Table of Contents
History of Diabetes
Symptoms of Diabetes
Tests For Diabetes
What are the Differences Between Type 1 and Type 2 Diabetes?
Medications to Treat Diabetes
Lifestyle Choices for a Diabetic
Effects of Diabetes Across the Lifespan
A Cure for Diabetes Mellitus is Now a Reality
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Tests For Diabetes
Today Diabetes affects 5% of the world’s population. Diabetics face significant long-term disabilities and complications if they don’t keep their blood glucose under control. Because of the need to diagnose, treat and control this chronic condition researchers have discovered several short term and long term methods of monitoring blood sugar as well as testing for the condition.
Some physicians follow specific recommendations to test for diabetes in their general patient population. Those who are over 45 and obese should be tested and those younger than 45 and obese should be considered.
Doctors will use several different tests, combine the results of those tests, and determine if a person has diabetes. The first, and simplest test, is the fasting blood sugar test. A small blood sample will be taken at the lab after the patient has had nothing to eat or drink after midnight. Normal blood sugar is between 70-110; considered borderline to 135 and high over 140.
Fasting blood sugar can be affected by several other factors. If a person is taking a diuretic or steroid it may alter the test. Also, some people who may be considered ‘pre-diabetic’ will also test with high blood sugar when they are ill but their values will return to normal after the illness has subsided.
Many physicians will consider a 2 or 4 hour oral glucose tolerance test (OGTT) if there is some question of a current diagnosis of diabetes or if they suspect the individual may suffer from pre-diabetic condition. During this test the patient arrives at the lab having fasted since midnight. They then drink a high concentration glucose drink. During the next 2 or 4 hours their blood sugar is measured every hour and urine tested every 30 minutes. During a normal test the blood sugar will not go above 110 even though the body has been stressed with a high dose of sugar. If there is diabetes the numbers will be elevated during the test.
Physicians will combine the results of a fasting blood sugar, OGTT, and physical examination and history to make a definitive diagnosis of diabetes.
Once a person has been diagnosed with diabetes it is important to continue to monitor their disease process. This is done through the use of several different blood tests. All diabetics learn to self monitor blood glucose through the use of a glucometer at home. These small machines measure the amount of glucose in the blood by measure a small blood sample obtained through a finger stick.
Then once every 3 – 6 months your doctor should order an A1C test to give you and the doctor an overall view of how well the glucose has been controlled in the past three months. The A1C is also called a glycosylated hemoglobin test. The American Diabetes Association recommends that this test is done twice a year for people who are well controlled and more often when blood sugars are not well controlled, if diabetics have other illness (illness affects control of the blood sugar) or when the treatment of the condition is changed.
The A1C test is reported as a percentage of how well controlled the blood glucose has been in the previous months. Physicians agree that the number should be between 6.5% and 7%. In a research study reported in July 2007 scientists reported initial findings of a study that proposes to change the units in which the A1C is measured to make the results easier for patients to understand.
A serum creatinine test is recommended once a year. This is a simple blood test that helps the doctor to determine how well your kidneys are performing. Serum creatinine is excreted through the kidneys and is a by-product of muscle metabolism. So if your kidneys aren’t working well they won’t excrete as much of the chemical.
A urine microalbumin test also evaluates the health of your kidneys by measuring the amount of protein that leaks through the kidneys into the urine. If your kidneys become damaged the waste products that kidneys normally filter remain in your blood and the protein that normally is in your blood leaks to your kidneys. The test is usually done on a one time fresh urine sample, although your physician may do a quantitative 24 hour study and ask you to collect 24 hours of urine.
The last test that is commonly done is lipid tests to evaluate your low density lipoproteins (LDL) and high density lipoproteins (HDL). Diabetes and heart disease are linked because of the damage that is done to the body from the diabetes and because those with diabetes have a higher risk of developing heart disease.
Doctors use the results of these tests to help determine how much vessel damage may be happening. The American Heart Association and the American Diabetes Association recommend that these tests are done once a year, more often if you are on lipid lowering drugs.
