What tests are done to determine the type of diabetes?

Now let me explain what tests are done to determine the type of diabetes. I am happy to be able to assist you. Let's start. What tests are done to determine if it is diabetes? 1. Blood sugar: Elevated blood sugar is the basis for diagnosing diabetes. Here are two points to note: first, do not overlook postprandial blood sugar as it has greater significance in the early diagnosis of diabetes; second, urine sugar test results can only serve as a clue for diagnosing diabetes and cannot be used as a diagnostic basis. In other words, the diagnosis or exclusion of diabetes cannot be based on urine sugar test results. Linqian Rehabilitation Hospital

2. Oral glucose tolerance test (OGTT): When a person's fasting blood sugar or blood sugar 2 hours after a meal is higher than normal individuals, but does not reach the diagnostic criteria for diabetes, an OGTT is needed to determine if they are in the impaired glucose regulation (IGR) stage or actually have diabetes.

3. Pancreatic function tests: This includes insulin release test (IRT) and C-peptide release test (CPRT). This test measures the secretion levels and curve characteristics of insulin and C-peptide at various time points on an empty stomach and after meals to understand the extent of pancreatic function decline and assist in determining the type of diabetes the patient has.

4. Autoantibody tests: This includes tests for glutamic acid decarboxylase antibody (GA-DA), insulin antibody (IAA), pancreatic islet cell antibody (ICA), etc. These tests are mainly done to determine the type of diabetes the patient has. What tests are done to diagnose diabetes? To determine the type of diabetes and assess the severity of the condition, the following tests are usually conducted: glucose tolerance test, insulin receptor binding rate determination, insulin release test, and C-peptide stimulation test.

1. Glucose tolerance test The oral glucose tolerance test is a glucose loading test where the patient needs to consume 75g of glucose. Blood samples are then taken at 30 minutes, 60 minutes, and 120 minutes after consumption for analysis. It is important to note that the glucose tolerance test should be done on an empty stomach. In normal circumstances, a fasting blood sugar level of 3.9-6.1mmol/L is considered normal. If the fasting blood sugar level does not exceed 7.0mmol/L, it cannot be diagnosed as diabetes. If the fasting blood sugar level is ≥6.1mmol/L but <7.0mmol/L, it indicates impaired fasting blood sugar, which is higher than normal but has not reached the level of diabetes. If the blood sugar level exceeds 7.8mmol/L after a meal but does not reach 11.1mmol/L, it is considered abnormal glucose tolerance. If the blood sugar level exceeds 11.1mmol/L after a meal, it can be diagnosed as diabetes.

2. Glycated hemoglobin and glycated albumin This test primarily checks for glycated hemoglobin and glycated serum protein. These two tests can reflect the average blood sugar levels over the past 2-3 months and the past 2-3 weeks, respectively. If the value of glycated hemoglobin is above 6.5%, it can confirm the diagnosis of diabetes.

How to determine the type of diabetes Medical research has confirmed that diabetes is a dysfunction of pancreatic function. Relying solely on fasting blood sugar to determine whether someone has diabetes will inevitably result in some cases being missed, because in the early stages of diabetes, postprandial blood sugar levels increase while fasting blood sugar levels may be high or normal. On the other hand, some non-diabetic patients, such as hyperthyroidism, acromegaly, liver disease, and long-term steroid users, may experience elevated blood sugar levels, so relying solely on fasting blood sugar can result in misdiagnosis. Urine sugar levels are influenced by the renal glucose threshold and do not directly correlate with blood sugar levels. Therefore, urine sugar cannot be used as a basis for diagnosing diabetes. To accurately diagnose diabetes, determine its type and severity, one must undergo a glucose tolerance test, insulin release test, and C-peptide stimulation test. If possible, an insulin receptor binding rate test is even better. A diagnosis of diabetes can be made based on fasting blood sugar levels ≥7.0mmol/1 or postprandial blood sugar levels ≥11.1mol/1 (excluding factors such as pancreatic tumors, hyperthyroidism, Cushing's syndrome, acromegaly, liver disease, and long-term use of steroid medications).

Based on the diagnosis of diabetes and whether insulin release is normal or abnormal, and whether C-peptide release is within normal range or insufficient, a diagnosis of type 2 diabetes can be made. The criteria for mild, moderate, and severe cases are as follows: Mild: The difference between fasting blood sugar and blood sugar level 3 hours after a meal is between 3-5mmol/1 (if it exceeds 5mol/1, factors such as cold, infection, emotional fluctuations, and fatigue should be excluded). Insulin secretion is either normal or insufficient, and C-peptide release is within the normal range.

