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Tests for Diabetes. Diagnosis FAQ


What tests are needed to diagnose diabetes?

The diagnosis of diabetes is mainly based on blood sugar levels. Diagnosis if there are diabetes-related symptoms (dry mouth, polydipsia, polyuria, polyphagia, weight loss) and abnormal blood glucose (fasting blood glucose ≥7.0mmol / L and / or 2 hours postprandial blood glucose ≥11.1mmol / L) Diabetes. 

If there are no symptoms, physical examination reveals abnormal blood glucose. After repeated examinations, blood glucose is still abnormal (fasting blood glucose ≥7mmol / L and / or postprandial blood glucose ≥11.1mmol / L) can also be diagnosed.

Does fasting blood glucose refer to the pre-meal blood glucose of each meal, or does it refer to the pre-meal blood glucose in the morning only? Does postprandial blood glucose refer to after each meal?

 Fasting blood glucose refers to the morning pre-meal blood glucose, fasting 8 to 10 hours, postprandial blood glucose refers to the blood glucose value of 2 hours after each meal.

 In addition, some foreign diagnostic criteria also include glycated hemoglobin, which means that the reaction takes 2-3 months.

The average blood glucose level can be diagnosed if ≥6.5%, but currently glycated hemoglobin is not used as a diagnostic standard for diabetes in most countries of the world.

The diagnostic significance of fasting blood glucose and postprandial blood glucose is different. 

Postprandial blood glucose is highly sensitive, blood sugar with high sugar load is easy to be high, and diabetes is more likely to be found.

Fasting blood glucose is more specific and the accuracy of diabetes diagnosis is better. So patients do diabetes during the diagnostic test, fasting blood glucose and postprandial blood glucose need to be checked together to avoid missed diagnosis.

Usually adopts the international general diabetes diagnostic test-oral glucose tolerance test (OGTT test): 
Fasting blood is drawn after 8-10 hours of fasting, then 75g of anhydrous glucose powder is dissolved in 200 - 300ml of water, drink within 5 minutes. 
Follow the sugar Blood was drawn 2 hours after the first bite.
 If fasting blood glucose ≥7mmol / L and / or postprandial blood glucose ≥11.1mmol / L, diabetes can be diagnosed.

There are three conditions in pre-diabetes. One is abnormal fasting blood glucose (fasting blood glucose 6.1mmol / L - 7.0mmol / L).

The second is abnormal blood glucose after a meal, also known as impaired glucose tolerance (glucose 2 hours after a meal 7.8mmol / L - 11.0 mmol / L).

Third, both impaired fasting blood glucose and abnormal glucose tolerance.

How to diagnose the situation of high and low blood sugar before and after meals?

It is mainly divided into 2 situations. First, if the patient has the typical symptoms of diabetes such as polydipsia, polyuria, polyphagia, weight loss, vulvar itching, blurred vision, etc.
It meets the standards of fasting blood glucose and postprandial blood glucose.

Diabetes can be diagnosed if satisfied. 
Secondly, if there are no symptoms or signs, blood glucose needs to be tested at different times. If all tests are abnormal, diabetes can be diagnosed. If not, the diagnosis cannot be confirmed. 

Fasting blood glucose is the blood glucose level in the basic state, which is less affected by the action of insulin, mainly affected by hepatic gluconeogenesis and other hormones, and has high accuracy; the 2-hour postprandial blood glucose is the blood glucose after load, and the sensitivity is better. 

The reserve and function of pancreatic islets, if the reserve and function of insulin is poor, it is easy to postprandial blood sugar high.

In clinical practice, many diabetic patients have fasting blood glucose less than 6.1mmol / L, and postprandial blood glucose ≥ 11.1mmol / L.

How can we understand the Diabetes inspection report?

The inspection report needs to understand several key indicators: The first blood glucose index, fasting blood glucose, postprandial blood glucose and glycated hemoglobin. Especially for patients with insulin, the blood glucose index needs to be monitored. 

If the blood glucose control is poor, the monitoring frequency needs to be increased. If the blood glucose control is good, Properly reduce the frequency of monitoring; the second blood pressure indicator, high blood pressure has a great impact on diabetes, and the normal blood pressure should be less than 140 / 90mmHg. 

Diabetic patients need to control blood pressure more strictly, it is better to control below 130 / 85mmHg, the elderly and patients with long-term hypertension can be relaxed.
The third blood lipid index, such as cholesterol, triglycerides, high density lipoprotein, low density Lipoprotein, etc.
The fourth weight index, weight should be as normal or close to normal as possible.

In addition, attention should also be paid to the examination of complications, such as electrocardiogram, lower extremity vascular examination, fundus, proteinuria, nerves, etc.

Only one examination is required. If there are complications, the frequency of examinations should be increased appropriately.

Once diabetes is diagnosed, it is necessary to screen for diabetic complications and evaluate metabolic indicators to comprehensively consider the severity of diabetes.

The severity of diabetes complications can be used as an indicator of diabetes control.

There are two reasons for this. One is related laboratory tests, which can provide a reference for the subsequent treatment effect. The other is that diabetes complications can be found early to avoid serious The consequences.


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