Diagnosis of diabetes
The diagnosis of diabetes is generally not difficult, with fasting blood glucose greater than or equal to 7.0 mmol/L and/or greater than or equal to 11.1 mmol/l two hours after meal. Type diabetes after diagnosis:
Type 1 diabetes
The onset age is young, mostly < 30 years old, the onset is sudden, polyuria, polyphagia, wasting symptom is obvious, blood sugar level is high, many patients with ketoacidosis as the first symptom, serum insulin and C peptide level is low, ICA, IAA or Gad antibody can be positive. Oral medication alone is not effective, the need for insulin treatment.
Type 2 diabetes
Common in the elderly, obese high incidence, often accompanied by hypertension, dyslipidemia, arteriosclerosis and other diseases. Onset insidious, early without any symptoms, or only mild fatigue, thirst, not obvious increase in blood glucose to do a glucose tolerance test can be confirmed. Serum insulin levels were normal or elevated in the early stage and low in the late stage.
Differential diagnosis of diabetes mellitus
1. Liver disease
Patients with liver cirrhosis often have abnormal glucose metabolism, typical fasting blood glucose normal or low, postprandial blood glucose rose rapidly. Fasting blood glucose may also be elevated in the elderly.
2. Chronic kidney disease
Mild abnormality of glycometabolism may occur.
3. Stress
Many stress states such as heart, cerebrovascular accident, acute infection, trauma, surgery may lead to a transient increase in blood sugar, stress factors removed 1 ~ 2 weeks can be recovered.
4. Endocrine disease
Such as Acromegaly opposite of microcephaly, Cushing’s syndrome, hyperthyroidism, pheochromocytoma, glucagonoma can cause secondary diabetes, in addition to increased blood sugar, there are other characteristics, it is not difficult to identify.
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