First, the type of diabetes
There are four types.
1. Type 1 diabetes (caused by the destruction of beta cells, which usually leads to absolute insulin deficiency)
2, Type 2 diabetes (progressive decline in insulin secretion based on insulin resistance leads to)
3. Other causes of specific types of diabetes, such as genetic defects in beta cell function, genetic defects in insulin action, exocrine diseases of the pancreas (e.g. cystic fibrosis), drugs or chemicals (after HIV/AIDS treatment or organ transplantation)
4. Gestational diabetes mellitus (GDM)
Note: Some diabetic patients have difficulty distinguishing between type 1 and type 2.
Second, diabetes diagnosis criteria
Glycosylated hemoglobin ≥ 6.5%. (Must use a certified test.)
Or fasting blood glucose ≥ 126 mg/dL (7.0 mmol/L). (Fasting for at least 8 hours.)
OR Oral glucose tolerance test with two-hour plasma glucose ≥ 200 mg/dL (11.1 mmol/L).
(Apply WHO method, 75 g of dehydrated sugar dissolved in water.) Or patients with typical symptoms of hyperglycemia or hyperglycemic crisis with random plasma glucose ≥ 200 mg/dL (11.1 mmol/L).
Note: The first three need to be confirmed by reexamination.
III. Increased risk of diabetes (prediabetes) typing
Fasting glucose 100-125 mg/dL (5.6-6.9 mmol/L) (impaired fasting glucose)
or 2-hour plasma glucose 140-199 mg/dL (7.8-11.1 mmol/L) in a 75-g oral glucose tolerance test (impaired glucose tolerance)
or glycated hemoglobin 5.7-6.4%
IV. Prevention of type 2 diabetes in prediabetic patients (delaying the onset of type 2 diabetes)
1. Patients with impaired glucose tolerance, impaired fasting glucose or glycosylated hemoglobin 5.7-6.4% should reduce body weight by 7% and be physically active for at least 150 minutes/week, with moderate activity, such as brisk walking.
2. Metformin may be considered, especially in those with BMI >35 kg/m^2, age <60 years, and previous gestational diabetes.
3.Check for progression to diabetes at least once a year.
4. Screen and treat correctable risk factors for cardiovascular disease.