Moderate: The difference between fasting blood sugar and blood sugar level 3 hours after a meal is between 5-10mmol/1. Insulin release is lower than normal values by 1/3 at 1 hour and 2 hours after a meal, and C-peptide release is either within the normal range or mildly low. Severe: The difference between fasting blood sugar and blood sugar level 3 hours after a meal is below 10mmol/1. Insulin release is lower than normal values by 2/3 at 1 hour and 2 hours after a meal, or it is consistently low throughout the four time points. C-peptide release is low.

What tests should be done for diabetes screening? Urinalysis typically includes examination of urine color (COL), transparency (CLA), glucose (GLU), bilirubin (BIL), pH level, ketones (KET), urinary protein (PRO), and other parameters. These indicators can indirectly reflect a patient's blood sugar level and determine the presence of ketoacidosis or urinary tract infection.

Precautions: Generally, it is ideal to have a check-up every six months. Do not eat anything after 10 p.m. on the day before the examination and ensure you have an empty stomach on the day of the examination. Females should avoid collecting urine samples during menstruation. It is best to collect midstream urine. The key indicators to pay attention to are: glucose level > 10mmol or the presence of ketone bodies. Prompt action should be taken and medical attention sought if necessary.

Glucose tolerance test: patient examination. Factors for diabetes examination: Three aspects that diabetes patients must regularly examine include: First, the most common method of evaluating blood glucose control in diabetes patients is to test blood glucose and glycated hemoglobin. Diabetes antibodies, including glutamic acid decarboxylase antibodies, are very common in clinical practice, especially in middle-aged and elderly patients who are more prone to diabetes. Therefore, for some related tests on how to diagnose diabetes, friends who have had diabetes for over 50 years or have had diabetes for over 5 years, or who have cardiovascular and cerebrovascular diseases or blood lipid abnormalities.

Hypertensive individuals and smokers must undergo at least one annual ultrasound examination of the lower arteries. The most important examination that patients with urinary system diseases should regularly undergo is blood glucose-related tests, including fasting blood glucose. The most important test for diabetes is blood glucose, with a diagnostic criterion of fasting blood glucose equal to or higher than 7 mmol/L, or postprandial blood glucose after two hours. The content of diabetes testing includes oral glucose tolerance test, insulin and C-peptide release test, which is the most important part of diabetes examination.

Glycated hemoglobin is the gold standard for determining whether blood sugar control levels meet the standards. The measurement of glucose in the blood is part of the three tests for diabetes, including urine protein test, manual ophthalmoscope test, and retinal test. Tests related to diagnosis and classification:

1. Blood sugar: Elevated blood sugar is the basis for diagnosing diabetes. In clinical practice, commonly tested blood sugar levels include fasting blood sugar and postprandial blood sugar. According to the standards set by the World Health Organization, a person can be diagnosed with diabetes if their fasting blood sugar is greater than or equal to 7.0 mmol/L (126 mg/dL), or if their postprandial blood sugar is greater than or equal to 11.1 mmol/L (200 mg/dL). It is important to note two points: first, postprandial blood sugar should not be ignored as it has greater significance for early diagnosis of diabetes; second, the result of urine sugar test can only serve as a clue for diagnosing diabetes and cannot be used as the sole basis for diagnosis. In other words, the diagnosis of diabetes cannot be confirmed or ruled out based solely on the urine sugar test results.

2. Oral glucose tolerance test (OGTT): When a person's fasting blood sugar or postprandial blood sugar is higher than normal but does not meet the diagnostic criteria for diabetes, an OGTT is needed to determine whether they are in the impaired glucose regulation (I-GR) stage or actually have diabetes.

3. Islet function test: This includes insulin release test (IRT) and C-peptide release test (CPRT). The test measures the levels and curve characteristics of insulin and C-peptide in the fasting and postprandial states to assess the degree of islet function decline and assist in determining the type of diabetes.

4. Autoantibody test: This includes tests for glutamic acid decarboxylase antibody (GA-DA), insulin antibody (IAA), islet cell antibody (ICA), etc. This test is mainly used to determine the type of diabetes. These antibodies are often positive in type 1 diabetes patients and negative in type 2 diabetes patients. Among them, GA-DA appears earlier and lasts longer in the blood of diabetes patients, making it the most significant for diagnosis.

