Diagnosing Type 2 Diabetes

Unlike Type 1 Diabetes which produces symptoms that cannot be ignored, many people with Type 2 Diabetes do not notice that they have it since the symptoms of Type 2 Diabetes often develop gradually and hardly be noticed.

As there is no clear-cut guidelines for when to screen for diabetes, experts from the American Diabetes Association (ADA) always recommend all adults should have routine diabetes screening starting at age 45, or younger if at high risk. It is important that diabetes is diagnosed as early as possible so that the treatment can be started as fast as possible.

Blood samples drawing and glucose level within the blood measuring are the most common tests for diabetes. Testing may be done when the symptoms suggest the presence of diabetes or as a screening exam to detect unrecognized diabetes. The followings are tests available for diagnosing Type 2 Diabetes:

Random Blood Glucose
The Random Blood Glucose Test can be done at any time to measure the blood sugar levels. It is not accurate enough to diagnose diabetes, but it is indicative of diabetes if the blood sugar level of the patient is at least 200mg/dL associated with typical symptoms of diabetes. These symptoms can be “Excessive thirst”, “Frequent Urination”, “Weight loss or gain” and “Increased fatigue”.

A repeat test should be taken to confirm the results since there is a 40% risk of developing diabetes within 5 years in those people whose results indicate pre-diabetes if they do not improve their lifestyle and health.

Fasting Plasma Glucose Test
The fasting Plasma Glucose (FPG) test is the standard test for diabetes. A blood sample is obtained after eight hours of fasting. The blood is usually drawn in the morning before breakfast. The test can help diagnose diabetes and pre-diabetes which is a situation in which your glucose levels are high but not at a diagnostic level. According to the ADA, FPG levels are considered as normal up to 100mg/dL. Diabetes is diagnosed when the blood sugar is 126mg/dL or higher. Levels between 100mg/dL and 125mg/dL are referred to as impaired fasting glucose or pre-diabetes. These levels are considered to be risk factors for Type 2 Diabetes.

Although FPG test is the most common test used to diagnose diabetes, it is not always reliable. Therefore, a repeat test is recommended if there is presence of diabetes suggested in the initial test. People with FPG levels in high end of the normal range have a greater risk to develop Type 2 Diabetes.

Oral Glucose Tolerance Test
The Oral Glucose Tolerance Test (OGTT) is more complex than the FPG and may over-diagnose diabetes in people who do not have it. It is suggested that to take this test as a follow-up after FPG when the patients have symptoms or risk factors of diabetes with a normal result in the FPG test or other tests. A blood sample will be taken every 30 minutes for the next two hours after drinking a sweet sugary beverage containing 75mg of glucose. It is considered as normal when the OGTT level is below 140mg/dL. Diabetes is diagnosed when the OGTT levels are over 200mg/dL or higher. OGTT levels between 140mg/dL and 199mg/dL are indicated impaired glucose tolerance or pre-diabetes.

The A1C Test
A1C test is another test of blood glucose test used to diagnose Type 2 Diabetes. This test is used to test for blood levels of glycosylated hemoglobin. It is not used for initial diagnosis but it is useful for determining the severity of diabetes. Some experts stated that A1C is a good indicator of the blood glucose levels and it can help predict complications in people who have FPG levels of 110mg/dL to 139mg/dL. It is recommended that people with diabetes should take the A1C test at least twice a year because it is the best measure of blood glucose control.

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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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What cause Gestational Diabetes

Although no one knows the cause of Gestational Diabetes yet there are some theories as to why the condition occurs.

There is an organ called the placenta develops in the uterus during pregnancy. It is a connection between the mother and the baby to make sure the baby obtains sufficient nutrition. It also releases certain hormones like cortisol and estrogen. These hormones block the working of insulin-controlling the blood sugar. This is termed insulin resistance. The insulin is unable to function properly due to these hormones.

Gestational diabetes develops when the organ makes produce insulin, yet the pancreas cannot produce enough insulin to maintain the blood sugar level at a safe level. However, most pregnant women do not suffer from gestational diabetes because the pancreas works to produce extra quantities of insulin to compensate for insulin resistance.

