Monday, August 24, 2009

Diagnosis of Type 1 Diabetes


Most people who develop Type 1 Diabetes have symptoms that force them to visit the doctors. The most common symptoms that they have are "Increased urination", "Increased thirst" and "Weight loss due to an increased appetite". From the previous articles, we may know that the signs and symptoms of Type 1 Diabetes are related to the high blood sugar levels.

There are no clear-cut guidelines for when to screen for diabetes. According to some experts, they recommended that people who are over 45 should be tested regularly for diabetes. Although some might feel this is not necessary to take the testes, early screening may identify some people with impaired sugar levels that would finally normalize.

When the symptoms of some people who develop Type 1 Diabetes are a bit more vague, it may take longer time to diagnose. Drawing blood samples and measuring the sugar levels within the blood are the major testes for diabetes, and the followings are testes available for diagnosing Type 1 Diabetes:

Fasting Plasma Glucose (FPG) Test
This measures blood glucose after at least 8 hours of not eating or drinking except water. Blood is usually collect early in the morning before breakfast. It is an easy, convenient and cost saving test, therefore it is the more preferred test for diagnosing diabetes. According to the ADA, if a fasting blood glucose level of 126mg/dL or higher on two occasions, it is indicative of diabetes. The fasting blood glucose test is the most common test used for diagnosing diabetes.
However, it is not completely reliable. It is known that the FPG test is more accurate in the morning, but some people might take the test in the afternoon and show normal results may actually have high blood glucose levels that would have been different from the results of the morning test.

Oral Glucose Tolerance Test (OGTT)
During the oral glucose tolerance test, a fasting blood sugar is obtained initially. There are two steps process that begins with a standard FPG blood test after a fast of at least eight hours. The person is then asked to drink a75 grams of sweet sugary beverage. Blood glucose levels are then obtained every 30 minutes for the next two hours. If the result of the blood glucose level is below 140mg/dL at two hours, it is considered as normal. If the blood glucose level is greater than 200mg/dL at two hours, it is indicative of diabetes. And it is indicated as impaired glucose tolerance if the blood glucose level is between 140mg/dL and 200mg/dL at two hours. Therefore, this test is more accurate than the FPG test for diagnosing diabetes.
Random Plasma Glucose Test.
In this test, a sample of blood can be obtained and tested any time without fasting. This test is not as accurate as either the FPG or the OGTT. However, if a high blood glucose level is found out and the patients is suffering from one or more symptoms of early diabetes, then he/she is diagnosed as diabetes. According to the ADA, when a random glucose level is greater than 200mg/dL, then it is indicative as diabetes.

Urine and Blood Tests
People who develop diabetes will take the urine test. The urine sample is tested to see if there is any glucose contained. Normally, glucose does not form in the urine, but some glucose can overflow through the kidneys and into the urine if people have diabetes. Once the blood glucose level rises above 180mg/dL, glucose will spill over into the urine.
In addition, Ketones might present in the urine when the body start to break down an excessive amount of fat for energy. When there is insufficient insulin, Ketones are produced by the breakdown of fat and muscle to prevent the fat from leaving fat cells. Ketones are toxic at high levels. The presence of Ketones can indicate a serious complication of Type 1 Diabetes.

When the urine is tested containing glucose, the blood test will be used to confirm the diagnosis of diabetes. If the blood glucose level is not high enough to diagnose diabetes, an oral glucose tolerance test is needed. Further blood and urine tests are needed when patients are diagnosed with diabetes to find out whether he/she has Type 1 or Type 2 Diabetes.
The second blood test is used to look for a protein named auto-antibodies which is created by the immune system to attack the beta cells. If the auto-antibdies are found, then type 1 diabetes diagnosis is confirmed.

Last but not least, it is important to diagnose diabetes as early as possible. The earlier you diagnose, the earlier the treatment start.

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