To have a good diagnose of diabetes we need to visit an endocrinologist. The endocrinologist will use diverse medical tests and chemist analysis to determine the type of diabetes of the patient.
One of the principal tests is the urine chemist analysis, which helps detect glucose and cetones, due to the fat decomposition. However, a sole urine test does not always diagnose diabetes. There are other tests that, combined, give values or measurements that show the diabetic state of the patient. When the person analyzes their glucose level, during fasting (more than 120 mg/dl) or as random way (more than 180 mg/dl), then you can detect diabetes.
A) WAY TO MAKE A DIAGNOSE
The principal ways to make a diagnose to determine the amount of glucose in the blood are 4:
1) Urine Analysis:
The principal test is the urine analysis, which helps determine the glucose and cetones level in the urine. This test has historical character but, nowadays is not used often. The determination of acetone in the urine is a very important analysis in patients with diabetes type I, pregnancy with preexistent diabetes or gestacional diabetes.
To make a urine analysis, the urine of the patient must be collected in a period of 24 hours, and that way you will determine the values of the glucose in the blood. This is a very economic method; an alternative to the modern methods of glucose level monitoring. The urine analysis determine the amount of glucose in the urine, which is a useful information and approximate to the levels of glucose. The other determination are the cetonas in the urine in the patients with diabetes.
The cetonas are produced by the decomposition of the fat and muscle, and are harmful in high levels. These high levels of cetona in the blood can cause a serious infection called cetoasidosis, which requires of immediate medical care.
All diabetics must verify the presence of cetonicos bodies in the urine in case of acute illness (pneumonia, cardiac attack, cerebral vascular accident, stress) or when the levels of glucose in the blood are very high (for example, 300 mg/dl) during the pregnancy or when there are symptoms of ceto-acidosis as nauseas, vomits or abdominal pain. The cetonas are usually present in the urine, but under the level of detection of the rutinary analysis methods. However, positive cetonic bodies are observed in normal subjects during fasting and in a 30% of the urine tests in pregnant women during the morning.
2) Glucose level in blood (Fasting)
Another test to determine the level of glucose in the blood; during fasting. When the results are higher than 20 mg/dl in two opportunities, the presence of diabetes in the organism is confirmed. If the level are between 100 and 120 mg/dl it’s called alteration of the glucose during fasting or pre-diabetes. These levels are considered risk factor for diabetes type II and its complications. If the results are inferior and have diabetes symptoms an oral glucose tolerance test must be taken.
3) Glucose level in blood (No Fasting):
This test determines the random level of glucose in the blood; (not fasting). With no preparation and at any time of the day. If the measurement of values is superior to 180 mg/dl; then, it can be said that there is diabetes and we can confirm this when the usual symptoms appear: such as excessive thirst, urine and fatigue (this test can be confirmed with other level of glucose in the blood during fasting).
4) Oral Tolerance to Glucose:
This fourth test Glucose Oral Tolerance. This is a conclusive test. It’s taken during fasting a blood sample from the arm; the diabetes is diagnosed if the level of glucose is superior to 180 mg/dl. After two hours. This test is usually used to determine the presence of diabetes type II and diabetes during pregnancy).
You must ask the doctor how often you have to check the levels of hemoglobin A1c (HbA1c); average measurment of glucose in the blood during the prior 2 or 3 months. This is a very useful way to determine how well the treatment is functioning.
Once the diabetes is diagnosed, the endocrinologist must ask for more annual medical test to prevent the complication of diabetes in a long term.
These tests are: Height measurement, weight and index of body mass to see if the person is overweight; determine the arterial tension, if there is hypertension there must be some indications to regulate it; feet exam; a retina test to see if there are any damaged vasos sanguineos and possibilities of having blurry vision; and, finally, some more tests to see the functioning of the kidneys, liver and thyroid glandule.