Tests reflecting average blood sugar control: Both fasting blood sugar and postprandial blood sugar reflect a person's blood sugar level at a specific moment, which can be influenced by many incidental factors, especially for patients with large blood sugar fluctuations. To accurately understand the overall blood sugar level over a certain period of time, patients must undergo the following tests:

1. Glycated hemoglobin (HbA1c): It is formed by the combination of hemoglobin in red blood cells and glucose in the blood. The normal value is 4% to 6% (percentage of glycated hemoglobin in total hemoglobin). The result of glycated hemoglobin test is usually not affected by incidental factors and can objectively and accurately reflect a person's overall blood sugar level over the past 2 to 3 months.

2. Glycated serum protein (GSP): It is formed by the combination of albumin in plasma and glucose in the blood. The normal value is 1.5 to 2.4 mmol/L. The status of glycated serum protein can reflect a person's overall blood sugar level over the past 2 to 3 weeks. Tests related to metabolic disorders and complications:

The greatest harm of diabetes to the body is its various complications. To have a more comprehensive understanding of the condition, diabetes patients must undergo the following tests: 1. Urine routine: This includes tests for urine sugar, ketones, protein, white blood cells, and other indicators. These indicators can indirectly reflect the patient's blood sugar level and clarify whether they have ketoacidosis and urinary tract infections. In addition, quantitative determination of urinary microalbumin is an important basis for early detection of diabetic nephropathy.

2. Blood lipid: Diabetes patients often have lipid metabolism disorders. Patients with elevated cholesterol, triglycerides, and low-density lipoprotein, as well as decreased high-density lipoprotein, should use lipid-regulating drugs appropriately to correct lipid metabolism disorders. 3. Blood pressure and blood viscosity: High blood sugar, high blood pressure, high blood lipid, and high blood viscosity are known as the four hidden "killers" of diabetes patients. At the initial diagnosis, diabetes patients must understand their blood pressure, blood lipid, and blood rheological conditions. If there are abnormalities, appropriate treatment should be given in a timely manner.

4. Body mass index (BMI): It is calculated as BMI = weight (kg) / height (m) squared. Body mass index can serve as a reference for the daily calorie intake of diabetes patients and guide their clinical drug selection. For example, overweight or obese diabetes patients should preferentially use biguanide drugs for treatment, while lean diabetes patients should preferentially use sulfonylurea drugs.

5. Liver function and kidney function: By examining the patient's liver function and kidney function, it is possible to determine whether they have diabetic nephropathy and guide their clinical drug selection. Some hypoglycemic drugs are not suitable for diabetes patients with impaired liver or kidney function.

6. Fundus examination: Diabetes patients often have no ocular symptoms in the early stages of diabetic retinopathy, and by the time the disease is in its late stage, it can be difficult to control the eye disease. Therefore, diabetes patients should undergo fundus examination at the initial diagnosis to determine whether they have diabetic retinopathy, cataracts, or glaucoma. They should not wait until their vision becomes blurry before getting their fundus checked.

7. Nervous system: Diabetes patients can use a 10-gram monofilament to conduct touch sensitivity tests to detect early diabetic peripheral neuropathy. In addition, relevant examinations of the autonomic nervous system, such as measuring blood pressure in standing and lying positions, can be performed to determine the presence of orthostatic hypotension.

In addition, newly diagnosed diabetes patients should undergo tests such as electrocardiogram, cardiac ultrasound, lower limb vascular ultrasound and angiography, chest X-ray, and bone density to determine whether they have coronary heart disease, heart failure, lower limb arterial sclerosis or stenosis, pulmonary infections or tuberculosis, and osteoporosis.

Generally speaking, for patients who have been diagnosed with diabetes, blood sugar (including fasting blood sugar and postprandial blood sugar) should be tested once a week, glycated hemoglobin should be tested every 2 to 3 months, blood lipids, liver function, kidney function, and urinary microalbumin excretion rate should be tested every 6 months, and fundus examination should be done every 6 months to a year. Once diabetes patients experience symptoms such as edema, proteinuria, visual impairment, numbness of hands and feet, and intermittent claudication, most of their complications are already in the irreversible late stage, making treatment difficult. Therefore, comprehensive examinations must be conducted at the initial diagnosis, and medication should be taken on time with regular follow-up to achieve stable blood sugar control and avoid the occurrence of complications.

The above is the full knowledge points about what tests to do to determine the type of diabetes explained in this article. I hope it is helpful to you.