Diabetes diagnosis

Diabetes is a metabolic disorder that has attracted a lot of attention off late. This disorder results in a rise in the glucose level in the body, which can be a result of either low production of insulin or decrease in the uptake of insulin by the cells. Diabetes is basically of two types insulin-dependent diabetes (type I) and non-insulin dependent diabetes (type II). Other than these it can also be classified as gestational diabetes or pre-diabetes.

Signs and symptoms

If you observe any of the signs and symptoms mentioned below you should immediately report to your doctor.

Frequent urination

Increased thirst and increased fluid intake

Increased appetite

Weight loss because of no reason

These symptoms are found to occur fast in cases of type I diabetes especially when it is seen to occur in children. These symptoms however take time to show up in cases of type II diabetes.

If you observe any of these symptoms you should make sure that you see a doctor and get yourself diagnosed for diabetes.

The diagnostic approach for diabetes

In case of type I diabetes and most of the cases of type II diabetes the symptoms of excessive urination and thirst are the main factors for diagnosis. These symptoms are seen to become severe and worsen over the weeks and in most of the cases of type I diabetes the degree of ketoacidosis is used as a tool.

The diagnosis of the other classes of diabetes is done in other ways like:

General health check up

Detection of hyperglycemia during a long-term observation in cases of unrecognized diabetes

Changes in vision

Unexplained weakness an fatigue

Diabetes Screening: This is the most recommended diagnostic approach in all the cases of diabetes. The screening test depends on the circumstances and the local policy. However, the usual test include blood glucose tests, fasting blood glucose test, formal glucose tolerance test, a blood glucose test two hours after 75 g of glucose.

Screening of other medical conditions: There are a number of other medical conditions like high blood pressure, coronary artery disease, increased cholesterol levels, chronic pancreatitis, polycystic ovary syndrome etc. The risk of diabetes increases with chronic use of medications like high-dose glucocorticoids, some chemotherapy agents.

There are times that diabetes is detected when a person suffers from a problem that occurs because of diabetes like frequent heart attacks, poor wound healing, stroke, foot ulcer, eye problem etc.

The diagnostic criteria for diabetes

Diabetes is recognized by the recurrent or persistent hyperglycemia and is diagnosed by any of the following methods:

Fasting blood glucose level: This test is conducted after overnight fasting (not eating after midnight). Any value above 140mg/dL at any two diagnosis situations means that the person is suffering from diabetes. The normal fasting blood glucose level is 70-110 mg/dl.

Oral glucose tolerance test: This test is performed in a lab in the presence of a doctor or a qualified lab technician. The test is started with a person fasting for not more than 10 hours. The initial blood is withdrawn and then the person is given a glucose drink. After 30 minutes again the blood is tested. This is then followed by 1, 2, and 3 hours after drinking of the glucose. For conducting this test it is important for the person to be in a condition of good health. If a person is suffering from diabetes then the glucose level would increase fast and would take time to come down as compared to that in normal people.

The glucose tolerance test can show any of the following diagnosis:

Normal Response: The person undergoing the test is said to have a normal response when after the 2-hour glucose level testing the level is less than or equal to 110 mg/dl.

Impaired Fasting Glucose: When the person undergoing the test has fasting glucose equal to or greater than 110 and less than 126 mg/dl, they are said to have impaired fasting glucose. This is taken as a risk factor and people with this level are likely to develop diabetes in the future. People with this level of fasting glucose would trigger another test in the future, but by itself. However, this test does not make the diagnosis of diabetes.

Impaired Glucose Tolerance: The person taking the test is said to have impaired glucose tolerance when the 2-hour glucose results from the oral glucose tolerance test is greater than or equal to 140 but less than 200 mg/dl. This is also a risk factor for future diabetes. There has recently been change in lowering the upper value to 180 mg/dl to diagnose mild diabetes so as to provide early medication and prevent the complications resulting form diabetes.

Diabetes: The person is said to be suffering from diabetes when oral glucose tolerance tests show that the blood glucose level at 2 hours is equal to or more than 200 mg/dl. This however, is confirmed by conducting another test on some other day. There has recently been change in lowering the upper value to 180 mg/dl to diagnose mild diabetes so as to provide early medication and prevent the complications resulting form diabetes.

Gestational Diabetes: if the patient is a pregnant woman then she is said to have gestational diabetes when she has any two of the following: a fasting plasma glucose of more than 105 mg/dl, a 1-hour glucose level of more than 190 mg/dl, a 2-hour glucose level of more than 165 mg/dl, or a 3-hour glucose level of more than 145 mg/dl.

Diabetes diagnosis

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