Diabetes screening at home in Kenya: blood sugar, HbA1c, and what the numbers mean
Who should be screened for diabetes, the difference between fasting blood sugar and HbA1c, and what each result range tells you about your risk.
Roughly 1 in 8 Kenyan adults over 35 has diabetes and doesn't know it. The screening tests are simple, cheap, and increasingly available as home services. Here's what to ask for and what the numbers actually mean.
Who should be screened, and how often
- Every adult aged 35+ should be screened at least every three years.
- Annual screening if you have a parent, sibling, or child with type 2 diabetes.
- Annual screening if your BMI is 25+ or you have central obesity (waist > 90 cm men, > 80 cm women).
- Annual screening if you have hypertension, high cholesterol, or PCOS.
- Pregnant women should be screened for gestational diabetes between 24 and 28 weeks.
Fasting blood sugar — the simplest screen
A finger-prick or venous sample after at least eight hours of no food (water is fine). A reading below 5.6 mmol/L (100 mg/dL) is normal. 5.6 to 6.9 mmol/L is pre-diabetes — lifestyle changes are urgent. 7.0 mmol/L or higher on two separate occasions is diabetes.
HbA1c — the three-month average
HbA1c (glycated haemoglobin) reflects your average blood sugar over the last eight to twelve weeks. It doesn't require fasting and isn't affected by a stressful day. Below 5.7% is normal. 5.7 to 6.4% is pre-diabetes. 6.5% or higher is diabetes. For an existing diabetic patient, the treatment target is usually below 7.0%.
Oral glucose tolerance test — the tiebreaker
Used when fasting and HbA1c results disagree, or for gestational diabetes screening. You drink a measured 75 g glucose load and your blood sugar is checked after two hours. Above 11.1 mmol/L confirms diabetes; 7.8 to 11.0 mmol/L is impaired glucose tolerance.
What to do if you screen positive
A single high reading is not a diagnosis. The next steps are repeat testing on a different day and a clinical assessment. Pre-diabetes is reversible in most people through 5 to 10 percent weight loss, 30 minutes of brisk walking five days a week, and cutting refined carbohydrates. Type 2 diabetes management starts with the same lifestyle changes plus medication — usually metformin first-line.
Combine the tests for the most reliable picture
If your budget allows, do a fasting blood sugar plus HbA1c together. Doing both detects more cases than either alone, especially in patients with anaemia or sickle cell trait, where HbA1c can read falsely low or high.