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Diagnosis and treatment of diabetes (Types 1 & 2)

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Blood tests are used to confirm diagnosis of diabetes types 1 and 2 and prediabetes because early in the disease type 2 diabetes may have no symptoms. Testing enables health care providers to find and treat diabetes before complications occur, which can delay or prevent type 2 diabetes from developing. Any one of the following tests can be used for diagnosis of type 1 or type 2 diabetes, not all are recommended for diagnosing all types:

  1. A1C test, also called the hemoglobin A1c, HbA1c, or glycosylated hemoglobin test
  2. Fasting plasma glucose (FPG) test
  3. Oral glucose tolerance test (OGTT)

Another blood test, the random plasma glucose (RPG) test, is sometimes used to diagnose diabetes during a regular health checkup. If the RPG measures 200 micrograms per deciliter or above, and the individual also shows symptoms of diabetes, then a health care provider may diagnose diabetes. Blood test levels for diagnosis of diabetes and prediabetes are outlined below.

  A1C test (percent) Fasting Plasma Glucose test (mg/dL) Oral Glucose Tolerance test (mg/dL)
Diabetes 6.5 or above 126 or above 200 or above
Prediabetes 5.7 to 6.4 100 to 125 140 to 199
Normal About 5 99 or below 139 or below

Comparison of tests and diagnosis for diabetes type 1 and diabetes type 2

  Diabetes type 1 Diabetes type 2
Possible cause factors
  • Genetic
  • Environmental
  • Auto-immune factors
  • Idiopathic
  • Genetic
  • Obesity
  • Physical inactivity
  • High/low birth weight
  • Gestational diabetes mellitus (GDM)
  • Poor placental growth
  • Metabolic syndrome
Commonly afflicted groups (but not exclusive to)
  • Children
  • Teens
  • Adults
  • Elderly
  • Certain ethnic groups.
Prone ethnic groups
  • All
  • African-American
  • Latino/Hispanic
  • Native American
  • Asian
  • Pacific Islander
Prevalence
  • 5%
  •  95%
Affected age group
  • Between 5 – 25 (although type 1 can affect at any age)
  • Until recently, the only type of diabetes that was common in children was type 1 diabetes, most children who have type 2 diabetes have a family history of diabetes, are overweight, and are not very physically active. Usually develops around puberty
Test
  • A1C test
  • Random plasma glucose
  • Fasting plasma glucose
  • Genetic testing is conducted in cases where there is a family history of the disease
  • A1C test
  • Random plasma glucose
  • Fasting plasma glucose
  • Oral glucose tolerance test could also be conducted though rarely

Treatment and prevention of diabetes type 1 and type 2 Below are a list of the current methods used to treat diabetes type 1 and type 2.

  Diabetes type 1 Diabetes type 2
Cure  None There is no cure for type 2 diabetes, although sometimes gastric surgery, lifestyle and medication treatment can result in remission. Physical exercise, healthy loss of weight and diet control is advised
Treatment
  • Injections of insulin
  • Sometimes medicine by mouth
  • Dietary plan
  • Physically active
  • Regular check up of blood sugar levels
  • Controlling blood pressure
  • Monitoring cholesterol levels
  • Using diabetes medicines
  • Sometimes insulin injections
  • Healthy food choices
  • Exercise
  • Self Monitoring of Blood Glucose (SMBG)
  • Controlling blood pressure
  • Monitoring cholesterol levels
Prevention
  • No prevention – the pancreas fails to produce sufficient amounts of insulin
  •  Preventable and can be delayed with a healthy diet and exercise

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Dr. Rajiv Kovil
Consultant Diabetologist, Dr. Kovil’s Diabetes Care Centre

Dr. Rajiv Kovil is a Consultant Diabetologist at Dr. Kovil’s Diabetes Care Centre, the first Preventive Diabetes Centre & Diabetic Foot Clinic in Mumbai, KLS Memorial Hospital and Holy Spirit Hospital among others. He is a founder member of United Diabetes Forum, a forum of practising diabetologists in India. He has also written various articles on diabetes for medical journals such as Asian Journal of Diabetology and Medical Image. His Preventive Diabetes Centre & Diabetic Foot Clinic is an initiative to provide preventive diabetic measures as well as to function as a specialized Foot Clinic for diabetic patients not only in terms of equipment but more importantly in terms of expertise.

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