathy screening.
Treatment initiated: metformin BD (uptitrated to 1 g BD at 4 weeks); dietary counselling (low-GI diet, reduced refined carbohydrates, portion control); walking 30 minutes daily; self-monitoring blood glucose strip prescription.
FBG 10.2 mmol/L, HbA1c 8.4% — Type 2 Diabetes diagnosed. LDL elevated. Kidney function normal. No proteinuria.
Diabetes medication started; a cholesterol-lowering medication for LDL; lifestyle modification; ophthalmology referral; podiatry referral for foot care; HbA1c repeat in 3 months.
HbA1c at 3 months: 7.1% (improving). FBG self-monitoring: averaging 7.2 mmol/L. Calf wound healed at 8 weeks with wound care. Ophthalmology: no retinopathy. LDL 2.4 mmol/L on statin.
the patient's HbA1c reached 6.8% at 6 months — below the 7% treatment target. Her wound healed. No complications detected at diagnosis. She attends quarterly and has told her two sisters to get tested.
Type 2 diabetes is asymptomatic for years. By the time you feel symptoms — excessive thirst, frequent urination, slow wound healing — the condition has often been present long enough to begin causing complications. Annual testing is the only way to catch it early.
A slow-healing wound in a person with undiagnosed diabetes is not just a wound problem — it is a vascular problem. Treating the wound without testing the blood sugar misses the underlying cause.
You can have Type 2 diabetes for years and feel fine. An annual fasting blood sugar test takes 5 minutes. If you're over 40 with a family history — book it now.
Book online or via WhatsApp — same-day results on most tests, transparent pricing.