Diabetes Mellitus
Diabetes Mellitus
• This test is a blood check at any time of the day when you have severe
diabetes symptoms.
• Diabetes is diagnosed at blood sugar of greater than or equal to 200
mg/dl
Oral Glucose Tolerance Test (also called the OGTT)
• The OGTT is a two-hour test that checks your blood sugar levels
before and 2 hours after you drink a glucose solution of 75g. It tells
the doctor how your body processes sugar.
• Diabetes is diagnosed at 2 hour blood sugar of greater than or equal
to 200 mg/dl
Result Oral Glucose Tolerance Test
(OGTT)
Normal less than 140 mg/dl
Prediabetes 140 mg/dl to 199 mg/dl
Diabetes 200 mg/dl or higher
Diagnosis of GDM
• The ADA has recommended the use of either the one- or two-step approach at 24–
28 weeks of gestation in pregnant women not previously known to have diabetes.
• The one-step approach involves performing a 75-g OGTT, with plasma glucose
measurement when the patient is fasting and at 1 and 2 hours in this group of
gravida at 24-28 weeks' gestation.
• Optimally, perform the OGTT in the morning after an overnight fast of at least 8
hours. The diagnosis of GDM is made when any of the following is met or exceeded :
• Fasting: 92 mg/dL (5.1 mmol/L)
• 1 hour: 180 mg/dL (10.0 mmol/L)
• 2 hour: 153 mg/dL (8.5 mmol/L)
• The two-step approach is a 1-hour (nonfasting) plasma glucose
measurement after a 50-g oral glucose load in women at 24-48 weeks'
gestation who were not previously diagnosed with diabetes. If the plasma
glucose level after 1 hours is ≥140 mg/dL perform a fasting 100-g OGTT.
• The diagnosis of GDM is made if at least two of the following four plasma
glucose levels (measured during OGTT) are met or exceeded :
• Fasting: 95 mg/dL (5.3 mmol/L)
• 1 hour: 180 mg/dL (10.0 mmol/L)
• 2 hour: 155 mg/dL (8.6 mmol/L)
• 3 hour: 140 mg/dL (7.8 mmol/L)
Preventing Type 2 Diabetes
• You will not develop type 2 diabetes automatically if you have
prediabetes. For some people with prediabetes, early treatment can
actually return blood sugar levels to the normal range.
• Research shows that you can lower your risk for type 2 diabetes by 58%
by:
• Losing 7% of your body weight (or 15 pounds if you weigh 200 pounds)
• Exercising moderately (such as brisk walking) 30 minutes a day, five
days a week
• Don't worry if you can't get to your ideal body weight. Losing even 10
to 15 pounds can make a huge difference.
Long-term complications of diabetes
• Long-term complications of diabetes develop gradually. The longer you have diabetes — and
the less controlled your blood sugar — the higher the risk of complications. Eventually, diabetes
complications may be disabling or even life-threatening. Possible complications include:
• Cardiovascular disease. Diabetes dramatically increases the risk of various cardiovascular
problems, including coronary artery disease with chest pain (angina), heart attack, stroke and
narrowing of arteries (atherosclerosis). If you have diabetes, you're more likely to have heart
disease or stroke.
• Nerve damage (neuropathy). Excess sugar can injure the walls of the tiny blood vessels
(capillaries) that nourish your nerves, especially in your legs. This can cause tingling, numbness,
burning or pain that usually begins at the tips of the toes or fingers and gradually spreads
upward.
• Left untreated, you could lose all sense of feeling in the affected limbs. Damage to the nerves
related to digestion can cause problems with nausea, vomiting, diarrhea or constipation. For
men, it may lead to erectile dysfunction.
• Kidney damage (nephropathy). The kidneys contain millions of tiny blood vessel
clusters (glomeruli) that filter waste from your blood. Diabetes can damage this
delicate filtering system. Severe damage can lead to kidney failure or irreversible
end-stage kidney disease, which may require dialysis or a kidney transplant.
• Eye damage (retinopathy). Diabetes can damage the blood vessels of the retina
(diabetic retinopathy), potentially leading to blindness. Diabetes also increases
the risk of other serious vision conditions, such as cataracts and glaucoma.
• Foot damage. Nerve damage in the feet or poor blood flow to the feet increases
the risk of various foot complications. Left untreated, cuts and blisters can
develop serious infections, which often heal poorly. These infections may
ultimately require toe, foot or leg amputation.
• Skin conditions. Diabetes may leave you more susceptible to skin
problems, including bacterial and fungal infections.
• Hearing impairment. Hearing problems are more common in people
with diabetes.
• Alzheimer's disease. Type 2 diabetes may increase the risk of dementia,
such as Alzheimer's disease. The poorer your blood sugar control, the
greater the risk appears to be. Although there are theories as to how
these disorders might be connected, none has yet been proved.
• Depression. Depression symptoms are common in people with type 1
and type 2 diabetes. Depression can affect diabetes management.
Test to detect Complication of DM
• Microalbumin level-to check check early sign of kidney damage
Hypoglycemia
• Decrease in blood glucose level below 70 milligrams per deciliter (mg/dL)
• Causes
• Medications. Taking someone else's oral diabetes medication accidentally is a possible
cause of hypoglycemia. ...
• Excessive alcohol drinking. ...
• Some critical illnesses. ...
• Insulin overproduction. ...
• Hormone deficiencies.
• Not eating enough
• Postponing or skipping a meal or snack
• Increasing exercise or physical activity without eating more or adjusting your medications
Early warning signs and symptoms of hypoglycemia