DIABETES : DIAGNOSIS

By Dr. Maame Araba A. Oduro (MB.ChB.)

Senior House Officer, SRH, Ghana

Diabetes is not merely high blood sugar but a far-reaching metabolic imbalance

The previous post (click here) has done a great job in explaining why glucose is needed in the body and I will go ahead to comment on a statement made and continue from there.

“The concentration of glucose in the blood is subject to intense control”. This control comes about due to a chemical substance called insulin (Click here to read about it). Insulin helps keep your blood sugar level from getting too high (hyperglycemia) or too low (hypoglycemia).

This introduction to insulin leads me to talk about the diagnosis of diabetes.

Diabetes simply results from lack of, or reduced effectiveness of insulin produced by the body (endogenous insulin) as well explained in this article. That is when the body no longer produces insulin due to certain causes or when the insulin produced by the body is not effective to regulate the amount of glucose in the blood.

Insulin helps in regulating the amount by helping glucose enter the body’s cells where it is used for energy or helping to store glucose in another form for future use.

When there is lack of endogenous insulin, there is a lot of glucose left in the blood. This causes what is popularly known as high blood sugar (hyperglycaemia).

Diabetes is not merely high blood sugar but a far-reaching metabolic imbalance but hyperglycaemia is an important aspect of diabetes and helps in early diagnosis.

There are types of diabetes mellitus which has been tackled in [konlan’s article]. The main purpose of this post is to know about the diagnosis/screening of diabetes (The tests you are asked by your medical doctor to do and the interpretation)

Basically, there are three tests that can be done to screen for or diagnose diabetes. These are,

  1. The glycated haemoglobin test (HbAIC)
  2.  Fasting glucose
  3. OGTT (oral glucose tolerance test)/ 2-hour plasma glucose test

The last two both require the individual to fast for a period. There will be an article about it in another post (or you could read more about these tests online and direct questions to this blog if you have them).

The WHO criteria for diagnosing diabetes mellitus is a helpful tool to health workers and includes:

  1. Symptoms of high blood glucose, a.k.a hyperglycaemia (e.g. Polyuria; that is increased production of large volumes of urine in a day, increased thirst/polydipsia, unexplained weight loss, visual blurring etc.) and once the blood glucose test shows increased levels of glucose (fasting test of not less than 7mmol/l or random test not less than 11.1mmol/l).
  2. Raised blood glucose on two separate occasions – Fasting test not less than 7mmol/l, random test of not less than 11.1mmol/l or OGTT with 2h value not less than 11.1mmol/l
  3. HbAIC not less than 48mmol/mol.

In conclusion, I would like to share some recommendation from care.diabetesjournals.org

  1. Testing for prediabetes and risk for future diabetes in people who show no symptoms should be considered in adults of any age who are overweight or obese (check BMI) and who have one or more additional risk factors for diabetes. 
  2. If tests are normal, repeat testing carried out at a minimum of 3-year intervals is reasonable.
  3. Testing for prediabetes should be considered in children and adolescents who are overweight or obese and who have two or more additional risk factors for diabetes.
Testing for prediabetes and risk for future diabetes in people who show no symptoms should be considered in adults of any age who are overweight or obese and who have one or more additional risk factors for diabetes

Photo source: who.org

Diabetes has a lot of complications which is basically grouped by its effects on blood vessels, both large and small. These complications are in my opinion what makes diabetes a “killer” disease as blood vessels are the transport system of our bodies.  Delivering nutrients and oxygen to our cells, this ability decreases when they are affected and the overall effect is the decaying or dying of our cells.

Hence the importance of diabetes prevention.

NB:Your body mass index (BMI) is an index that determines your nutritional status (either you are underweight, normal, overweight/pre-obese or obese). It is calculated as a division of your body weight (in kilograms) by a square of your height (in metres).

ABOUT THE AUTHOR

Dr. Maame Araba A. Oduro (MB. ChB.)

Dr. Maame Araba A. Oduro (Bsc. Human Biology, MB. ChB.) is a senior house officer at SRH, Ghana. She has 2 years experience in the field of medicine. Having practised in two major hospitals in two different regions in Ghana, Dr. Oduro has been exposed to different health situations that required innovation and tactical use of her medical knowledge and skills. She has a month’s experience also in the Medical university of Silesia hospital located in Katowice in Poland, as an exchange student.

Leave a Reply

Your email address will not be published. Required fields are marked *