Nephrology Department, The Third Affiliated Hospital of Sun Yat-sen University
Triple A
What are the criteria for diagnosing diabetes mellitus
1. Criteria for determining diabetes mellitus
If fasting blood glucose is between 6.1 mmol/L and 7.0 mmol/L, then it is called impaired fasting blood glucose. If the fasting blood sugar is normal and the postprandial blood sugar is 7.8mmol/L to 11.1mmol/L, it is called impaired glucose tolerance.
Fasting glucose impairment and hypoglycemia can be seen as a transitional stage from normal to diabetes, but can be reversed to normal with proper treatment. If they are not treated properly, they progress to diabetes.
The normal concentration of human blood glucose is: fasting venous plasma glucose 9-6.0mmol/L, postprandial venous plasma glucose <7.8mmol/L. The normal value of glycosylated hemoglobin is less than 6.5%. The normal value of glycated hemoglobin is 4.6～6.4.The criteria for diagnosing diabetes mellitus by glucose tolerance test and steamed bread meal test: Fasting blood glucose ≥7.0mmol/L, 2-hour blood glucose ≥11.1mmol/L, or blood glucose ≥11.1mmol/L at any time, can be diagnosed as diabetes mellitus.
2. Diagnostic criteria and typing of diabetes mellitus
2.1. Diagnostic criteria of diabetes mellitus have insulin receptor gene abnormality: deletion or mutation of insulin receptor, which can range from hyperinsulinemia and mild glucose to severe diabetes mellitus, and there may be acanthosis nigricans, including type A insulin resistance, goblins, lipoatrophic diabetes mellitus, and so on.
2.2, Diagnostic criteria for diabetes mellitus are endocrine disorders: including cortisolism, acromegaly, pheochromocytoma, and glucagonoma.
2.3, the diagnostic criteria for diabetes mellitus are pancreatic diseases: any kind of lesion causing diffuse islet damage can cause hyperglycemia, these lesions include fibrocalcific pancreatic disease, pancreatitis, trauma or pancreatectomy.
2.4, diabetes mellitus type 1 diabetes mellitus: the age of onset of light, most <30 years old, the onset of disease suddenly, polydipsia, polydipsia, polyphagia, emaciation, high blood glucose levels, many patients with ketoacidosis as the first symptom, serum insulin and C-peptide levels are low, ICA, IAA, or GAD antibody can be positive.
2.5, diabetes mellitus type 2 diabetes mellitus: common in middle-aged and elderly people, obese people with a high incidence, often accompanied by hypertension, dyslipidemia, atherosclerosis and other diseases.
3, diabetes screening methods
3.1, check four indicators. Fasting blood glucose (5.6 mmol/L), blood lipids, blood pressure, and weight (waist circumference 90 cm for men and 80 cm for women). If any of these are abnormal, further tests are necessary.
3.2. Check two more indicators, namely glycosylated hemoglobin (6.1 percent) and fasting blood sugar. Glycated hemoglobin is regarded as the gold standard for evaluating the efficacy of diabetes, and a hemoglobin level greater than 6.5 percent can assist in the diagnosis of diabetes. Glycated hemoglobin can also be used as a predictor. If it is above 5.6, the risk of diabetes increases. Therefore, if one of the above two indicators is abnormal, it is necessary to carry out the third step of the examination.
3.3 Glucose tolerance and insulin levels. If glucose tolerance is abnormal or insulin level is high, it means that insulin resistance already exists and it is in the pre-diabetic stage, which may progress into a real diabetic soon if intervention is not started.
Diabetes dietary taboos
1, high sugar content of food: white sugar, brown sugar, icing sugar, glucose, maltose, honey, chocolate, milk sugar, fruit sugar, preserves, canned fruits, soft drinks, fruit juice, sweet drinks, jam, ice cream, sweet cookies, cakes, sweet breads and sugary pastries.
2, easy to raise blood fat food: butter, mutton fat, lard, butter, cream, fat, cholesterol-rich foods, should pay special attention to, should not be used or less, to prevent atherosclerotic heart disease.
3, should not drink alcohol. Because the alcohol contained in the wine does not contain other nutrients only for heat, each gram of alcohol about 7 kilocalories (294 joules), long-term drinking on the liver is not good, and easy to cause the rise of serum triglycerides.
Preventing diabetes
Changing bad dietary habits, rationalizing dietary structure, and controlling the intake of protein, fat, and sugar. Some people worry that eating more fat will trigger high blood pressure, atherosclerosis, and accordingly increase the intake of carbohydrates, which is precisely for the occurrence of diabetes to provide regulation.
To increase activity. Exercise can improve the function of the endocrine system, increase the body's ability to resist disease, inhibit obesity, reduce weight, improve fat metabolism, and promote the oxidation of glucose good operation.
To maintain a happy spirit, a good mood, meet the things that do not go well, calmly deal with, properly disposed of, avoid emotional impatience, worry and anxiety.
Regular checkups, blood glucose and urine glucose tests, and prevention of impaired glucose tolerance should be actively strengthened.