Diabetes Mellitus

Diabetes mellitus commonly referred to as diabetes is a disease characterized by high blood glucose levels.

 

Criteria for the diagnosis of diabetes

1. A1C(previously known as HbA1c) ≥6.5%.

or

2. Fasting Plasma Glucose ≥126 mg/dl (7.0 mmol/l).

Fasting is defined as no caloric intake for at least 8 h. 

or

3.  Two-hour plasma glucose ≥200 mg/dl (11.1 mmol/l) during an OGTT.

The test should be performed using a glucose  load containing the equivalent of 75 g anhydrous glucose dissolved in water.                                      

 or 

4. In a patient with classic symptoms of hyperglycemia (frequency of urination, increased thirst and apetite) or hyperglycemic crisis, a random plasma glucose ≥200 mg/dl (11.1 mmol/l)

 In the absence of unequivocal hyperglycemia, result should be confirmed by repeat testing.

 

Type 1  diabetes – results from beta cell destruction, usually leading to  absolute insulin deficiency

Type 2 diabetes – results from a progressive insulin  secretory defect on the background of insulin resistance

Other specific types of diabetes due to other causes, e.g.,  genetic defects in beta cell function, genetic defects in insulin action,  diseases of the exocrine pancreas (such as chronic panreatitis), and drug or  chemical-induced diabetes (such as in the treatment of AIDS or after organ  transplantation)

Gestational diabetes mellitus (GDM) – diabetes diagnosed  during pregnancy

 

Prediabetes – Before people develop type 2 diabetes, they  almost always have “prediabetes”—blood glucose levels that are higher than  normal but not yet high enough to be diagnosed as diabetes.  There are three  different tests your doctor can use to determine whether you have  prediabetes:
•    The A1C test
•    The fasting plasma glucose test  (FPG)
•    The oral glucose tolerance test (OGTT)

 

10 Must Know Facts for Diabetics 

1. Diabetes is a chronic and lifelong disease. Diabetes can be controlled but cannot be cured.

2. Diabetes usually remains asymptomatic. But it causes silent damage. Elevated blood glucose levels cause damage to major organs of the body like heart, kidney, eyes, nerves, blood vessels, etc. So get yourself treated for diabetes even if you are not having any problems.

3. Classic symptoms of increased thirst, urination and appetite along with weight loss occurs with high blood glucose (>200mg/dL). A lesser elevation in blood glucose, as already mentioned, remains asymptomatic but should never be ignored.

4. Those with diabetes need to follow dietary restrictions and lead a healthy life style.

5. Those with diabetes usually need medicines for control of blood glucose on a long term basis. Do not take/change medicines on your own; follow your doctor’s advice.

6. Type 1 diabetes is treated with insulin. Stopping insulin can have grave consequences like diabetic ketoacidosis. Ask your doctor about ketone bodies if you are a type 1 diabetic.

7. Type 2 diabetes is usually treated with oral medicines. A type 2 diabetes patient with very high blood glucose can be transiently treated with insulin. Use of insulin for a few days in such a situation does not make your body dependent on insulin. Insulin might be required on a long term basis because the oral medicines are unable to lower your blood glucose.

8.  Hypoglycemia is a complication of treatment of diabetes. Please ask your doctor about symptoms of hypoglycemia and its management. Some of the medicines can cause side effects. Discuss with your doctor if you are having any problem from the medicines prescribed to you. The damage done from high blood glucose is however much more than side effects of medications.

9. Following a regular lifestyle and sticking to your meal timings is very essential. One of the most common cause of variation in blood glucose is changes in timing or quantity or quality of meals.

10. Blood glucose and HbA1c should be monitored regularly as per the instruction of your doctor. Long term complications of diabetes include heart disease, retinopathy (damage to retina), nephropathy (kidney disease), neuropathy (damage to nerves), diabetic foot and so on. All patients with diabetes should be screened annually for these problems. Contact your doctor for even apparently minor problems.