How is diabetes mellitus diagnosed
Symptoms and diagnosis:
how can you recognize type 2 diabetes?
In contrast to type 1 diabetes, type 2 diabetes usually shows less typical symptoms and is therefore usually only discovered late. Often unspecific symptoms occur such as tiredness, weakness and decreased performance. A frequent urge to urinate and an increased feeling of thirst can also be signs of diabetes: Above a certain blood sugar concentration, the excess glucose is excreted in the urine (so-called kidney threshold). The sugary urine draws more water than usual, so that those affected now have to urinate much more often than before. The body makes up for the loss of fluids by creating a strong feeling of thirst.
Other symptoms of diabetes can include:
- constant feeling of hunger
- Weight changes
- depressive mood
- recurring urinary tract infections
- poorly healing wounds.
Hyperosmolar coma is rare, but typical of type 2 diabetes: When blood sugar levels are extremely high, the kidneys excrete so much fluid that the body can no longer compensate for the loss through drinking. The fluid deficiency averages eight to twelve liters. The body dries out more and more, which can lead to impaired consciousness or even a coma. The causes of a hyperosmolar coma are often infectious diseases, treatment with diuretics or the consumption of foods with a high sugar content.
Diagnosis: recognize diabetes
In order to detect type 2 diabetes as early as possible, it is important to regularly take part in preventive examinations and to check your blood sugar. This is especially true if you are at increased risk of diabetes. The doctor examines the blood, measures the blood pressure and checks height and body weight. If diabetes goes unnoticed for years, cardiovascular diseases, damage to the kidneys and eyes and dangerous circulatory disorders in the feet and legs can develop. However, if diabetes or its preliminary stages are identified in good time and treated accordingly, the disease and its secondary diseases can be avoided.
To diagnose diabetes, the doctor measures the following values:
- Fasting blood sugar
- Occasional blood sugar (blood sugar measured at any point in time)
- oral glucose tolerance test
- Long-term blood sugar (HbA1c-Value)
Fasting blood sugar
The value is determined in the morning before breakfast, i.e. on an empty stomach. You should not eat anything for at least four hours before the blood draw and also avoid beverages containing calories, coffee, black tea and smoking. The fasting blood sugar or the fasting glucose proves the presence of diabetes if the value is at least 126 mg / dl or 7.0 mmol / l in the blood plasma. Values between 110 and 125 mg / dl are considered borderline. It may then be a pre-diabetes stage (impaired glucose tolerance). An oral glucose tolerance test (sugar load test) is often carried out for further testing.
Oral glucose tolerance test
This examination is used to detect the early stages of diabetes, in which the blood sugar is only temporarily increased - especially after eating. Three days before the examination, you should eat a normal diet with sufficient carbohydrates and refrain from smoking. The test is carried out in the morning on an empty stomach, that is, you should not eat anything 10 hours beforehand. For the test, drink a liquid with 75 g of sugar. Blood sugar is measured before and two hours after drinking. If it is at least 200 mg / dl or 11.1 mmol / l after two hours, diabetes is present.
Occasional blood sugar
In the presence of diabetes, the occasional blood sugar is at least 200 mg / dl or 11.1 mmol / l.
Long-term blood sugar (HbA1c-Value)
The HbA1c (Glycohemoglobin) is the dye in red blood cells (hemoglobin) that is linked to sugar residues. This value shows how high the concentration of blood sugar was in the last six to eight weeks and is therefore also referred to as long-term blood sugar or blood sugar memory. Diabetes exists when the HbA1c- Value is at least 6.5% or 48 mmol / mol. The value is also important in the course of diabetes treatment: an increased HbA1c indicates poor blood sugar control.
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