All you need to know about diabetes

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1.What is diabetes and how does it affect a person?
Diabetes mellitus is an abnormal carbohydrate metabolism characterized by high glucose.
It is associated with a relative or absolute impairment in insulin secretion, along with varying degrees of peripheral resistance to the action of insulin.

Most commonly, there are two types:
Type 1 diabetes leads to absolute insulin deficiency.
Type 2 diabetes ->90 percent and is characterized by hyperglycaemia and variable degrees of insulin resistance and deficiency.
Normal – Fasting plasma glucose <100 mg/dL (5.6 mmol/L). Fasting is defined as no caloric intake for at least eight hours.
Diabetes mellitus – The diagnosis of diabetes can be established with any of the following criteria (table 2) [26]:

  • Fasting plasma glucose ≥126 mg/dL (7.0 mmol/L)
  • A1C ≥6.5 percent (47.5 mmol/mol)
  • Two-hour plasma glucose ≥200 mg/dL (11.1 mmol/L) during an OGTT
  • Random (or “casual”) plasma glucose ≥200 mg/dL (11.1 mmol/L) in the presence of symptoms

2.How often should people get checked for diabetes?

  • A fasting plasma glucose value <100 mg/dL (5.6 mmol/L) or A1C <5.7 percent should be considered normal. We suggest retesting patients with these results at three-year intervals.
  • For those with borderline results (fasting plasma glucose 100 to 125 mg/dL or A1C 5.7 to 6.4 percent), we suggest follow-up every one to two years.
  • The diagnosis of diabetes is confirmed if both the A1C and fasting plasma glucose are above their diagnostic thresholds, if two consecutive A1C levels are ≥6.5 percent, or if two consecutive fasting plasma glucose levels are ≥126 mg/dL (7.0 mmol/L)

Testing should be considered in overweight or obese (BMI ≥25 kg/m2 or ≥23 kg/m2 in Asian Americans) adults who have one or more of the following risk factors:

  • First-degree relative with diabetes
  • High-risk race/ethnicity (eg, African American, Latino, Native American, Asian American, Pacific Islander)
    History of CVD
  • Hypertension (≥140/90 mmHg or on therapy for hypertension)
  • HDL cholesterol level <35 mg/dL (0.90 mmol/L) and/or a triglyceride level >250 mg/dL (2.82 mmol/L)
  • Women with polycystic ovary syndrome
  • Physical inactivity
  • Other clinical conditions associated with insulin resistance (eg, severe obesity, acanthosis nigricans)
  • Patients with prediabetes (A1C ≥5.7% [39 mmol/mol], IGT, or IFG) should be tested yearly.
  • Women who have been diagnosed with GDM should have lifelong testing at least every 3 years
  • For all other patients, testing should begin at age 45 years

If results are normal, testing should be repeated at a minimum of 3-year intervals, with consideration of more frequent testing depending on initial results and risk status.

3.How should a person with diabetes monitor and keep it under control?
A person with diabetes should work out a management plan with their treating physician best suited to their lifestyle, incorporating the goals as per the guidelines and protocols established by the American Diabetes Association or other such bodies.

4.What are the different levels of diabetes?
Prediabetes : (fasting plasma glucose 100 to 125 mg/dL or A1C 5.7 to 6.4 percent)
Diabetes : FPG ≥126 mg/dL (7 mmol/L) , A1C ≥6.5%. or 2-hour plasma glucose ≥200 mg/dL (11.1 mmol/L) during an OGTT or In a patient with classic symptoms of hyperglycemia or hyperglycemic crisis, a random plasma glucose ≥200 mg/dL (11.1 mmol/L).
Diabetes with complications.