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History and physical examination are

most important tools for diagnosing


diabetes Mellitus, however to confirm
diagnosis one should have following
laboratory tests.
!   
  

HgbA1c blood test - an average blood sugar measure


over about 3 months.

Fructosamine blood test - an average blood sugar


measure over about 2 weeks

rine Sample for Sugar and Ketones

You may have your urine analysis for sugar or ketones


which are produced by breakdown of fat and muscle
cells to diagnose diabetes but you should keep in mind
that if you are having positive urine test for sugar then
it is not necessary that you are suffering from diabetes
because there are other conditions as well which also
cause sugar to appear in urine.
!HE FAS!  BLOOD L
OSE (S
AR) !ES!
For diagnosing Diabetes Mellitus one must have this test
because it is best, easy and comfortable to perform. You
should have overnight fast (at-least 8 hours) before
performing this test. f fasting blood glucose is below
100mg/dl, then you don't have diabetes. Between
100mg/dl to 125mg/dl is called a Pre-diabetes or mpaired
fasting glucose condition. f fasting blood glucose is above
126mg/dl on more than two occasions then you are
suffering from diabetes.
RADOM (O-FAS! ) BLOOD L
OSE !ES!

t is also a good test for diagnosing diabetes. n this test we


take sample of blood shortly after taking a meal and then
check glucose level in blood. f this level is above 200mg/dl,
then there are much chances that you are suffering from
diabetes. But diagnosis should be confirmed the very next
day by fasting blood glucose or by glucose tolerance test
ORAL L
OSE !OLERAE !ES! (O!!)

!hough this test is not commonly used these days but


it is still a gold standard for diagnosing diabetes. For
diagnosing gestational diabetes this is best test.
nstructions for O!!
!his is test for a person who is in good health and have
no other illness.
Person should be normally active and not bed ridden.
Person is not taking anti diabetic drugs or any drug
which alters blood sugar level.
Before test, person should eat high carbohydrate diet for
three days.
o alcoholic beverages.
On test day one should not smoke or take coffee.
!he beta cells of the pancreas are where
insulin is produced. Diabetes occurs as a result
of inadequate production or inbility of body
cells to use insulin and metbolize glucose.
!  

!he cause of type 1 diabetes is still not fully understood. Some


theorize that type 1 diabetes is generally a virally triggered
autoimmune response in which the immune system's attack on
virus infected cells is also directed against the beta cells in the
pancreas. !he autoimmune attack may be triggered by reaction to
an infection. n type 1, pancreatic beta cells in the slets of
Langerhans are destroyed or damaged sufficiently to effectively
abolish endogenous insulin production. !his etiology distinguishes
type 1's origin from type 2. t should also be noted that the use of
insulin in treating a patient does ''not'' mean that patient has
type 1 diabetes; the type of diabetes a patient has is determined
only by the cause³fundamentally by whether the patient is insulin
resistant (type 2) or insulin deficient without insulin resistance
(type 1).
!his vulnerability is not shared by everyone, for not
everyone infected by the suspected organisms develops
type 1 diabetes. !his has suggested presence of a genetic
vulnerability and there is indeed an observed inherited
tendency to develop type 1. t has been traced to
particular HLA genotypes, though the connection
between them and the triggering of an auto-immune
reaction is still poorly understood.
!   

nsulin resistant means that body cells do not respond


appropriately insulin when is present.
nlike type 1
diabetes mellitus, insulin resistance is generally "post-
receptor", meaning it is a problem with the cells that
respond to insulin rather than a problem with the
production of insulin.
!his is a more complex problem than type 1, but is
sometimes easier to treat, especially in the early years when is
insulin often still being produced internally. !ype 2 may go
unnoticed for years before diagnosis, since symptoms are
typically milder and can be sporadic. However, severe
complications can result from improperly managed type 2
diabetes , including renal failure, erectile dysfunction,
blindness, slow healing wounds (including surgical incisions),
and arterial disease, including coronary artery diseases. !he
onset of type 2 has been most common in middle age and
later life, although it is being more frequently seen in
adolescents and young adults due to an increase in child
obesity and inactivity. A type of diabetes called MODY is
increasingly seen in adolescents, but this is classified as
diabetes due to a specific cause and not as type 2 diabetes.
 
Ö nsulin is a peptide hormone composed of 51 amino
acids and has a molecular weight of 5808 Da. t is
produced in the islets of Langerhans in the pancreas. !he
name comes from the Latin insula for "island". nsulin's
structure varies slightly between species of animal. nsulin
from animal sources differs somewhat in "strength" (in
carbohydrate metabolism control effects) in humans
because of those variations. Porcine insulin is especially
close to the human versionO
Ö nsulin is a hormone that is central to
regulating carbohydrate and fat metabolism in
the body. nsulin causes cells in the liver, muscle,
and fat tissue to take up glucose from the blood,
storing it as glycogen in the liver and muscle.
Ö shen control of insulin levels fails, diabetes mellitus
will result. As a consequence, insulin is used medically to
treat some forms of diabetes mellitus. Patients with !ype 1
diabetes mellitus depend on external insulin (most
commonly injected subcutaneously) for their survival
because the hormone is no longer produced internally.
Patients with !ype 2 diabetes mellitus are often insulin
resistant, and because of such resistance, may suffer from
a relative insulin deficiency. Some patients with !ype 2
diabetes may eventually require insulin if other
medications fail to control blood glucose levels
adequately, though this is somewhat uncommon.