Tests for Diabetes｜Diagnostic criteria and systemic evaluation (HbA1c, blood glucose level, and complication tests)
Diabetes Testing - Diagnosis and Systemic Evaluation
Diabetes is a disease that often progresses with few or no subjective symptoms. Therefore, it is very important to accurately diagnose the disease through testing and at the same time evaluate the overall condition of the body.
Many people are seen after having abnormal blood glucose or HbA1c levels noted during a physical examination.
Here, the diagnostic criteria and main tests for diabetes, as well as the evaluation of complications and atherosclerosis, are explained in an easy-to-understand manner.
Tests necessary to diagnose diabetes (blood glucose and HbA1c)
Blood tests are central to the diagnosis of diabetes.
Major tests include the following
fasting blood sugar
Blood glucose levels are measured after 10 hours or more of not eating.
HbA1c (hemoglobin A1c)
This test reflects the average blood glucose status over the past month or two and allows evaluation of daily blood glucose accumulation.
blood sugar level at any time
Blood glucose levels are measured regardless of mealtime.
As needed,75g oral glucose tolerance test(a test that measures blood glucose levels two hours after drinking glucose).
Diagnostic Criteria for Diabetes Mellitus
A patient is classified as "diabetic type" if any of the following criteria are exceeded
Fasting blood glucose: 126 mg/dL or higher
75g oral glucose tolerance test 2-hour value 200mg/dL or more
Blood glucose at any time 200 mg/dL or more
HbA1c 6.5% or higher
In actual practice, diabetes is diagnosed based on a comprehensive evaluation of blood glucose and HbA1c together.
Obviously high blood sugar and,
Thirst
Polyuria
Weight loss
and other typical symptoms, a diagnosis may be reached at that point.
On the other hand, if the values are in the borderline range, the patient should be retested and carefully evaluated.
Pre-diabetic (borderline)
If fasting blood glucose is slightly high or HbA1c is 6.0-6.4% approx. are considered "pre-diabetic".
Even at this stage, lifestyle changes and regular follow-up are important because of the possibility of progression to diabetes in the future.
Tests to determine the type of diabetes mellitus
When diabetes is diagnosed, it is important to evaluate "what type of diabetes" is present. This is because it is related to the treatment plan.
Mainly blood tests are used to check the following items
Assessment of insulin secretion
It checks how well the body is secreting insulin. It mainly measures an item called C-peptide.
autoantibody test
When type 1 diabetes is suspected, we examine whether immune abnormalities are involved. Anti-GAD and anti-IA-2 antibodies are measured.
Assessment of secondary diabetes mellitus
Check to see if pancreatic disease, hormonal abnormalities, or the effects of drugs are the cause.
Tests for diabetes complications
With diabetes, it is important to check for complications from the time of diagnosis. Complications can progress even before symptoms appear.
Renal Function Assessment
Urine and blood tests will be performed to check the effect on the kidneys.
fundus examination
The blood vessels in the back of the eye are observed to check for diabetic retinopathy. Regular checkups are necessary even if there are no abnormalities in vision.
We collaborate with ophthalmologists to perform fundus examinations in the hospital.
Evaluation of Neuropathy
Check for numbness and decreased sensation in the feet. Note that neuropathy can cause foot wounds and ulcers.
Evaluation of atherosclerosis and comorbidities
Diabetes is a disease that tends to promote atherosclerosis. Therefore, the risk of heart and brain diseases as well as blood glucose are evaluated at the same time.
Lipid test and blood pressure measurement
Identify risk factors for atherosclerosis.
carotid duplex (ultrasound)
The blood vessels in the neck are examined by ultrasound to evaluate the degree of arteriosclerosis.
ABI (ankle-brachial index)
This test is performed to determine if there is a blood flow disturbance in the legs.
Diabetes testing is more than just checking blood glucose levels,Assessment of the condition of blood vessels and nerves throughout the body to prevent future complicationsis important.
Continuity is the key to diabetes testing.
Diabetes testing does not end with diagnosis, but is an ongoing process.
HbA1c: usually every 1-3 months
Renal function and urinalysis: Routine
Retinopathy examinations: every month to every year, depending on the condition
Evaluation of arterial stiffness: as needed
Complications develop quietly, so regular checkups can help prevent serious illness in the future.
Our diabetes testing system
At Ikejiri-Ohashi Sera Clinic, in addition to blood glucose and HbA1c evaluations, we combine disease type diagnosis, fundus examination, nerve evaluation, carotid artery echocardiography, and ABI for a comprehensive systemic check.
We have a system in place to perform these examinations, including fundus examinations, in the hospital,Complete medical care in one clinicWe aim to
Those who have abnormal blood glucose or HbA1c levels indicated in a physical examination are recommended to see a doctor as soon as possible, even if they have no symptoms.
Diabetes testing is the first step in preventing future complications and atherosclerosis.
The following article also discusses diabetes in more detail.
Diabetes Symptoms and Complications
◼️Go to Diabetes and Endocrinology page
◼️Go to General Internal Medicine Page
◼️TOP