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Diagnosis of diabetes


Diabetes mellitus develops in violation of the metabolism of carbohydrates and water in the body. This condition causes pancreatic dysfunction and impaired insulin production, which is involved in the processing of sugar. With untimely diagnosis, the disease can cause serious complications, up to death.

Symptoms of the disease

Signs of diabetes appear depending on the type of disease. With type 1 problems, the affected pancreas partially or completely stops the production of the hormone. Because of this, the body does not metabolize glucose from food. Without drug treatment, the development of the disease cannot be controlled.

Signs of Type 1 Diabetes

Patients suffering from type 1 diabetes are usually under 30 years old. They note the following signs of pathology:

  • sudden weight loss
  • increased appetite
  • the smell of acetone in the urine,
  • sudden mood swings,
  • excessive fatigue,
  • a sharp deterioration in well-being.

Without the use of insulin, type 1 diabetes can be complicated by ketoocytosis. Due to the disease, poisonous compounds appear in the body, which are formed due to the breakdown of lipid cells.

Signs of Type 2 Diabetes

Type 2 diabetes is more often diagnosed in people after 35 years of age. The disease is more prone to obese patients. According to statistics, 85% of people diagnosed with diabetes mellitus suffer from type 2 pathology. The disease is characterized by excessive production of insulin in the body. But in this case, insulin becomes useless, as the tissues lose their sensitivity to this hormone.

Type 2 diabetes is rarely complicated by ketoocytosis. Under the influence of negative factors: stress, taking medications, blood sugar levels can rise to around 50 mmol / L. The condition becomes the cause of dehydration, loss of consciousness.

Allocate the general symptoms of the disease that occur with type 1 and type 2 pathology:

  • feeling of constant dry mouth
  • thirst
  • a sharp change in body weight,
  • poor regeneration of wounds even with minor damage to the skin,
  • drowsiness and weakness
  • disability
  • decreased sex drive,
  • numbness of arms and legs,
  • tingling sensations in the limbs
  • furunculosis,
  • lowering body temperature
  • itchy skin.

Research methods

Diagnosis of the disease includes clinical and laboratory studies. In the first case, the doctor collects an anamnesis of pathology - examines the patient, determines his height and weight, hereditary predisposition to the problem. The study continues if the patient has 2 or more signs of the disease.

When making a diagnosis, risk factors are taken into account:

  • over 40 years old
  • overweight
  • lack of physical activity,
  • violation of carbohydrate metabolism in women during pregnancy and after childbirth,
  • polycystic ovaries in the fair sex,
  • constant increase in blood pressure.

People over 40 years of age should regularly check the level of sugar in the body (1 time in 3 years). People at risk for diabetes are required to be screened once a year.

Type 2 diabetes can be diagnosed by some test or screening. Such a study allows you to identify pathology in the early stages of development, when the disease is not accompanied by characteristic symptoms.

A reliable way to diagnose pathology is to identify an indicator of glycosylated hemoglobin. The degree of deviation of the indicator from the norm depends on the concentration of sugar in the blood.

Basic diagnostic methods

Diagnosis of diabetes includes basic and additional techniques. The first group of studies includes:

  1. A blood test to determine the level of sugar.
  2. Glucose tolerance test. Before the examination, the patient drinks a cocktail and donates blood from the finger before and after it. The technique allows to distinguish the disease from prediabetes.
  3. Urinalysis for sugar.
  4. Detection of ketones in the patient’s blood or urine to determine the complications of the disease or its acute development.

Additional research methods

Additionally, the following indicators are determined:

  1. Autoantibodies to insulin.
  2. Proinsulin - to study the possibility of functioning of the pancreas.
  3. Indicators of hormonal background.
  4. C-peptide - to detect the rate of absorption of insulin in cells.
  5. HLA — typing — to identify possible hereditary pathologies.

Additional research methods are used to determine the most effective treatment tactics or in cases where the diagnosis of diabetes is difficult. The decision to prescribe additional tests is made by the doctor.

Preparation for glucose tolerance test

Before a glucose tolerance test, a doctor talks with the patient. The norm of indicators for each person is individual, therefore the test indicators are studied in dynamics.

