The diagnosis of diabetes is highly unreliable based on symptoms and urine glucose alone, as more than 50% of diabetic patients do not have significant symptoms. Urine glucose testing, on the other hand, is subject to false positives or false negatives due to a variety of factors, including the renal glucose threshold. In contrast, chronic hyperglycemia is the main change in all types of diabetes, so blood glucose measurement is the most reliable key indicator for diagnosing diabetes. However, blood glucose is susceptible to dynamic changes due to various factors, so some comprehensive diagnostic measures have to be taken.
For this reason, in 1997, the American Diabetes Association proposed the following new diagnostic criteria for diabetes after summarizing the scientific reports from various countries, and they are used to this day.
1. What exactly are the diagnostic criteria for diabetes mellitus?
The current criteria for diagnosing diabetes can be met by any one of the following.
(1) symptoms of diabetes (polyhydramnios, polyuria, unexplained weight loss), and random (at any time after meals, without deliberately not eating) intravenous blood glucose ≥ 11. 1 mmol/L;
(2) Venous blood glucose ≥ 7.0 mmol/L after fasting (8 hours without food intake);
(3) Venous blood glucose ≥ 11. 1 mmol/L after 2 hours of oral glucose tolerance test OGTT;
(4) Non-fasting glycated hemoglobin HbA1C test value ≥ 6. 5%.
Because there are many factors affecting blood glucose, clinicians generally do not diagnose diabetes based on a single fasting or random blood glucose higher than normal.
More than two tests are often needed, or an oral glucose tolerance measurement is added to help make the diagnosis. There is up to 10 years of pre-hyperglycemia in the progression of the condition to diabetes. During this period there is type 1 diabetes often with autoimmune symptoms present. In contrast, both type 1 and type 2 diabetes show impaired fasting glucose and impaired glucose tolerance. During this period, the patient’s pancreatic beta cells are not functioning adequately or insulin utility is impaired.
Simply put, there is a problem with the body’s ability to regulate blood sugar.
2. What is the problem?
The first is impaired fasting glucose IFG.
During thousands of years of evolution, our ancestors had the possibility of not having enough to eat at any time, and our brain and nerve cells need a lot of glucose as a source of energy at any time, so the ability to regulate fasting blood sugar is very important to the body.
The ability to stabilize fasting blood glucose characterizes our body’s ability to regulate blood glucose.
When fasting (usually asked to fast for at least 8 hours when preparing to go to the hospital for testing).
A fasting blood glucose ≥ 7.0 is diagnosed as diabetes.
And what is the normal fasting blood sugar for a person? It is fasting blood glucose < 6.1.
That is, when 7.0 > fasting blood sugar ≥ 6.1 is impaired fasting blood sugar.
We all know that too high or too low blood glucose concentration is a disaster for the body cells.
After we eat a lot, the body must try to stabilize the blood glucose concentration within a suitable range in a short time, neither to put the body cells under the duress of high blood glucose, but also must try to avoid low blood glucose. So the next most important thing is the glucose tolerance reduction IGT, which characterizes the body’s ability to regulate blood sugar spikes.
On an oral glucose glucose tolerance test or 2 hours after a meal.
A blood glucose concentration ≥ 11.1 would be diagnosed as diabetes.
And what is the glucose tolerance of a normal person? It is a blood glucose concentration <7.8, which means that the normal glucose tolerance (NGT) is 7.8.
11.1>2 hours blood glucose concentration ≥7.8 is impaired glucose tolerance (IGT).
Warm reminder: these two indicators are crucial in the development of diabetes.
Therefore, patients with hyperglycemia in prediabetes should pay attention to the monitoring of blood glucose and pay attention to the two indicators of impaired glucose and glucose tolerance.
Early examination and early intervention as a great role in controlling the development of the disease.