Analyzes for diabetes mellitus - Causes, symptoms and treatment. MF.
Already on early signs the patient can suspect at itself a diabetes and in this case it is necessary to hand over at once some analyzes to confirm or deny suspicions. How can you identify diabetes?
In the diagnosis of diabetes , the important role of is played by laboratory research methods and their correct interpretation.
There is a definite algorithm for examining people with suspected diabetes mellitus. Healthy people with normal body weight and unhealed heredity examine the level of glucose in the blood and urine( on an empty stomach).
When obtaining normal values, an additional analysis is necessarily given for glycated hemoglobin( HG).About 5-8% of hemoglobin in the erythrocytes, adds a molecule of glucose, so these molecules are called glycated. The degree of glycation depends on the concentration of glucose, which is retained in the erythrocytes throughout their 120-day life( the norm is 4.5-6.5% of the total amount of hemoglobin).Therefore, at any given time, the percentage of glycated hemoglobin reflects the average level of glucose concentration in the patient's blood for 2-3 months prior to the study. When controlling the therapy of diabetes, it is recommended to maintain the level of glycated hemoglobin less than 7% and revise the therapy at a GH level of 8%.
When obtaining a high level of glycated hemoglobin( screening in a healthy patient), it is recommended to determine the blood glucose level after 2 hours after loading with glucose( 75 g).This test is especially necessary if the blood glucose level is higher than normal but not high enough to show signs of diabetes. The test is carried out in the morning, after an overnight fast( not less than 12 hours).Determine the baseline level of glucose and 2 hours after taking 75 g of glucose dissolved in 300 ml of water. In norm( immediately after loading with glucose), its concentration in the blood increases, which stimulates the secretion of insulin. This in turn reduces the concentration of glucose in the blood, after 2 hours its level almost returns to the original in a healthy person and does not return to normal, exceeding the baseline values by half in patients with diabetes mellitus.
I would like to note that it is insulin( a hormone of the pancreas) that is involved in maintaining a constant level of glucose in the blood( the degree of its secretion is determined by the level of glucose).Insulin is necessary for differentiation of various forms of diabetes. So, type 1 diabetes is characterized by a low level of insulin, the second type - normal or elevated.
The definition of insulin is used to confirm a diagnosis in people with borderline glucose tolerance impairments. Normally, the level of insulin is 15-180 pmol / l( 2-25 mcd / l).
You may need additional studies to diagnose diabetes .This definition of the C-peptide, antibodies to the beta-cells of the islets of Langerhans, antibodies to insulin, antibodies to GAD, leptin.
No less important is the determination of the C-peptide. Insulin and C-peptide are the final products of proinsulin transformation in beta cells of pancreatic islets. Determination of the C-peptide provides control over the functioning of beta cells of the pancreas and insulin production. Diagnostically significant is the fact that it is the C-peptide that allows you to assess the level of insulin and more clearly choose the necessary( missing) dose of insulin. If the C-peptide in the blood drops, then this indicates insufficiency of insulin produced by special cells of the pancreas. Normally, the C-peptide level is 0.5 to 2.0 μg / L.
Currently, much attention is paid to the detection of antibodies to the beta-cells of the islets of Langerhans, the presence of which leads to the destruction of the cells themselves and the violation of insulin synthesis, which is the result of the appearance of type 1 diabetes. Autoimmune mechanisms of cell destruction can be hereditary in nature, as can, however, be triggered by a number of external factors, such as viral infections, various forms of stress and exposure to toxic substances. Thus, the determination of antibodies to beta-cells can be used for early diagnosis and detection of predisposition to type 1 diabetes. In patients with autoantibodies, a progressive decrease in beta-cell function and insulin secretion is observed.
Antibodies to insulin are found in 35-40% of patients with type 1 diabetes. Antibodies to insulin can be observed in the stage of prediabetes.
Antigen is also found, representing the main target for autoantibodies associated with the development of insulin-dependent diabetes. This antigen was glutamic acid decarboxylase( gad), a very informative marker for the diagnosis of prediabetes. Antibodies to GAD can be determined in a patient 5-7 years before the clinical manifestation of the disease. Importantly, the definition of these markers allows in 97% of cases to differentiate type 1 diabetes from type 2, when a type 1 diabetes clinic is masked for type 2.
And finally, the signal marker for body weight is leptin, which is formed in fat cells. It gives a signal to the brain to stop eating food and increase energy consumption. However, this mechanism is broken when there is a large excess of weight. These people have too many fat cells that release leptin, and its level increases significantly with every extra gram of weight. When leptin in the blood becomes too much, it ceases to play its signal function.
Remember always that timely diagnosis and treatment will allow you to avoid complications of the disease.