Diagnosis and Examination of Diabetes Mellitus


Diagnosis and Examination of Diabetes Mellitus
Diabetes mellitus is a very common disease. Then, what examinations are required for patients with diabetes mellitus?



1Blood sugar
Blood sugar is the sole criterion for diagnosing diabetes mellitus. Patients who have obvious  "three polys and one little” symptom, can be diagnosed only through one time abnormal blood sugar value. While for patients without symptoms, twice abnormal blood sugar values are required. For people suspected with diabetes mellitus, 75g glucose tolerance test is required.

2Glucose in urine
The glucose in urine of patients with diabetes mellitus often is positive but determination of glucose in urine is not taken as diagnostic criteria.

3Urinary ketone bodies
    When patients with diabetes mellitus have ketosis or ketoacidosis, urinary ketone bodies are positive.

4. Glycosylated hemoglobin (HbA1c)
Glycosylated hemoglobin (HbA1c) can reflect the average blood sugar level of the two months before collecting blood. It is the most valuable index for judging the control state of blood sugar.

5. Glycosylated serum protein
Glycosylated serum protein can reflect the average blood sugar level of 1-3 weeks before collecting blood.

6.Serum insulin and C-peptide level
    Serum insulin and C-peptide level can reflect the reserve functions of islet beta cells. 

7Blood lipid
Patients with diabetes mellitus often have abnormality of blood lipid, which is particularly obvious when the blood sugar is not controlled well.

8Immune index
Positive islet cell antibodies, insulin autoantibody and glutamate decarboxylase are three important indexes for humoral immunologic abnormalities of type I diabetes mellitus, which is of great value to diagnosis of type I diabetes mellitus. Immune indexes may have a certain positive rate in the relatives of patients with type I diabetes mellitus, which is of significance to prediction of type I diabetes mellitus.

9Urine albumin excretion
In the early period of diabetic nephropathy, the albumin is mildly elevated.
Diagnostic criteria for different types of diabetes mellitus

Generally, it is not difficult to diagnose diabetes mellitus, which can be diagnosed if the  fasting plasma glucose is greater than or equal to 7.0 mmol/L and/or the 2h postprandial plasma glucose is greater than or equal to 11.1 mmol/L. Among which, type I diabetes mellitus and type II diabetes mellitus have different features.
Type I diabetes mellitus
    The age of onset of type I is younger and is typically less than 30 years old. The onset is acute and patients have obvious symptoms of drinking a lot, eating a lot and emaciation and have high blood sugar level. Quite a few patients have ketoacidosis as first symptom, and are with low serum insulin and C-peptide level and the immune indexes are positive. Oral hypoglycemic agents are not effective for patients and patients have to receive insulin therapy.
Type II diabetes mellitus
It is common in middle-aged and elderly people and the incidence rate is high in obese people. It is often accompanied by hypertension, dyslipidemia, arteriosclerosis and other diseases. During the early period of type II diabetes mellitus, patients have no any symptom or only slightly feel fatigue and thirsty, which is not easy to find. Patients who have no obvious rise in blood sugar shall conduct glucose tolerance test for diagnosis. The serum insulin level is normal or is elevated in early period but will be lower in late stage.


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