Diabetes diagnosis (part1)

Typical cases have prompted more than three of this disease syndrome. Diagnosis of mild asymptomatic person depends entirely on testing, regular health check-ups or in other diseases and accidental discovery. First of all, many patients found that complication, and then trace and the disease. However, regardless of symptoms or complications, the key is first of all take into account the possibility of this disease and for urine, blood sugar screening, to be confirmed.

(A) urine sugar test results to determine diabetes should pay attention to the following situations. Determination of the results of urine for diagnosis of reference, and diagnosis of diabetes depends on the determination of blood glucose.

1. For small or micro-diabetes, and occasionally appear to be in the meal blood glucose and oral glucose tolerance test carried out, and takes note of copper plaque Department's solution was to restore the sugars, such as copper oxide into a reaction, many drug , such as morphine, salicylic acid type, chloral hydrate, amino aspirin, benzoic acid of ammonia, a large number of citric acid, uric acid and many other sugars, such as the original copper sulfate can also be false-positive results occur. At present it is widely used in glucose oxidase-based urine test, the false-positive results could have been avoided.

2. Clinical signs of diabetes and urine sugar or a suspect repeatedly negative, attention should be given and the determination of fasting blood glucose two hours after a meal, except for renal sugar threshold in order to increase the situation.

(B) Determination of blood glucose blood sugar there are three commonly used methods: venous plasma glucose (VPG), capillary whole blood glucose (CBG) and venous whole blood glucose (VBG). In which the two most commonly used before. Measured in different ways the result of a slight difference. VPG method results measured CBG than 10%, compared with about 15% of high-VBG. Analysis of blood sugar and pay attention to the report, except when caused by increased glucose concentrations in other circumstances, such as after the injection of sugar, a variety of endocrine disorders, and stress-induced brain lesions, etc., will be dealt with later. Especially in mild or early type Ⅱ patients and normal fasting blood glucose can not be easy to except the need for two hours postprandial blood glucose or oral glucose tolerance test.

(C) fasting blood glucose tolerance test for normal or slightly higher in patients with diabetes and isolated, or have diabetes in patients with suspected (if positive family history, or repeated miscarriage, premature birth, stillbirth, giant baby, birth, abortion by the maternal, or repeatedly made furuncle carbuncle swollen sores, etc.), oral glucose tolerance test should be carried out. However, fasting blood glucose increased significantly while the heavy-duty diagnosis of autosomal dominant cases have been able to establish that a large number of glucose can increase the burden, should be exempt.

1. Oral glucose tolerance test (oral glucose tolerance test, OGTT) the most commonly used, in the past, adult one-100g, in recent years, WHO proposed to use 75g (or whether adult or child per kg standard body weight 1.75g, total no more than 75g) oral law. In the before and after oral sugar 1 / 2, 1,2,3-hour glucose test blood samples, urine samples collected at the same time check urine sugar.

Results: The normal (age 15 to 50 years old) for fasting blood glucose 70 ~ 100mg/dl (glucose oxidase enzymes real sugar Law), sugar absorption peak at 30 ~ 60 minutes (more than 50 years after the shift), there is generally no more than 170mg/dl, 2 hPG concentration of the restoration of the normal range, three hours can be reduced to below normal. Negative urine sugar. Compared with 100g and 75g is not very different from law, only the latter an early return to normal blood sugar. Glucose tolerance over 50 years of age tend to reduce the physiological, the peak in 1 hour and increased every 10-year-old increase in blood glucose 10mg/dl.