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?
1.Blood
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.
2.Glucose
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.
3.Urinary
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.
7.Blood
lipid
Patients with diabetes
mellitus often have abnormality of blood lipid, which is particularly obvious
when the blood sugar is not controlled well.
8.Immune
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.
9.Urine
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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