Diagnosis diabetes Mellitus

The diagnosis of diabetes mellitus is made in any of the following three circumstances:

• Fasting blood sugar equal to or greater than 126 mg / dl (= 7.0 mmol / L).
• blood sugar without fasting equal to or greater than 200 mg / dl (= 11.1 mmol / L), with diabetic syndrome (polyuria, polydipsia, polyphagia, weight loss).
• blood sugar within two hours after giving 75 grams of sugar orally (oral glucose tolerance test) equal to or greater than 200 mg / dl (= 11.1 mmol / L).

Except in clear cases of increases in blood sugar and compatible clinical signs, these criteria should be confirmed by repeating the tests on another day. Prediabetes states are diagnosed as follows:

• Altered fasting blood glucose or Altered basal blood glucose: These are individuals who do not meet the criteria for diabetes but with fasting blood sugar between 110 and 125 mg / dl (= 6.1-7.0 mmol / L)
• Impaired glucose tolerance: These are individuals who do not meet the criteria for diabetes but who have alterations in the sugar overload curve (blood glucose levels two hours after an oral overload with 75 g of glucose between 141 and 199 mg / dl (= 7.7- 11.1 mmol / L).

How is it diagnosed?

Although the best parameter to diagnose diabetes is the fasting blood glucose, during 2010 various medical societies have proposed to use the glycated hemoglobin value (HbA1c) as an appropriate method for the diagnosis of diabetes mellitus.

Glycated hemoglobin (HbA1c)

We must know that HbA1c in the blood is the best method (in the follow-up of diabetics) for the control of sugar with the established treatment and, therefore, the risk of long-term complications. If we use HbA1c for diabetes diagnosis, this is done when the HbA1c is greater than 6.5%, although it must be repeated for confirmation in a new blood test. These recommendations should not be used for the pregnant or infant population.

How is it classified?

After the diagnosis of diabetes, it is interesting after know the type of diabetes presented by the patient. Until a few years ago we could consider that type 1 diabetes appeared in childhood and youth (generally before the age of 30) and that the type 2 appeared in adults> 40 years. In recent years type 2 diabetes is being seen also in adolescents, especially in obese adolescents. And some onset diabetesadults are type 1 forms.

• diabetes type 1: it is accompanied by thinness, a sudden onset of the disease and with clear signs. Patients with type 1 diabetes mellitus may have other autoimmune disorders such as autoimmune thyroid disease, adrenal insufficiency, pernicious anemia, and vitiligo. In type 1 diabetes, the presence of ICA autoantibodies is found with some frequency. When they appear in the blood, they serve as a marker of the autoimmune process of type 1 diabetes.
• Type 2 diabetes: It usually appears together with obesity and its development is slow and with few symptoms. People with type 2 diabetes mellitus often have associated disorders such as insulin resistance, hypertension, cardiovascular disease, dyslipidemia, or polycystic ovary syndrome.