How do I know I have diabetes?

हिन्दी (Hindi) मे पढ़िये

In the early years often diabetes remains a silent disease. This is one of the reasons that makes it more dangerous. It continues to damage our body while we never come to know of it. Only when some doctor advises us a blood test for some reason suddenly we learn that our blood sugar is high. Mostly it takes us by surprise. We feel that there must be something wrong with the report. Neither does the doctor do anything to help. He just gives a prescription of anti-diabetic drugs for life (what audacity!). We keep on repeating the test in search of a normal report. And lo! As I told you there is a normal report (how can doctors know so less?).

Of course, doctors do make mistakes. But just for once your doctor was probably right. If your blood sugar is high for consecutively two times you do require lifetime management. Management may or may not include drugs. Diagnosis of diabetes can be done in these ways:

1. Fasting blood glucose greater than 126 mg/dl (explain)
2. 2 hour post prandial blood glucose greater than 200 mg/dl
3. Glycosylated haemoglobin greater than 6.5
4. Presence of sugar in urine coupled with symptoms of diabetes mellitus

Serial no. 1 & 2 need to be repeated at least once on two different days.

Fasting blood glucose is done after 8 hours of fasting preferably an over night fast. 2 hour post prandial means the blood for testing is collected 2 hours after food.

Glycosylated haemoglobin is an interesting concept. It is a measure which tells us the history of our blood glucose level over the past 3 months.

Urine sugar is present when usually blood sugar is higher than 200 mg/dl. If blood sugar is less than that there may be no sugar in the urine. Again, there may be sugar in the urine in the presence of a normal blood sugar because of a renal (kidney) defect. So when a person first develops diabetes first the blood sugar rises.

The level of glucose in the blood is never static. It changes from time to time. If we test our blood at different times of the day we will get different values. However in normal people the values should not exceed the given normal range. If a person is fasting the blood glucose level should not exceed 100 mg/dl and 2 hours after food it should not exceed 140 mg/dl. What do we say when a person has a fasting blood glucose level of say 113 mg/dl? Is the person normal or diabetic. We can see the person is neither. The person has a condition technically known as impaired glucose tolerance. It means that it is neither normal nor can he be called a diabetic. Such people usually do not require antidiabetic medication.

An acute illness, pregnancy or abrupt weight gain may cause blood glucose to rise in those predisposed to type 2 diabetes mellitus. Again the glucose level may revert to normal after that particular phase passes away. Drug treatment for elevated blood glucose may be required during that particular phase. After the phase passes away the person will require frequent monitoring to detect again rising blood glucose levels.

When diabetes is not detected early we come to know of it later when there is some complication like a skin infection, a foot ulcer, diminished vision or a kidney disorder. People with diabetes are prone to heart attack and stroke. Diabetes may be diagnosed first in people who are hospitalized for these conditions.