History of Diabetes & Diabetics



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RPG Test


Random plasma glucose test measures plasma or blood-glucose levels. It is performed with a small blood draw taken at any time of the day no fasting is required or no worry about what you have eaten, so called as the casual plasma glucose test.

Casual plasma glucose test


It is a general used as a screening test for diabetes when a patient has had food or drink and therefore, cannot do a fasting plasma glucose test or oral glucose tolerance test.
Interpreting random plasma glucose test.

Interpreting random plasma glucose test


Blood glucose level of under 200 mg/dl or 11.1 mmol/L is normal.
Blood glucose level of over 200 mg/dl or 11.1 mmol/l is diabetes, if you additionally have diabetes symptoms.

Doctor recommends a subsequent re-test on a different day. This re-test should be  Fasting plasma glucose test or Oral glucose tolerance test.


Type 1 Diabetes Diagnosis Tests


High level of blood glucose is first test with random blood-glucose test, fasting blood-glucose test and/or oral glucose tolerance test.

This only helps to diagnose diabetes that is the condition with a high blood glucose/sugar level. After that how do we differentiate between diabetes type 1 & 2.


Diagnosing Type 1 Diabetes


The type 1 diabetes can be confirming with autoantibody testing; they are:

  • Islet cell cytoplasmic auto-antibodies

  • Glutamic acid decarboxylase auto-antibodies

  • Insulinoma-associated-2 auto-antibodies

  • Insulin Auto-antibodies

Islet cell cytoplasmic auto-antibodies test


This test helps to measure islet-cell autoantibodies that attack against a variety of islet cell proteins. This is the most commonly detected among newly diagnosed diabetes type 1, almost detected in about 80% of type 1 diabetes.

Glutamic acid decarboxylase auto antibodies test


This test helps to measure autoantibodies that attack against beta cell proteins (antigen) still it is not that much specific to beta cells. This is the also most commonly detected among newly diagnosed diabetes type 1, almost detected in about 75% of type 1 diabetes.

Insulinoma Associated 2 auto antibodies test


This test also measures autoantibodies attacking against beta cell antigens, but it is not specific, still detects in about 60% of type 1 diabetes.

Insulin Auto-antibodies test


This test measures autoantibody targeting against insulin; this is an antigen considered more specific to beta cells. Detected among 50% of type 1 diabetes children, it is not commonly detected among adults.
To confirm the diabetes type, expert suggest a combination of the above-said autoantibody tests for newly diagnosed diabetes, to distinguish between type 1 and type 2 diabetes.

Diagnosis of Juvenile Diabetes


There are numerous tests available to diagnose diabetes which can be done with the advice of your physician.

  • Urine test: - A urine sample will help us to detect glucose and ketones (acids that release in the blood and urine when the body uses fat instead of glucose for energy).

  • Blood test: - It is used to measure the amount of glucose present in the bloodstream

  • Glucose-tolerance test: - checks the body's ability to process glucose. Sugar levels in the blood and urine are monitored for 3 hours after drinking a large dose of sugar solution.

  • Fasting blood sugar: - It involves fasting overnight and blood being drawn the next morning.

Gestational Diabetes Test


Gestational diabetes diagnosis is with testing for blood-glucose level, if it is higher confirmed with other tests.

Gestational Diabetes Test


Gestational diabetes diagnoses similar to diabetes by blood-glucose level testing using random blood-glucose test, screening glucose tolerance test, and fasting blood-glucose test.

Random blood-glucose test


It helps to check for diabetes without regard to when you ate your last meal. A random blood-glucose level of 200 mg/dL or more, plus the presence of the symptoms: increased urination, increased thirst, unexplained weight loss, may mean that you have diabetes.

These tests can help in the diagnosis of gestational diabetes, for sure diabetes diagnosis without missing you need some additional tests based on the above test results.


Screening glucose tolerance test


For this test, you have to drink a glucose rich beverage and have the blood-glucose level checked after an hour; this test can perform at any time of the day. If the results are above normal, then you may need further tests to confirm gestational diabetes.

Fasting blood glucose


It measures your blood-glucose levels after you have gone at least eight hours fasting (without eating); this test is useful to detect diabetes or pre-diabetes.

Oral Glucose Tolerance Test (2-Hour Plasma Glucose Result)


It measures your blood’s plasma glucose after you have gone at least eight hours without eating, and two hours after you drink a glucose-containing beverage.

The OGTT plasma-glucose level measurement can be also useful in the diagnosis of Gestational diabetes. During this test, they check glucose levels for four times. If your blood-glucose levels are above normal at least twice during the test, you have gestational diabetes. The result for the glucose tolerance test is shown in the table below.