This diabetes usually develops between the week of 24th and 28th of the pregnancy. Pregnant women have to make certain changes in their daily habits to keep their blood sugar level within a safe range once they know they get gestational diabetes. Since there are more and more hormones continue release from the body during the pregnancy, it is harder and harder to control the blood sugar. Therefore, shots of insulin are necessary.

Those pregnant women with gestational diabetes do not mean that their babies will have diabetes. Most of them give birth to healthy babies. To lower the chance of having problems during pregnancy or birth, it is important for the pregnant women to maintain their blood sugar level within a safe range.

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What cause Type 2 Diabetes

Pancreas produces insulin allowing glucose to leave the bloodstream and enter the cells to be used as fuel. Type 2 Diabetes occurs when the pancreas does not produce enough insulin or the cells of the body become resistant to insulin. By certain researches, Type 2 Diabetes is mainly caused by a complicated interplay of genes and insulin abnormalities. Besides, lifestyle, family history and environment can also increase the chance of getting Type 2 Diabetes.

Genetic factors
Genes play an important role in determining one person’s risk of Type 2 Diabetes which has a genetic component. Researchers have already indentified at least 10 genetic variations linked to increase the risk for this disease. As one specific syndrome, maturity-onset diabetes of the young (MODY) seems related to one specific gene. Generally, it is thought that Type 2 Diabetes is the outcome from a combination of the presence of specific genes along with predisposing environmental factors. Parts of the insulin gene and other physiologic components involved in the regulation blood sugar are affected by the specific mutations.

Most of these genes are mainly regulating insulin action, including the processes that occur in the pancreas’ insulin-producing beta cells. The risk for obesity is increased by the FTO gene, and it appear to cluster around 3 genetic regions. In the future, researchers hope there is any way to delay or prevent the progression from pre-diabetes to diabetes.

Insulin abnormalities
Most patients with Type 2 Diabetes might have insulin resistance in muscle cells or excessive levels of insulin followed by a drop in insulin production. In Type 2 Diabetes, the receptors on cells in the body fail to respond to the action of the insulin, and which is known as insulin resistance. As a result, more insulin might be produced in response to this and overproduction is caused. This overproduction will exhaust the insulin-manufacturing cells in the pancreas. Insulin is insufficient available and those available insulin might be abnormal and work improperly.
Furthermore, there are researches determining the factors that might prompt insulin resistance. From several reports, both obesity and insulin resistance at different phases are marked by specific levels of free fatty acids and the hormones resistin and leptin. Till now, no one sure that if the elevated levels are simply a product of obesity or just play some role in diabetes. In addition, there is a chronic low inflammatory response related to the insulin resistance. This chronic low inflammatory response involves a number of immune factors such as TGH-beta 1 and C-reactive protein. These factors can cause damage for a long time and associate between the insulin resistance and heart disease.

Obesity
It is not surprising that being obese or overweight can put you at significant risk for developing Type 2 Diabetes. There are 4 out of 5 people with Type 2 are overweighing or obesity. Insulin resistance can also developed by excess fat, especially abdominal fat. In this case, insulin cannot process the blood sugar out of the blood and resulting in high blood sugar levels. Although not everyone with insulin resistance develops diabetes, there is a greater risk of Type 2 diabetes for those people with insulin resistance.

Inactive physical
Same as body fat and other hormones, muscle also affect diabetes development. Through exercise and strength training, lean muscle mass can be increased. This muscle plays an important role in protecting the body against insulin resistance and Type 2 Diabetes. A result has shown that doing more aerobic and resistance training exercises can help to reduce the insulin resistance.

Sleeping habits
According to the First National Health and Nutrition Examination Survey, body’s balance of insulin and blood sugar can be affected by sleeping habit by increasing the demand on the pancreas. If this condition last for a long time, Type 2 diabetes might be developed. From the analysis of data, those people who slept less than 5 hours or more than 9 hours have a greater risk of getting Type 2 Diabetes.

Eating habits
Poor eating habits can be important factors in the daily life. More wrong kinds of food you eat, higher risk of Type 2 diabetes you get. Studies have shown that eating a diet of high calorie, refined foods and beverages, and too little raw fruits, vegetables, and whole grains can increase the chance of getting Type 2 Diabetes.

