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Who are at risk of Diabetes?
Family history of Diabetes is the major risk factor. If you have a family history and your blood sugar is normal, it is advisable to check for Diabetes every year. Sedentary life-style, obesity, smoking, excessive alcohol intake, high blood pressure and in case of women previous Diabetes in pregnancy or delivering big baby (birth weight more than 4Kg) are risk factors for Diabetes.
What are the symptoms of Diabetes?
In adults, at least at the beginning you may not have any symptom. When your blood sugar is above 180 mg%, sugar starts appearing in the urine. Sugar in the urine drags water and you pass a lot of urine and feel dry and thirsty. You may also feel tired and loose weight. Your appetite increases and peculiarly you may notice that you are loosing weight in spite of eating more. Chance of infection is higher if you have high sugar and also your healing from infection, cut or wound may be unusually delayed. Some people complain of poor eyesight.
How do we diagnose Diabetes?
The normal blood glucose in the morning before taking any food (fasting) is less than 110 mg. There are three ways we diagnose Diabetes. Urine glucose is not reliable for diagnosis.
Fasting blood glucose 126 mg or more is diagnostic of Diabetes; value in-between 110mgms to 125mgs is called borderline Diabetes.
A random blood glucose sample taken anytime of the day more than 200 mg is also diagnostic of Diabetes. If there are no symptoms a repeat test is needed.
In doubtful cases sample is taken after a glucose drink, called glucose tolerance test (GTT)
Protocol for GTT
Normal diet for 3 days
Blood sample for sugar, urine sample not needed
75gms of glucose(GluconD) in 100 ml of water over 5 mins
Blood sample for sugar 2 hrs later, urine sample not needed
We have analysed the data of 'normal people" who underwent a routine health check in our hospital and have found that when the fasting blood sugar is more than 90mg/dl, they have an increase risk of having a 2hr value >140mg/dl (Impaired glucose tolerance or borderline diabetes). Hence we recommend GTT for anybody with a fasting sugar >90mg% to detect diabetes and borderline diabetes early.