Diabetes is a very common chronic metabolic disease, mainly caused by abnormal insulin secretion in the human body. Heredity, environment, etc. can all lead to the disease.
Diabetic patients generally have symptoms of polydipsia, polyphagia, polyuria and weight loss , which are called "three more and one less", and may also be accompanied by fatigue, weakness, etc. If the patient is in a state of high blood sugar and high blood sugar for a long time, it will cause serious damage to important tissues and organs such as cardiovascular and kidneys, endangering life safety. Therefore, diabetes needs timely medication control, but only if a clear diagnosis is obtained.
At present, the diagnosis of diabetes in our country still adopts the standards formulated by the World Health Organization (WHO) in 1999, which are based on venous plasma blood glucose , and the capillary blood glucose value is only used as a reference. Fasting plasma glucose (FPG) or 75g OGTT (glucose tolerance test) 2h plasma glucose (2hPG) values can be used alone for epidemiological surveys or population screening.
Fasting blood glucose screening is a routine screening method and has the advantage of being simple and easy to implement, but it may cause missed diagnosis. If fasting blood sugar or blood sugar at any time point is abnormal (fasting blood sugar ≥ 6.1 mmol / L and any time point blood sugar ≥ 7.8 mmol / L), but does not meet the standards for diabetes diagnosis, OGTT (fasting blood sugar) is feasible Blood glucose and 2h blood glucose after glucose load).
The examination can be carried out from 7 am to 9 am. The subject should remain fasting (8-10h), take a certain concentration of glucose aqueous solution orally, and drink it within 5 minutes.
Then the time is calculated from the first sip of sugar solution consumed, and blood is collected from the forearm before drinking and 2 hours after drinking to measure blood sugar. During the examination, the subjects are not allowed to drink tea, coffee and other beverages, nor are they allowed to smoke or do strenuous exercise.
Another thing to note is that in the first 3 days of the experiment, the intake of carbohydrate should be maintained at ≥150g/d. Drugs that may affect the OGTT results should also be stopped 3-7 days before the test, such as contraceptives , diuretics or phenytoin , etc.
In addition to blood tests, diabetes can also be diagnosed clinically by testing urine sugar, such as the test strip method.
The principle is: the test paper contains glucose oxidase, which can make glucose lose hydrogen ions and form gluconic acid lactone , and then forms gluconic acid through hydration, and then occurs under the action of the test paper chromogen. oxidation reaction and appear in different colors.
Urine contains different amounts of glucose, so it may appear in different colors, so you can judge urine sugar.
However, it should be noted that this method may not yield effective results for elderly patients with diabetes because the renal glucose threshold of such patients will increase, so it is not appropriate to use urine glucose testing for diagnosis in patients with abnormal renal glucose thresholds. diabetes.
In addition, some biochemical indicators can also be used as the basis for diagnosing diabetes, including insulin content levels, glycated proteins, fructosamine, etc.
Insulin is a hormone secreted by pancreatic islet beta cells and has a hypoglycemic effect. If the body is in a state of high blood sugar for a long time, it will affect the level of insulin, so this indicator can provide a basis for the diagnosis of diabetes. The current method for detecting insulin content levels is mainly microparticle enzyme immunoassay.
As for glycated protein , some studies have pointed out that the higher the blood sugar concentration, the faster the synthesis rate of glycated protein, and the synthesized glycated protein will be denatured and induce diabetes-related complications . Therefore, detecting glycated protein can provide a basis for the risk of diabetic vascular complications. This indicator is also the main reference data for evaluating the effect of diabetes treatment, but it is rarely used for the diagnosis of diabetes.
Fructosamine is a substance produced during the non-enzymatic glycation process of glucose and protein glycation. Studies have shown that its content is positively correlated with the patient's blood sugar level, and is relatively stable, regardless of exercise status, eating status, etc. It will not have much impact on the detection.
Some research results show that the level of fructosamine in diabetic patients with hyperglycemia is higher than that in healthy people, while the level in patients with diabetes and hypoglycemia is lower than that in healthy people. Therefore, researchers believe that measuring the level of fructosamine can provide a basis for diagnosing diabetes.
When diabetes is diagnosed, patients should follow the doctor's advice and take medication to stabilize blood sugar levels and prevent complications. At the same time, blood sugar levels need to be monitored every day to understand the effect of treatment and adjust the medication plan in a timely manner.
Conclusion
The incidence of diabetes has always been high, mostly related to bad eating habits, so we should consciously cultivate healthy eating habits to prevent the occurrence of diabetes. If relevant symptoms occur, you should go to the hospital for examination in time, and take timely intervention measures after a clear diagnosis.
Especially for elderly patients, dietary management and effective exercise should be included throughout the entire diabetes treatment process. At the same time, health education should be provided to them to improve their self-management ability and compliance with treatment, so as to avoid affecting blood sugar control or even aggravating the condition.
Reference:
[1] Lu Ruijian. The application value of routine urine tests and biochemical tests in the diagnosis of diabetes [J]. Electronic Journal of Clinical Medical Literature, 2019, 6(65): 128-129.
[2] Chinese Medical Association Diabetes Branch, National Office of Grassroots Diabetes Prevention and Management. National Grassroots Diabetes Prevention and Management Manual (2019) [J]. Chinese Journal of Internal Medicine, 2019, 58(10):713-735.
[3] Liu Guiyuan , Zhai Fengjuan. Research progress on the application of biochemical tests in diabetes diagnosis[J]. Chinese Prescription Drugs, 2019,17(3):23-24.