Environment
Exposure to certain chemicals and viruses might trigger those people with Type 2 Diabetes and genetically predisposed to it.

Obviously, same as Type 1 Diabetes, it is better to learn more about the causes and presentations of Type 2 Diabetes. The more you learn, the less chance of getting Diabetes.

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What cause Type 1 Diabetes

Nowadays, doctors know HOW Type 1 diabetes occurs but they do not know WHY Type 1 diabetes occurs. No one is yet sure what prompts the autoimmune response specifically that destroys the body’s ability to create insulin. Most scientists and doctors suggested that the combination of a genetic predisposition to diabetes that is triggered by an unknown environmental factor is the best guesses. Besides, autoimmune response and viruses are also the cause of Type 1 diabetes.

Genetics
According to some researchers, there is a definite link drawn between Type 1 Diabetes and a person’s genetic makeup. Some people might bear with developing Type 1 Diabetes. It is found that there are at least 18 genetic locations, labeled IDDM1-IDDM18 that is related to Type 1 Diabetes. The region of IDDM1 contains HLA genes which encode proteins named as major histocompatibailty complex. These genes affect the immune response.

Type 1 diabetes is not an inherited disease yet only a few people with a genetic predisposition to Type 1 Diabetes actually end up getting it. To some researches, there are only 10% developing Type 1 Diabetes if a first-degree relative has diabetes. Even in identical twins, there is only a 33% chance of developing Type 1 Diabetes if another twin has it. Children are more likely to inherit the disease from a father with Type 1 diabetes than from a mother with it.

Till now, genetic factors cannot be fully explained the development of Diabetes. The incidence of Type 1 Diabetes has undergone a major increase in certain European countries and the incidence has nearly tripled undergone in the northeastern United States over the past 30 years. Researchers stated that there is such an increase in cases at least 400 years if Genetic is the only cause of Type 1 Diabetes.

Autoimmune Response
Patients with Type 1 Diabetes are more likely to suffer from autoimmune problems. Type 1 Diabetes is usually named as a progressive autoimmune disease in which the insulin produced by the beta cells is slowly destroyed by the body’s own immune system. No one knows what first starts this cascade of immune events yet there are some evidences suggest that both genetic predisposition and environmental factors are involved.

Insulitis the progression from the first stage to full-blown diabetes can take more than 7 years. Unfortunately, while a person is aware that there is something wrong and visit the doctor with symptoms of Type 1 Diabetes, he/she might get 80-90% of the beta cells have been destroyed. However, more than half of patients with insulitis do not develop diabetes, which is an interesting research for the researchers to discover.

Besides, thyroid disease or celiac disease is one of the autoimmune problems to the patients. Thyroid disease causes the body use energy more or less quickly than it should while celiac disease causes the lining of the small intestine attacked by the immune system whenever the person eats gluten.

Environmental Triggers Viruses & Toxins
Some certain evidences showed that one or more viral infections may trigger the disease in genetically susceptible individuals. It is suggested that a viral protein that resembles a beta cells protein is introduced by an infection and this resemblance tricked the T cells and antibodies into attacking the beta protein as well as the virus.

Viruses under scrutiny are determined as enteric viruses which attack the intestinal tract. As well as mumps and congenital rubella, Epidemics of Coxsackie virus, one of the family of enteric viruses of particular interest, have been associated with incidence of Type 1 Diabetes.

Other researchers believe that the trigger is actually some sort of toxins in the environment. The toxin bacteria in the soil are blamed by some theory under investigation. These bacteria infest vegetables which are eaten by people genetically predisposed to Type 1 Diabetes. The pancreatic beta cells are attacked and an autoimmune reaction that targets to the beta cells is developed.

It is crystal clear that there is much more that needs to be learned before the medical community can begin to know the causes of and the ways to prevent Type 1 Diabetes. At this moment, what you should do is to get an early diagnosis and follow the right insulin-replacing treatment plan to have a normal and better life.