Diabetes tests have improved the way in which diabetes is monitored and treated. Now with vigilant monitoring and treatment patients have a lower risk of high blood pressure, stroke, heart disease and peripheral vascular disease then they once had even 10 years ago.
What are the Differences
Between Type 1 and Type 2 Diabetes?
The increased level of the blood sugar places the body systems and organs at high risk for damage. The most common organs that are damaged are the eyes, heart, kidneys and brain.
The medical terminology that describes high blood sugar is hyperglycemia. In a person who doesn’t suffer from the symptoms of diabetes a normal blood sugar value may fluctuate based on the laboratory where the blood is tested. These numbers usually range between 70 and 110. Below 65 your blood sugar is too low to support the function of your body and brain and above 120 your body is starting to feel the effects of the extra sugar.
There are basically two types of diabetes – Type 1, also known as juvenile diabetes, and Type 2, also known as adult onset diabetes. Type 2 diabetes is the more common of the two accounting for over 15 million people in the US out of the 17 million who suffer from diabetes.
Type-2 diabetes also used to be known as noninsulin-dependent diabetes since the condition causes carbohydrates, lipids and protein metabolism to be abnormal without shutting off the production of insulin as is what happens in Type 1 diabetes.
In Type 2 diabetes the body becomes resistant to the insulin that is produced which is a major reason for the complications associated with Type 2 diabetes. The condition is often under diagnosed, especially if it doesn’t cause extremely high blood sugar which may result in other neurological symptoms. Without the extremely high sugar levels a person may not recognize the other symptoms of untreated diabetes, such as weight loss because the body isn’t able to utilize the sugar metabolized, high thirst and increased urination.
Treatment of type 2 diabetes is different than that of Type 1. With Type 2 diabetes many people are, at least initially, able to control their condition with weight loss, diet, exercise and lifestyle changes if they so chose.
If they chose not to change the habits that brought them the problems they will be faced with oral or injectable medications that will mimic the action of insulin or decrease the amount of sugar that is metabolized by the body.
The range of treatment for Type 2 diabetes has increased in the past decade with the introduction of new oral medications that may delay the use of injectable insulin. Diabetics who have been experiencing symptoms less than 10 years and who are able to incorporate changes into their lifestyle may be able to use the oral hypoglycemic options for years before requiring the use of insulin.
New progress has been made in the area of islet cell transplantation but thus far this treatment has been reserved for patients with type 1 diabetes where the production of insulin is affected and not the body’s resistance to the use of the insulin.
People with Type 2 diabetes are faced with many challenges over the years as a result of the high levels of blood glucose that damages many of the body’s organs and systems. Some of the more common problems include neuropathies, heart disease, kidney failure, stroke, heart attack, blindness and peripheral vascular disease that can result in the loss of a lower extremity.
More About Type 1 Diabetes
Type 1 diabetes, insulin dependent diabetes, juvenile diabetes – they all are a different name for the same illness. In Type 1 diabetes the person experiencing the symptoms has developed an autoimmune response which destroyed the ability of the pancreas to produce insulin. The body no longer produces any insulin and so the name ‘insulin dependent’ diabetes. In Type 2 diabetes the body becomes resistant to insulin even though the person’s pancreas may secrete enough insulin to take care of the blood glucose.
Teens and children are most commonly diagnosed with Type 1 diabetes which led to the name juvenile diabetes. However, the incidence of Type 1 diabetes is the same across the lifespan so the number of children, teens, and adults diagnosed are the same. The number of people diagnosed with Type 2 diabetes is larger and more commonly diagnosed in adults which led to the name ‘adult onset diabetes’.
The name of the disease was changed to Type 1 diabetes in order to correct the misconception that Type 1 diabetes only happened to youngsters.
Type 1 diabetes is insulin dependent and the body isn’t resistant to the insulin that is administered. Oral medications aren’t helpful because they often work to correct some of the issues that people with Type 2 diabetes face.
Treatments for Type 1 diabetes include diet, exercise, insulin and close blood glucose monitoring. The term diet here doesn’t mean weight loss diets or the fad diets that are advertised throughout Hollywood. Instead this indicates a well balanced diet that supports the body’s nutritional requirements while not stimulating the liver to produce more glucose.Other Details
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