  1. The doctor learns from the patient about the drugs being taken. Some medications can affect the results of the study, so they are temporarily canceled. If it is not possible to discontinue the drug or select a suitable replacement, then the test results are decrypted taking into account this factor.
  2. 3 days before the procedure, the patient must limit the amount of carbohydrates consumed. The norm of carbohydrates is 150 g per day.
  3. In the evening before the test, the amount of carbohydrates consumed is reduced to 80 g.
  4. Before the study itself, they do not eat 8-10 hours, smoking and drinking are prohibited. Only non-carbonated water is allowed to drink.
  5. 24 hours before the test, physical activity is limited.

After the study, a diabetic patient may experience slight dizziness and irritation on the skin at the site of application of the tourniquet.

Differential diagnosis

Differential diagnosis of diabetes allows you to identify the type of disease. The specialist draws attention to the signs of pathology, since different types of diabetes are characterized by their symptomatic picture. The first type of pathology is characterized by a rapid onset, 2 - a slow development.

The table shows the criteria for the differential diagnosis of different types of diabetes

Criterion1 type2 type
Patient weightLess than normalAbove normal
The beginning of pathologySharpSlow
Age of patientIt is diagnosed in children 7-14 years old and in adults under 25 years old.Diagnosed after 40 years
Insulin indexLowElevated
C peptide scoreZero or underestimatedElevated
Antibodies to β-cellsAre presentAre absent
The tendency to develop ketoacidosisIs availableLow probability
Insulin resistanceNot markedAlways available
The effectiveness of sugar-lowering drugsLowHigh
The need for insulinConstantAppears in the late stages of the disease
SeasonalityExacerbation occurs in the autumn-winter periodNot detected
Components in the analysis of urineAcetone and glucoseGlucose

Using differential diagnosis, you can identify the types of diabetes: latent, steroidal or gestational.

Diagnosis of complications

Without treatment, pathology leads to a number of serious complications. Among which are:

Ketoacitosis. The disease can develop in anyone with diabetes. Among the signs of keocytosis are:

  • excess glucose in the blood,
  • frequent urination,
  • nausea
  • pain in the stomach
  • hard breath,
  • dry skin
  • redness of the face.

Symptoms should cause immediate medical attention.

Hypoglycemia is a critical decrease in blood sugar. The condition is accompanied by:

  • trembling in the body
  • weakness
  • excitability,
  • feeling of constant hunger
  • headaches.

If such symptoms are found, the patient urgently needs to check the level of glucose in the blood.

Cardiovascular pathology. With diabetes, the heart and blood vessels often suffer. There is a risk of heart failure or heart attack.

Neuropathy. The complication is diagnosed by a number of signs:

  • loss of limb sensitivity
  • feeling of chills
  • blood pressure instability
  • deformations of the feet,
  • decreased sex drive,
  • problems with emptying the bladder or intestines.

Pathology of the kidneys. An excess of sugar in the body increases the load on the organs of the urinary system. Diabetes mellitus causes renal failure. The following symptoms indicate problems in the urinary system:

  • clouding of urine
  • a sharp rise in temperature
  • lower back pain
  • frequent urination.

In diabetes mellitus, it is necessary to regularly pass urine for analysis in order to monitor the work of the kidneys.

Pathology of the visual system. Elevated sugar levels in the body cause damage to blood vessels. For this reason, patients develop problems - cataracts, rhinopathy. In order to prevent the development of complications, it is necessary to regularly visit an optometrist. The doctor will detect diseases of the visual system in the early stages of development.


Diabetes mellitus is incurable, therefore, the prevention of the development of the disease should be dealt with as soon as possible. Preventive measures include the following recommendations:

  • balanced diet,
  • rejection of bad habits,
  • breastfeeding
  • strengthening the immune system
  • treatment of chronic problems in the body.

To prevent pathology, it is important not only proper nutrition, but also the intake of a sufficient amount of fluid, since when the body is dehydrated, the production of pancreatic hormone decreases. Read more about diabetes prevention here.

