All You Need To Know About Diabetes - Part 4

Diagnosis

Diabetes mellitus is characterized by recurrent or persistent high blood sugar, and is diagnosed by demonstrating any one of the following:

Fasting plasma glucose level ≥ 7.0 mmol/l (126 mg/dl)

Plasma glucose ≥ 11.1 mmol/l (200 mg/dl) two hours after a 75 g oral glucose load as in a glucose tolerance test

Symptoms of high blood sugar and casual plasma glucose ≥ 11.1 mmol/l (200 mg/dl)

Glycated hemoglobin (HbA1C) ≥ 48 mmol/mol (≥ 6.5 DCCT %).

A positive result, in the absence of unequivocal high blood sugar, should be confirmed by a repeat of any of the above methods on a different day. It is preferable to measure a fasting glucose level because of the ease of measurement and the considerable time commitment of formal glucose tolerance testing, which takes two hours to complete and offers no prognostic advantage over the fasting test. According to the current definition, two fasting glucose measurements above 126 mg/dl (7.0 mmol/l) is considered diagnostic for diabetes mellitus (Verrotti  et al., 2012).

 The World Health Organization indicated that people with fasting glucose levels from 6.1 to 6.9 mmol/l (110 to 125 mg/dl) are considered to have impaired fasting glucose. people with plasma glucose at or above 7.8 mmol/l (140 mg/dl), but not over 11.1 mmol/l (200 mg/dl), two hours after a 75 g oral glucose load are considered to have impaired glucose tolerance. Of these two prediabetic states, the latter in particular is a major risk factor for progression to full-blown diabetes mellitus, as well as cardiovascular disease The American Diabetes Association since 2003 uses a slightly different range for impaired fasting glucose of 5.6 to 6.9 mmol/l (100 to 125 mg/dl) (American Diabetes Association, 2013).

Glycated hemoglobin is better than fasting glucose for determining risks of cardiovascular disease and death from any cause. The rare disease diabetes insipidus has similar symptoms to diabetes mellitus, but without disturbances in the sugar metabolism (insipidus means "without taste" in Latin) and does not involve the same disease mechanisms. Diabetes is a part of the wider condition known as metabolic syndrome (American Diabetes Association, 2013).

Prevention

There is no known preventive measure for type 1 diabetes. Type 2 diabetes can often be prevented by a person being a normal body weight, physical exercise, and following a healthful diet (Malik et al., 2010). Dietary changes known to be effective in helping to prevent diabetes include a diet rich in whole grains and fiber, and choosing good fats, such as polyunsaturated fats found in nuts, vegetable oils, and fish (Malik et al., 2010).Limiting sugary beverages and eating less red meat and other sources of saturated fat can also help in the prevention of diabetes.Active smoking is also associated with an increased risk of diabetes, so smoking cessation can be an important preventive measure as well (Hu  et al.,2012).

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