How to screen diabetes?
All cells in our body need energy, and the main substance that provides energy is glucose, which mostly comes from food. Glucose can only be used after entering the cell to produce energy. Insulin is the key to open the door of the cell. When your body cannot use or produce enough insulin, glucose cannot enter the cells and accumulate in the blood to form hyperglycemia (or hyperglycemia), causing various problems. This is diabetes. Diabetes is a lifelong disease. It is a chronic, systemic, and metabolic disease caused by the combined action of genetic and environmental factors. It is mainly characterized by high blood sugar. After diabetes occurs, it causes a series of metabolic disorders such as sugar, fat, protein, water and electrolytes. A large amount of sugar is excreted in the urine, and symptoms such as polydipsia, polyuria, polyphagia, weight loss, dizziness, and fatigue appear. If not well controlled, further development will cause various serious acute and chronic complications throughout the body, which can lead to chronic complications of tissues and organs such as eyes, kidneys, nerves, skin, blood vessels, and heart, leading to blindness and lower limbs. Gangrene, uremia, stroke or myocardial infarction are serious threats to health. Although diabetes cannot be cured at present, as long as you pay attention to your diet, exercise regularly, add drugs or insulin, and maintain an optimistic attitude, you can live a good life.
The oral glucose tolerance test (OGTT) is recommended for the screening of suspected diabetes and high-risk groups of diabetes. The specific method of the OGTT test is to take blood on an empty stomach (8-10 hours) to test the fasting blood glucose, take 75g of anhydrous glucose powder for adults or 1.75g/kg of anhydrous glucose powder (dissolved in 250-300ml of water) for children. After taking it within minutes, start timing from the first sip of sugar water, and measure blood glucose at half an hour, 1 hour, 2 hours, and 3 hours. Diabetes can be diagnosed when intravenous fasting blood glucose ≥ 7.0 mmol/L or OGTT two-hour blood glucose ≥ 11.1 mmol/L.
If it is difficult to perform OGTT, only fasting blood glucose can be monitored, but there is a possibility of missed diagnosis. Fasting blood glucose should be performed at least 8 hours after fasting overnight in the morning; if technical and economic conditions permit, glycosylated hemoglobin test is also a suitable method. More than 50% of type 2 diabetes cases in the population can only be detected after screening, so regular screening should be carried out for high-risk groups.
Types of diabetes
Diabetes can be divided into 4 types: type 1 diabetes, type 2 diabetes, special type diabetes and gestational diabetes.
What is type 1 diabetes and type 2 diabetes?
According to surveys, 6-9 out of every 100,000 people in my country will get type 1 diabetes. They are usually underweight or normal weight people, mostly under 20 years old. When they are infected with certain viruses, or due to other reasons, the body's immune system attacks the pancreatic B cells that secrete insulin. As a result, the pancreas cannot produce enough insulin and develops diabetes. They tend to get onset more quickly, may feel thirsty, urinate frequently, often feel hungry, tired, tired, nausea, vomiting, abdominal pain, and lose weight quickly. At this time, if there is no external insulin to help glucose enter the cells to produce energy, the body will use fat decomposition to produce energy. When fat is broken down to produce energy, ketone bodies will be produced. Ketone bodies are acidic substances. Decrease the pH of the blood, which we call "ketoacidosis". If the rescue is not done in time, people will be unconscious and life-threatening. Therefore, they must inject insulin every day to ensure that glucose is broken down to provide energy, and a cessation of insulin therapy will be life-threatening.
Type 2 diabetes is due to the decline of insulin's ability to assist glucose into cell metabolism, and the relatively insufficient insulin secretion, which leads to increased blood sugar. It accounts for more than 90% of the total number of diabetes. It mostly occurs in adults or elderly people over 30 years old, and has obvious family inheritance. Most of the patients with this type are obese, with slow onset, insidious, polydipsia, polyphagia, and weight loss. The symptoms of "three more and one less" are often not obvious, and more than half have no symptoms. They often undergo health checkups or visit a doctor for other diseases It is discovered that, from the detection of chronic complications at the time of discovery, the patient may have a course of 5-10 years at the time of diagnosis. Clinically, most patients can control their blood sugar stably after diet control and oral hypoglycemic drugs, and ketoacidosis is rare (but in special cases, such as infection, improper diet, casual use of hypoglycemic drugs, surgery, severe Exceptions in trauma). However, some patients, especially diabetic patients with insulin failure, suffer from severe insulin deficiency and need to use exogenous insulin to control blood sugar.
How to make a distinction between type 1 diabetes and type 2 diabetes?
Since the onset of type 1 diabetes is closely related to autoimmunity, we can distinguish between type 1 and type 2 diabetes based on the examination of pancreatic islet B cell autoantibodies. Patients with type 1 diabetes often have glutamate decarboxylase antibody (GA-DA), insulin antibody (IAA), and islet cell antibody (ICA), which can be positive during examination, while patients with type 2 diabetes are negative.
What is a special type of diabetes?
Special types diabetes include a series of relatively clear causes or secondary diabetes, which are caused by genetic defects, other endocrine diseases, drugs and chemicals, and infections. There are 8 subtypes and dozens of diseases. Including: (1) Adult-onset diabetes mellitus (MODY) among young people with defective B cell function genes, mitochondrial gene mutation diabetes, etc.; (2) Diabetes caused by insulin action gene defects; (3) Pancreatic exocrine diseases, such as pancreatitis , Pancreatic cancer, diabetes caused by pancreatectomy; (4) endocrine diseases, such as diabetes caused by hyperthyroidism, pheochromocytoma, acromegaly, etc.; (5) diabetes caused by chemical agents or drugs; (6) Certain viral infections, such as congenital rubella virus, cytomegalovirus infection caused diabetes; (7) immune-mediated diabetes, such as "Stiff-man" syndrome, insulin autoimmune syndrome, Turner syndrome can be accompanied by diabetes.
