Are all people with high blood sugar diabetic? This is not the case. In cases of stroke, myocardial infarction, severe pain, trauma, acute infection, etc., due to the stressful state of the muscles, the secretion of glucagon in the body increases significantly and a transient increase in blood glucose can occur. In addition, in liver diseases, liver glycogen synthesis is reduced and patients can have postprandial hyperglycemia. In addition to the above, there are special types of diabetes that should also be noted.
The etiology of most diabetic patients is still unclear, but the etiology of special types of diabetes is clear, and some of them can be cured fundamentally through surgery or other methods, so timely and accurate diagnosis is necessary, and the following must be clinically distinguished.
1, endocrinopathies: gigantism, hyperthyroidism, cortisolism, pheochromocytoma, aldosterone-secreting tumors, etc.
2, pancreatic diseases: pancreatitis, pancreatic tumors, pancreatic trauma, etc..
3, application of certain drugs: such as certain hormones, diuretics, oral contraceptives and alpha-interferon, etc.
High blood sugar is the main feature of diabetes, but high blood sugar does not necessarily mean diabetes. The following conditions can also manifest as increased blood glucose and not be diabetes.
(1) In liver disease, liver glycogen reserves are reduced.
(2) Acute infection, trauma, cerebrovascular accident, burns, myocardial infarction, severe pain, etc. in stressful conditions, when secretion of insulin antagonist hormone, adrenocorticotropic hormone, adrenomedullary hormone, growth hormone, etc. increases and insulin secretion is relatively insufficient, causing blood glucose to rise.
(3) Starvation and chronic diseases reduce physical strength and cause reduced glucose tolerance, which raises blood glucose.
(4) Taking certain drugs such as glucocorticoids, thiazide diuretics, tachyphylaxis, female oral contraceptives, niacin, aspirin, anti-inflammatory pain, etc., can cause a transient increase in blood sugar.
(5) Some endocrine diseases, such as acromegaly, cortisolism, hyperthyroidism, etc., can cause secondary diabetes.
(6) Pancreatic diseases, such as pancreatitis, pancreatic cancer, pancreatic trauma, etc., can become the primary cause of elevated blood glucose.
Common methods to confirm the diagnosis:
(1) Confirmation of diabetes mellitus.
1.With typical symptoms, fasting blood sugar 126mg/dl (7,0 mmol/l) or postprandial blood sugar ≥200mg/dl (11,1 mmol/l).
2.No typical symptoms, only fasting blood sugar 126mg/dl (7,0 mmol/l) or postprandial blood sugar 200mg/dl (11,1 mmol/l) should be repeated once again, and those who still reach the above value can be diagnosed as diabetes mellitus.
3. Without typical symptoms, only fasting blood sugar 126mg/dl (7,0 mmol/l) or postprandial blood sugar 200mg/dl (11,1 mmol/l) glucose tolerance test 2 hours blood sugar 200mg/dl (11,1 mmol/l) can be diagnosed as diabetes.
(ii) Diabetes can be excluded.
1.If the glucose tolerance 2 hours blood sugar between 140-200 mg/dl (7,8-11,1 mmol/l) is low glucose tolerance reduction; if the fasting blood sugar 110-126 mg/dl (6,1-7,0 mmol/l) is impaired fasting blood sugar, both are not diagnosed as diabetes.
2. If postprandial blood glucose <140 mg/dl (7, 8 mmol/l) and fasting blood glucose <100 mg/dl (5, 6 mmol/l) can exclude diabetes mellitus.
To note.
1.Severe symptoms and obvious hyperglycemia require blood glucose values exceeding the above indicators to confirm the diagnosis.
2. In acute infection, trauma, surgery or other stressful situations, although significant hyperglycemia is measured, it cannot be immediately diagnosed as diabetes mellitus.
3.An asymptomatic person cannot be diagnosed according to one blood glucose value, but must also exceed the diagnostic criteria at another time.
4. Most children with diabetes mellitus have serious symptoms, high blood glucose, positive urine sugar and urine ketone bodies, and do not need to do glucose tolerance test. A few people with less serious symptoms need to measure fasting blood glucose or glucose tolerance test.