Diagnosis of diabetesWhat kind of test and what number will be said to be diabetes?
Some people may feel uneasy about diagnosing diabetes like this.
In this article, we will discuss the diagnosis of diabetes.
table of contents
Diagnosis of diabetes
Diagnosis of diabetes is based on fasting blood glucose, glucose tolerance test, and presence of diabetes complications.
I will explain each in detail.
Measurement of fasting blood sugar
Fasting blood sugar is very important in diagnosing diabetes.Diabetes is difficult to diagnose based on fasting blood glucose alone, but it is an important indicator.
Fasting blood sugar: 100-109 mg/dL
Fasting blood sugar is slightly elevated.
This number alone cannot be used to diagnose diabetes. If this number continues, the risk of developing diabetes in the future is considered.
Fasting blood sugar: 110-125mg/dL
The number is high, and it is a state that is about to become diabetes, so-called pre-diabetes.
In this state, a detailed examination is required in addition to fasting blood sugar.
In addition to blood sugar levels, HbA1c values are also checked.
HbA1c values up to about 6% are considered normal. If it exceeds 7%, the risk of diabetes increases, so it is necessary to maintain HbA1c below 7%.
HbA1c can also be high in diseases other than diabetes, so it is necessary to examine other diseases, including the possibility of other diseases.
In addition to measuring HbA1c, people with pre-diabetes need to take a glucose tolerance test.
*About sugar tolerance test
Even if fasting blood sugar is normal, postprandial blood sugar may be high.A glucose tolerance test is a test to determine whether blood sugar levels are normal after a meal.If fasting blood sugar is normal, it is difficult to judge diabetes, so hidden diabetes can also be detected.
[Inspection method]
- You will arrive without breakfast and have your fasting blood sugar measured.
- After that, drink water with glucose dissolved in it. (This is called sugar load)
- Blood glucose levels are measured 30 minutes, 1 hour, and 2 hours after drinking glucose.
Diabetes is diagnosed when the blood glucose level exceeds 200 mg/dL after 2 hours.
If the blood sugar level after 2 hours is less than 140 to 200 mg/dL, it is considered borderline diabetes (preliminary).
If normal, the blood sugar level after 2 hours will also be within 140 mg/dL.
If fasting blood sugar is 126 mg/dL or higher and postprandial blood sugar is 200 mg/dL or higher
It's a situation where you have to strongly suspect diabetes.
Diabetes cannot be diagnosed by blood sugar alone, but HbA1c is also measured, and if it is 6.5% or higher, diabetes can be diagnosed.
Diagnosis of diabetes from other than blood sugar level
Diagnosis of diabetes may be possible in addition to blood sugar levels.
Diabetes has complications. Complications may occur if a long period of time has already passed since you had diabetes when you visited the hospital.
There are various complications of diabetes, but typical complications include diabetic retinopathy, diabetic nephropathy, and diabetic neuropathy.
Diabetes is strongly suspected in the presence of these complications.
diabetic retinopathy
Diabetic retinopathy is a disease in which the retina, which plays the role of a lens that reflects the scenery that enters the eye, is damaged by sugar and vision deteriorates.
If left untreated, there is a risk of blindness, and it is a disease that requires treatment.
When symptoms such as blurred vision, dust flying (floaters), and declining vision appear, the symptoms may be progressing.
You need to see an ophthalmologist as soon as possible, as retinal detachment and glaucoma can also occur.
diabetic nephropathy
Diabetic nephropathy is said to be a disease that develops when sugar damages the blood vessels of the kidneys and prevents them from properly filtering blood.
In the early stages of the disease, it is good to simply control the blood sugar level, but as the symptoms progress gradually, it becomes necessary to manage salt and protein intake, and limit the amount of water. is.
It is a serious complication that may eventually require dialysis.
diabetic neuropathy
It is a neurological disease caused by diabetes. The main cause is thought to be insufficient blood flow to nerves due to accumulation of damage to nerves due to blood sugar and accumulation of damage to peripheral blood vessels.
It is said that sensory disturbance and autonomic nerve disorder are likely to occur mainly.
Sensory disturbances begin with complaints of blurred or abnormal sensations in the toes (thickness of the skin on the feet, feeling of walking on gravel, etc.). .
Since the sensation of pain becomes dull, it becomes difficult to notice small wounds and suppuration.
If the wound goes unnoticed for too long, gangrene will gradually set in and the risk of amputation increases.
In order to avoid such a condition, it is necessary to carefully monitor the condition of the feet in addition to daily blood sugar control. In particular, people with ingrown toenails or those who wear safety shoes and work in environments where they are prone to injury need to be careful. Check your feet every time you take a bath.
Autonomic neuropathy may cause symptoms that blood pressure adjustment and urination / defecation are not going well. In addition, the pulse may be disturbed, and sweating disorders may occur.
summary
In this article, we discuss the diagnosis of diabetes.
Diagnosis of diabetes can be done by simple tests such as blood sampling and glucose tolerance test. If your daily health checkup points out that your blood sugar level is high, you need to see a medical institution as soon as possible and get a diagnosis. If there are few subjective symptoms and left untreated, complications may progress and may develop into irreversible problems.
Early diagnosis and early treatment are the rules.
In order to avoid diabetes, which causes serious complications, we recommend that you first see a doctor early to learn more about your physical condition.
Omotesando Helene Clinic specializes in regenerative medicine that does not place a burden on the body, and provides pre-counseling for those who cannot immediately start treatment.
Diabetes is also related to lifestyle habits such as obesity, excessive drinking and smoking, but it is generally said that it is difficult to improve lifestyle habits.
Therefore, if you use "regenerative medicine" that utilizes autologous stem cells, you can use your own cells to repair weakened cells in the body and prevent diabetes and complications.
"I'm curious, but I can't decide if prevention is really necessary now." You may be at risk of wandering life and death without realizing it, so Please feel free to contact us.
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References
・Ministry of Health, Labor and Welfare e-Health Net: Glycated Hemoglobin
https://www.e-healthnet.mhlw.go.jp/information/dictionary/metabolic/ym-066.html
・Ministry of Health, Labor and Welfare: Diabetes
https://www.mhlw.go.jp/www1/topics/kenko21_11/b7.html
・National Center for Global Health and Medicine Diabetes Information Center, Diagnosis and Testing
https://dmic.ncgm.go.jp/general/about-dm/030/index.html
Supervision: Dr. Yasushi Tsuda