Diagnosing Diabetes!

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Diabetes is diagnosed either by suspicion by the patient or the Doctor, when the following signs and symptoms are noticed.

Clinically it is suspected when there are some signs and symptoms noticed either by the patient or by the Doctor. As mentioned in the earlier articles, it can be a typical symptoms like Poly urea (frequent urination), Poly phasia (frequent hunger) or Poly dypsia (Excessive thirst). Or other symptoms or signs like Weight loss or gain, Fungal infections especially in the genitalia, teeth infections, non healing wounds etc.

It is also diagnosed accidentally or incidentally when a person undergoes pre employment health check, periodically check like annual check, check up before undergoing any operation or even during taking a policy.

During any health check, if the HbA1c (Glycosylated haemoglobin) is found to be more than 7 %, it indicates the person to be diabetic.

Confirmation of diabetes is always by Blood Test. The test is called Glucose Tolerance Test (GTT) . The test can be explained as follows

The person is asked to have a normal meal in the previous night, and asked to attend the hospital in the morning (on empty stomach) . Whereupon the Fasting Blood sample and Urine sample is taken.

The patient is given 75 gms of glucose. Every half an hour, blood and Urine samples are drawn and examined.

If the 1 & 1/2 hr blood sample is more than 180 mgs/dl (deci liter), the patient is pronounced to be a diabetic. The threshold level of blood sugar in normal kidneys is 180 mgs/dl and when the blood sugar is more than 180 mgs/dl, the glucose passes through the kidney and appears in the urine.

The normal blood glucose in fasting should be between 70 – 110 mgs/dl.
Post prandial (after food) blood glucose should be below 140 mgs/dl

When Post prandial is between 140 – 180 mgs/dl, the stage is considered to be glucose intolerance or Pre diabetes stage.

When Post prandial is more than 180 mgs/dl, it is considered to be Frank diabetes or overt diabetes.

These Pre diabetes group of people have great potential to become diabetic and have great scope for post phoning the occurrence by taking advise from doctors and also following the diet discipline, exercise etc

We shall cover the areas in the coming weeks

Source: Written for Spice your Life, by Dr. Nagarathnam Jetti, MBBS,DPH,DIH,FIAOH.

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