Diagnosis >> Diabetes

Diabetes - This is one of the most common human endocrine diseases. The main clinical characteristic of diabetes is a prolonged increase in blood glucose concentration, as a result of impaired glucose metabolism in the body.

The metabolic processes of the human body are entirely dependent on glucose metabolism. Glucose is the main energy resource of the human body, and some organs and tissues (brain, red blood cells) use glucose exclusively as energy raw materials. The breakdown products of glucose serve as a material for the synthesis of a number of substances: fats, proteins, complex organic compounds (hemoglobin, cholesterol, etc.). Thus, a violation of glucose metabolism in diabetes mellitus inevitably leads to a violation of all types of metabolism (fatty, protein, water-salt, acid-base).

We distinguish two main clinical forms of diabetes, which have significant differences both in terms of etiology, pathogenesis and clinical development, and in terms of treatment.

Type 1 diabetes (insulin-dependent) is characteristic of young patients (often children and adolescents) and is the result of absolute insulin deficiency in the body. Insulin deficiency occurs as a result of the destruction of pancreatic endocrine cells that synthesize this hormone. The causes of death of Langerhans cells (endocrine cells of the pancreas) can be viral infections, autoimmune diseases, stressful situations. Insulin deficiency develops sharply and is manifested by the classic symptoms of diabetes: polyuria (increased urine output), polydipsia (unquenchable thirst), weight loss. Type 1 diabetes is treated exclusively with insulin preparations.

Type 2 diabetes on the contrary, it is characteristic of older patients. Factors of its development are obesity, a sedentary lifestyle, malnutrition. A significant role in the pathogenesis of this type of disease is played by a hereditary predisposition. Unlike type 1 diabetes, in which there is an absolute insulin deficiency (see above), with type 2 diabetes, insulin deficiency is relative, that is, insulin in the blood is present (often at concentrations higher than physiological), however, sensitivity body tissues to insulin is lost. Type 2 diabetes is characterized by a prolonged subclinical development (asymptomatic period) and a subsequent slow increase in symptoms. In most cases, type 2 diabetes is associated with obesity. In the treatment of this type of diabetes, drugs are used that reduce the resistance of body tissues to glucose and reduce the absorption of glucose from the gastrointestinal tract. Insulin preparations are used only as an additional tool in the event of true insulin deficiency (with exhaustion of the pancreatic endocrine apparatus).

Both types of the disease occur with serious (often life-threatening) complications.

Methods for diagnosing diabetes

Diagnosis of diabetes implies the establishment of an accurate diagnosis of the disease: establishing the form of the disease, assessing the general condition of the body, determining associated complications.

Diagnosis of diabetes involves establishing an accurate diagnosis of the disease: establishing the form of the disease, assessing the general condition of the body, and identifying associated complications.
The main symptoms of diabetes are:

  • Polyuria (excessive urine output) is often the first sign of diabetes. The increase in the amount of urine produced is due to glucose dissolved in the urine, which prevents the reverse absorption of water from primary urine at the kidney level.
  • Polydipsia (severe thirst) - is the result of increased loss of water in the urine.
  • Weight loss is an intermittent symptom of diabetes, more characteristic of type 1 diabetes. Weight loss is observed even with increased nutrition of the patient and is a consequence of the inability of tissues to process glucose in the absence of insulin. In this case, starving tissues begin to process their own reserves of fats and proteins.

The above symptoms are more common for type 1 diabetes. In the case of this disease, symptoms develop quickly. The patient, as a rule, can give the exact date of the onset of symptoms. Often, the symptoms of the disease develop after a viral illness or stress. The young age of the patient is very characteristic for type 1 diabetes.

In type 2 diabetes, patients most often consult a doctor in connection with the onset of complications of the disease. The disease itself (especially in the initial stages) develops almost asymptomatically. However, in some cases, the following non-specific symptoms are noted: vaginal itching, inflammatory skin diseases that are difficult to treat, dry mouth, muscle weakness. The most common cause of seeking medical attention is complications of the disease: retinopathy, cataracts, angiopathy (coronary heart disease, cerebrovascular accident, vascular damage to the extremities, renal failure, etc.). As mentioned above, type 2 diabetes is more common in adults (over 45 years old) and proceeds against the background of obesity.