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Main Symptoms of Diabetes pt II

Apart from the major symptoms of diabetes, the minor symptoms often go unrecognized yet they are physical and neurological problems, these are:

Blurred vision
Diabetes can lead to macular degeneration and eventual blindness. Blurred vision can be caused by tissue being pulled from your eye lenses and might affect your eyes’ ability to focus. However, there are some treatment can deal with this problem. With proper treatments, the problem can be improved.

Numbness and/or tingling in the hands and feet
It is peripheral neuropathy which is a symptom of diabetes and can cause nerve damage in the extremities. Too much sugar might damage your nerves, as the tiny blood vessels feed those nerves. You might feel numbness and/or tingling in your hands and feet.

Irritability
Diabetics might feel irritability because of lack of energy.

Slow healing of cuts and bruises
Do you find that there are some minor scratches and wounds on your body don’t heal properly or quickly? Diabetes often leads to impaired immune system function. The problem of slow healing can be improved when there is more glucose in your body.

Dry and itchy skin
Itchy skin is sometimes a symptom of diabetes. It can affect circulation and proper sweat gland function.

More skin and/or hand-to-treat yeast infections
The ability of recovering from infections is affected when there is more sugar in your body. It is difficult to recover from bladder and vaginal infections especially women with diabetes.

Gum problems
There are several symptoms related to the gum and teeth. When you find your gums are tender, red and/or swollen, this could be a sign of diabetes. Your teeth can become loose as the gums pull away from them. Nevertheless, you might experience more gum disease and/or gum infections.

Sexual dysfunction among men
When men are over 50 and experience frequent sexual dysfunction, then it could be a symptom of diabetes.

If you or your family member are experiencing any of these symptoms on a regular basis, that might be a sign of diabetes. You should better visit the doctors as soon as possible, and it might prevent the more serious health problems occurring.

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Main Symptoms of Diabetes pt I

People usually neglect the ponderance of diabetes. They can often have diabetes and be completely unaware as the symptoms of diabetes are not significant and seems harmless. However, the earlier diabetes is diagnosed, the greater chances to avoid the serious health problems caused by diabetes.

The most common symptom of diabetes Type 1 and Type 2 is elevated blood sugar levels. In Type 1, the body cannot produce enough insulin to regulate the blood glucose levels. In Type 2, the body develops resistance to insulin which means that it is unable to use the insulin and function properly.

It is important to know the side-effects of high blood glucose, which are commonly recognized as the noticeable symptoms of diabetes. There are some of the common early warning signs of diabetes:

Frequent urination
Do you notice that you always wake up repeatedly during the night going to the toilet? Diabetics will urinate more often when there is too much glucose in their blood. If your body cannot produce enough insulin or no insulin, then your kidneys cannot filter the glucose back into the blood. Your kidneys will take more water from your blood as to dilute the glucose and fills up your bladder.

Excessive thirst
Have you been drinking more water than usual lately? It is not related to exercise, hot weather or short-term illness, but it is related to the frequent urination. It is because you have urine more than usual, you will need to replace that lost liquid, thus you will drink more water than usual.

Excessive hunger
Excessive hunger means that although you know you’ve eaten, you are still hungry all the time. It is because the insulin in your blood is not functioning properly or not there at all, and your cells will get hungry. Therefore, your body will try to get more energy, and which is from the food.

Tiredness and fatigue
Tiredness and fatigue is one of the most common symptoms of diabetes. You might find that you will fall asleep unexpectedly after meals. It is because glucose cannot enter into your blood and cells, and no energy providing to the cells when your insulin is not working properly or is not there at all. Thus you will feel tired and listless more than usual.

Unusual and rapid weight loss
There is a dramatic change in weight is a sign to visit a doctor. Unusual weight loss is more common among people with diabetes Type 1. Since your body cannot make enough insulin, it will then find out other energy sources. As a result of lack of energy, the muscle tissue and fat will be broken down for providing energy.

While many of the signs and symptoms of diabetes can be related to other causes, testing for diabetes is very easy and if there is one or more of these symptoms presented, you should visit the doctor. And if diabetes is suspected and diagnosed in the early stage, other more serious symptoms of advanced diabetes can often be prevented or controlled.

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