EPISODE 2॥ ડાયાબીટીસ નિદાન॥ બોર્ડરલાઇન ડાયાબીટીસ/પ્રિ-ડાયાબિટીસ॥ DR. Ram Odedara
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The diagnosis of diabetes is typically based on blood tests that measure blood glucose levels. There are several diagnostic criteria depending on the type of diabetes being considered:
Fasting Plasma Glucose (FPG) Test: This test measures blood glucose after fasting for at least 8 hours. A diagnosis of diabetes is made if the fasting glucose level is 126 mg/dL (7.0 mmol/L) or higher on two separate occasions.
Oral Glucose Tolerance Test (OGTT): This test involves measuring blood glucose levels before and 2 hours after consuming a glucose-rich drink. A diagnosis of diabetes is made if the 2-hour glucose level is 200 mg/dL (11.1 mmol/L) or higher.
Random Plasma Glucose Test: This test measures blood glucose at any time of the day, regardless of when the person last ate. Diabetes may be diagnosed if the glucose level is 200 mg/dL (11.1 mmol/L) or higher, along with symptoms of diabetes such as increased thirst and urination.
Hemoglobin A1C Test: This test measures the average blood glucose level over the past 2-3 months. A diagnosis of diabetes is typically made if the A1C level is 6.5% or higher.
In some cases, if initial tests are inconclusive, additional testing may be required to confirm the diagnosis. It’s important to note that diagnosis and interpretation of results should always be done by a healthcare professional, who will consider symptoms, medical history, and other factors in making a diagnosis of diabetes.
Pre-diabetes is a condition where blood sugar levels are higher than normal but not yet high enough to be diagnosed as type 2 diabetes. It’s a warning sign that you could develop diabetes if you don’t make lifestyle changes. Eating a healthy diet, exercising regularly, and maintaining a healthy weight can help prevent or delay the onset of type 2 diabetes in pre-diabetic individuals. Regular check-ups and monitoring are also important.
There are several types of medications used to treat diabetes, each working in different ways to help manage blood sugar levels. Here are some common categories of diabetes medications:
Metformin: This is usually the first-line treatment for type 2 diabetes. It works by reducing the amount of glucose produced by the liver and improving insulin sensitivity in the body’s tissues.
Sulfonylureas: Examples include glyburide, glipizide, and gliclazide. They stimulate the pancreas to release more insulin, which helps lower blood sugar levels.
DPP-4 Inhibitors (Dipeptidyl Peptidase-4 Inhibitors): Examples include sitagliptin, saxagliptin, and linagliptin. They help lower blood sugar levels by increasing insulin release and decreasing the amount of glucose made by the liver.
GLP-1 Receptor Agonists (Glucagon-like Peptide-1 Receptor Agonists): Examples include exenatide, liraglutide, and dulaglutide. They mimic the action of GLP-1, a hormone that stimulates insulin release, slows stomach emptying, and reduces appetite.
SGLT2 Inhibitors (Sodium-Glucose Co-Transporter 2 Inhibitors): Examples include canagliflozin, dapagliflozin, and empagliflozin. They work by blocking the reabsorption of glucose by the kidneys, allowing excess glucose to be excreted in urine.
Insulin: For type 1 diabetes and sometimes for type 2 diabetes that cannot be adequately controlled with oral medications alone, insulin therapy is necessary. There are different types of insulin (rapid-acting, short-acting, intermediate-acting, and long-acting) that may be used depending on individual needs.
These medications may be used alone or in combination to achieve target blood sugar levels. The choice of medication depends on factors such as type of diabetes, overall health, kidney function, and individual response to treatment. It’s important for individuals with diabetes to work closely with healthcare providers to determine the most appropriate treatment plan and to monitor for any potential side effects or interactions with other medications.