When examining a patient, the doctor draws attention to the condition of the skin (inflammation, scratching) and the subcutaneous layer of fat (decrease in case of type 1 diabetes, and an increase in type 2 diabetes).

If diabetes is suspected, additional examination methods are prescribed.

Determination of blood glucose concentration. This is one of the most specific tests for diabetes. The normal concentration of glucose in the blood (glycemia) on an empty stomach ranges from 3.3-5.5 mmol / L. An increase in glucose concentration above this level indicates a violation of glucose metabolism. In order to establish a diagnosis of diabetes, it is necessary to establish an increase in blood glucose concentration in at least two consecutive measurements carried out on different days. Blood sampling for analysis is carried out mainly in the morning. Before blood sampling, you need to make sure that the patient did not eat anything on the eve of the examination. It is also important to provide the patient with psychological comfort during the examination in order to avoid a reflex increase in blood glucose as a response to a stressful situation.

A more sensitive and specific diagnostic method is glucose tolerance test, which allows you to detect latent (hidden) disorders of glucose metabolism (impaired tissue tolerance to glucose). The test is carried out in the morning after 10-14 hours of night fasting. On the eve of the examination, the patient is advised to abandon increased physical exertion, alcohol and smoking, as well as drugs that increase blood glucose concentrations (adrenaline, caffeine, glucocorticoids, contraceptives, etc.). The patient is given a drink containing 75 grams of pure glucose. The determination of the concentration of glucose in the blood is carried out after 1 hour and 2 after the use of glucose. A normal result is a glucose concentration of less than 7.8 mmol / L two hours after glucose intake. Если концентрация глюкозы колеблется от 7,8 до 11 ммоль/л, то состояние исследуемого расценивается как нарушение толерантности к глюкозе (предиабет).The diagnosis of diabetes is established if the glucose concentration exceeds 11 mmol / l two hours after the start of the test. Both a simple determination of glucose concentration and a glucose tolerance test make it possible to assess the state of glycemia only at the time of the study. To assess the level of glycemia over a longer period of time (approximately three months), an analysis is carried out to determine the level of glycosylated hemoglobin (HbA1c). The formation of this compound is directly dependent on the concentration of glucose in the blood. The normal content of this compound does not exceed 5.9% (of the total hemoglobin content). An increase in the percentage of HbA1c above normal values ​​indicates a long-term increase in the concentration of glucose in the blood over the past three months. This test is carried out mainly to control the quality of treatment for patients with diabetes.

Urine glucose test. Normally, there is no glucose in the urine. In diabetes mellitus, an increase in glycemia reaches values ​​that allow glucose to pass through the renal barrier. Determining blood glucose is an additional method for diagnosing diabetes.

Determination of acetone in urine (acetonuria) - diabetes is often complicated by metabolic disorders with the development of ketoacidosis (accumulation of organic acids of intermediate products of fat metabolism in the blood). Determination of ketone bodies in the urine is a sign of the severity of the condition of the patient with ketoacidosis.

In some cases, to determine the cause of diabetes, a fraction of insulin and its metabolic products in the blood is determined. Type 1 diabetes is characterized by a decrease or complete absence of a fraction of free insulin or peptide C in the blood.

In order to diagnose diabetes complications and make a prognosis of the disease, additional examinations are carried out: fundus examination (retinopathy), electrocardiogram (coronary heart disease), excretory urography (nephropathy, renal failure).

  • Diabetes. Clinic, diagnostics, late complications, treatment: Textbook.-method. benefit, M.: Medpraktika-M, 2005
  • Dedov I.I. Diabetes in children and adolescents, M.: GEOTAR-Media, 2007
  • Lyabakh N.N. Diabetes mellitus: monitoring, modeling, management, Rostov n / A, 2004

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Specialist consultation required!

What do you need to know to recognize diabetes?

To successfully resist a disease, you need to know what we are dealing with. The better we are informed about it, the more successfully we can fight it.

