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Diagnosis Of Diabetes
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For making a diagnosis of diabetes, it is important to establish that the level of glucose in blood is above a certain limit.

After many studies a normal level of glucose in blood has been agreed upon. Measuring glucose level in blood can easily make a diagnosis of diabetes.

Blood Glucose levels :

Diabetes can be diagnosed by measuring serum or whole blood glucose level. After many population studies a normal level of glucose in blood has been established. In a normal person the fasting blood glucose level has been set on a maximum value of 110 mg/dl and a post-meal value which is taken 2 hours after starting meals has been set at a maximum of 140 mg/dl.

The following table shows the blood glucose values in mg/dl and their diagnostic interpretation:

 

 

Normal

      High Risk of

         Diabetes

Diabetes

Fasting

Less than 100

101-125

More than 126

 

2 Hours Post meal

 

Less than 140

140-199

More Than 200

 

Source : American Diabetes Association, 2008

If the fasting glucose level is 126 or more and post meal level is equal to or greater than 200, it is diagnostic of diabetes. If fasting glucose is between 101 and 125, it is known as Impaired Fasting Glucose. If 2 hours Post Meal Glucose is more than 140 but less than 200 it is known as Impaired Glucose Tolerance. Both the above conditions indicate high possibility of having diabetes in the future.

If there is some problem in the diagnosis, then Oral Glucose Tolerance Test is advised. In this test fasting glucose sample is taken, but instead of food for post-meal test 82.5 gm of glucose (equivalent to 75 gm. Anhydrose glucose) mixed in one glass of water is given following which blood glucose is measured after 2 hours.

 

The following table gives the diagnostic interpretation of OGTT:

 

Status

Fasting

2 Hrs Post Glucose

Normal

Less than 100

Less than 140

High Risk of Diabetes

101-125

140-199

Diabetes

More than 126

More than 200

 

(According to ADA - 2008 & WHO guidelines)

Role of  Urine Glucose / Sugar  Test:

Only a simple urine test cannot definitely tell whether a person has diabetes or not. When the level of glucose in blood is more than 200 mg., only then it appears in urine. For example if a person’s fasting glucose level is 170 mg. then that person is diabetic, but his urine sugar may be nil.

On the other hand, in a condition called Renal Glycosuria glucose is present in urine although such a person is not diabetic. In such persons although the blood glucose is normal, glucose appears in urine due to reduced renal threshold. This entity does not require treatment.

Glycosylated Hemoglobin A1c :

This test gives average glucose of last 8 to 12 weeks. This test is more important in knowing the status of diabetes control rather than the diagnosis of diabetes.

 
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