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Diabetes mellitus is a metabolic disease characterized by a high concentration of glucose in the blood and sometimes in the urine.
The World Health Organization recognizes three major forms of diabetes: type 1 diabetes (formerly classified as insulin-dependent diabetes and juvenile diabetes), type 2 diabetes (previously classified as non-insulin-dependent diabetes), and gestational diabetes.
All forms of diabetes are caused by difficulty in producing or absorbing insulin: a condition in which beta cells in the pancreas do not produce enough insulin and a condition called insulin resistance, which is expressed by reduced sensitivity to insulin leading to the excess production of insulin.
Patients with diabetes have two opposite extremes: hyperglycemia, often caused by insufficient blood insulin, and hypoglycemia, usually caused by too much insulin in the blood.
Roughly, about 90% of people with Diabetes have type 2 Diabetes and about 10% of type 1 diabetes. In Israel, Diabetes is the fourth most common cause of death (2010).
Diagnosis and Symptoms
The methods of diagnosis of different types of diabetes are the same, although because type 1 diabetes is manifested in more severe and faster symptoms, the disease is often detected when the patient is already in a state of blodd keto-acidosis. Type 2 diabetes, on the other hand, can be a silent disease and a person can tolerate it for many years without knowing it at all, which puts the patient at high risk for long-term complications.
Methods of diagnosis:
Urine sugar testing - This test will check if sugar is found in the urine. In a healthy person, there should be no sugar in the urine. However, when the blood sugar level is higher than 180 mg / dl (the so-called "renal threshold"), the sugar passes through the kidney and reaches the urine.
Glucose blood glucose testing - This test will check blood glucose levels. This test is conducted in the morning, after a twelve-hour night fast. A sugar level above 126mg / dl is considered as a diagnosis of diabetes, 100-126mg / dl pre-diabetes (or borderline diabetes) and a range of up to 100mg / dl is considered normal.
GTT - A test performed if there is a suspicion of diabetes or gestational diabetes by testing the patient's tolerance to sugar loading. In a healthy person, blood sugar increases immediately after drinking or eating sugar-containing products, and returns to normal after several hours. Diabetics, on the other hand, will not be able to cope with the large amount of sugar in their bodies. Sugar values after two hours of up to 140mg / dl will be considered standard, 140-199mg / dl as diabetic-borderline and over 200mg / dl in diabetes mellitus.
Glycosylated Hemoglobin (HBa1c) - testing the amount of sugar bound to hemoglobin protein in blood cells. Since their life span is about 120 days, the test gives an average of the glucose level throughout the period. In a healthy person, the percentage of hemoglobin is 4 to 5.4. Diabetes is diagnosed when the hemoglobin value is more than 6.5 percent (or 6.5 percent).
It should be noted that in order to diagnose diabetes, one laboratory test is not enough, but the test should be repeated once again. Only after two consecutive pathological tests can the disease be diagnosed.
After the weight of the patient's age, the severity of his symptoms, his physical condition, and his medical history, it is possible to determine whether it is type 1 or type 2 diabetes. Diagnosis of type 1 diabetes can also be obtained if antibodies that attack the insulin-producing beta cells in the pancreas are found in the blood, and there is high level of keto-acid in the urine. These antibodies include an insulin antibody, an antibody to pancreatic cells, and antibodies to GAD. However, there are no specific tests to diagnose type 2 diabetes and the diagnosis is made by way of the rejection of type 1 diabetes.
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