Diabetes most often affects people between the ages of 40 and 60. In the initial stage, the disease usually does not make itself felt, and that he is ill, a person learns only after some serious health incident or after a medical examination.

Diabetes is a chronic disease, it is impossible to completely get rid of its manifestations. It is characterized by an increased level of glucose (sugar) in the blood, which occurs due to insufficient production of insulin or due to the fact that the cells of the body's tissues stop responding correctly to insulin.

A blood test is needed to diagnose diabetes. Such a diagnosis is made when the level of glucose in the blood exceeds 125 mg / dl. There are several types of diabetes:

  • Type 1 diabetes. In this case, the pancreas produces too little insulin or does not produce it at all. Such patients need constant injections of insulin. You must also adhere to a healthy diet.
  • Type 2 diabetes. In this type of diabetes, the body cannot properly use the insulin produced by the pancreas. Type 2 diabetes is more common in older people, as well as in full and sedentary people.

For its treatment, insulin and drugs that lower blood sugar are used. You must also do exercise and eat right.

  • Gestational diabetes. Gestational diabetes can develop in women during pregnancy. At the same time, the action of insulin “blocks” the hormones of pregnancy. This type of diabetes most often occurs in women over 25 years old, especially when they have high blood pressure and too much weight.

Gestational diabetes can be associated with heredity and polycystic ovary syndrome. In 70% of cases, gestational diabetes is corrected by diet. Moderate physical activity also helps.

How to recognize diabetes

This disease has certain manifestations that help to recognize it. True, they can be sporadic or similar to the symptoms of other diseases.

In any case, having noticed such symptoms in yourself, you need to see a doctor and do a blood test for sugar.

3. Constant thirst

If the throat is “dry up” all the time, you are constantly thirsty - this is another sign that allows you to recognize diabetes. The fact that the body requires more and more water is a clear alarm signal, indicating that not everything is in order with the body.

Constant thirst is associated with the fact that the body loses too much fluid in the urine.

In this case, it is recommended to quench your thirst with water, natural juices and infusions of herbs. And in no case - sweetened drinks, coffee, alcoholic drinks and juices sold in bottles or bags, since all these drinks increase blood sugar.

4. Tingling sensation in fingers, numbness of limbs, itching

Another signal that speaks of possible diabetes, but not directly related to elevated blood sugar levels, is tingling in the fingers, numbness of the limbs, and itching. This is a manifestation of the so-called "neuropathy" - degenerative-dystrophic changes in the peripheral nerves. These symptoms may worsen at night.

6. Vision problems

With diabetes, vision often worsens. Eye diseases such as cataracts, glaucoma, retinopathy develop.

Therefore, with this diagnosis, special attention should be paid to the eyes. This will help prevent or delay the development of the pathologies mentioned above. They are very dangerous for eyesight. For example, retinopathy without the necessary treatment can lead to blindness.

Diabetics often have problems with the nervous system.

7. Wounds heal poorly

If accidental cuts and wounds heal poorly, this also signals a problem in the body. This is often one of the signs of diabetes.

With this disease, the normal so-called "vascularization" is disturbed. As a result, wounds heal poorly and slowly. published by

P.S. And remember, just changing our consciousness - together we change the world! © econet

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Other important points

Treatment standards for type 1 diabetes include diet, insulin, and regimen compliance. To correctly calculate the dosage of the drug, you need to check the sugar level daily. The medicine is divided into several types: long-term, short-term and medium-term insulin. The type of drug is prescribed by the doctor, depending on the characteristics of the course of type 1 diabetes. Subject to these rules, the development of pathology slows down.

The treatment regimen for type 2 diabetes is compiled individually for each patient. The main point of therapy is to increase insulin production to the required levels. Treatment is supplemented by a diet containing a minimal amount of carbohydrates and exercise. In the absence of positive dynamics from therapy, patients are prescribed insulin administration.

Modern diagnosis of diabetes includes numerous clinical and laboratory studies. It is important not only to determine the presence of the disease, but also to identify its type, variety. For this purpose, a differential diagnostic method is used.