Oral glucose tolerance test Gestational diabetes



Fasting

95 or higher

One hour after meals

180 or higher

Two hour after meals

155 or higher

Three hour after meals

140 or higher

Note: Some labs use other numbers for this test.
These numbers are for a test using a drink with 100 grams of glucose

Learn to check your blood-glucose level


Your health care team may ask you to use a blood-glucose meter to check your levels on your own. You have to learn:

Your health care team may ask you to check your blood glucose.

  • when you wake up

  • just before meals

  • 1 or 2 hours after your food (break fast, lunch & dinner)

Blood glucose targets for gestational diabetes


  • On awakening - not above 95

  • one hour after meals - not above 140

  • two hours after meals - not above 120

Each time you check your blood glucose, record the results properly, and take it with you when you visit your health care team. If your results are often out of range, they will suggest ways to reach the targets.

A1C goal to prevent type 2 diabetes


Keeping your A1C less than 6 will help ensure a healthy life.

A1C test overview

Every diabetic’s goal is to keep his or her blood glucose at ideal levels. Valuable reason behind this goal to achieve effective blood-glucose control is:



  • feel better

  • prevent or delay the diabetes complications such as nerve, eye, kidney, and blood vessel damage.

First step to keep track of the blood-glucose level is by checking the blood glucose at home using home blood-glucose meter. This provides only current blood-glucose level.

Suppose you want to know how you have done as a whole. For this, a test is available, which provide an average blood-glucose level for the past 2 to 3 months called as Glycated hemoglobin or HbA1c or simply A1C. The result provides you a good overall picture of how well; the diabetes treatment plan is working.


Gestational diabetes A1C goal


Keeping your A1C less than 6 if you are pregnant will help ensure a healthy baby. If possible, women should plan early and work to get their A1C below six before getting pregnant.

Ketones Test


Test for ketones in your morning urine. High levels of ketones are a sign that your body is using your body fat for energy instead of the food you eat. Using fat for energy is not recommended and harmful. Ketones may be unhealthy to your baby too.

Diagnose LADA

Diagnose LADA based on two blood tests currently in use to detect LADA:


  • GAD Antibody test - Attacking the beta cells of the pancreas by inflammatory cells, produces an enzyme GAD (Glutamic Acid Decarboxylase), so this is a marker for the diagnosis of LADA in adults.

  • C-Peptide test - C-Peptide (an amino acid) produced by the pancreas proportional to the amounts of insulin in produce. A low level of C-peptide in the blood indicated that the pancreas is not producing enough insulin and can suggest LADA in a type 2 patients.

Diabetes management

To keep your blood glucose in control through out the day you need diet modifications, regular exercise, medicine (tablets/insulin injections).Insulin injection is not needed immediately after the diagnosis of diabetes is made (unless your doctor feels this is an emergency).

If you are obese you need to reduce your weight through diet control and give up sedentary habits so that your insulin’ works better. Your treatment should be started and supervised by an expert, who should review every 3-6 months to help you keep your blood glucose in control. You should register in a diabetic clinic for regular blood pressure check ups, ECG and advice for care.

Treatment is aimed at maintaining the blood glucose in the normal range and HbA1c less than 7%, by balancing food intake with oral medication or insulin and physical activity year after year, to prevent complications of diabetes.

An emotional stress (a death in family, displeasure at work or at home) may increase and disturb the control of diabetes. You need to discuss the problem with your doctor for suitable adjustment in dosage of medication and stress control exercises.

By keeping a good control of diabetes at all times, you will be able to prevent the complications of diabetes affecting the nerves, eyes, kidneys, heart and blood vessels.  



Measures to control Blood sugar level:

Diabetes can be controlled to a great extent by controlling blood sugar levels. For controlling blood sugar levels it is mandatory for an individual to undergo periodic monitoring of blood sugar levels under the guidelines of the physician. There are many methods to control blood sugar levels. They are-



  • Have proper balanced diet

  • Maintain an active lifestyle

  • Do regular exercises

  • Avoid smoking and intake of alcohol

  • Take proper medications

  • Do skipping meals or eat unhealthy food.

A properly controlled blood sugar level will keep the diabetes in check.

Treatment is effective and important

All types of diabetes are treatable, but Type 1 and Type 2 diabetes last a lifetime; there is no known cure. The patient receives regular insulin, which became medically available in 1921. The treatment for a patient with Type 1 is mainly injected insulin, plus some dietary and exercise adherence.

Patients with Type 2 are usually treated with tablets, exercise and a special diet, but sometimes insulin injections are also required.

If diabetes is not adequately controlled the patient has a significantly higher risk of developing complications, such as hypoglycemia, ketoacidosis, and nonketotic hypersosmolar coma. Longer term complications could be cardiovascular disease, retinal damage, chronic kidney failure, nerve damage, poor healing of wounds, gangrene on the feet which may lead to amputation, and erectile dysfunction.


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