The diagnosis of DM upheld on the basis of the examination of blood glucose levels. The diagnosis cannot be upheld on the basis of the existence of glucosuria. To the determination of the diagnosis of DM, the recommended blood glucose examination is an examination of glucose in the blood plasma with enzymatic vein.
The use of whole blood (wholeblood), vein, or the number of different diagnostic criteria appropriate standardisation by WHO.
Whereas for the purpose of monitoring the results of the treatment can be performed using capillary blood glucose checks with glukometer.
Diagnosis of diabetes mellitus
A wide range of complaints can be found in people with diabetes. The suspicion of the presence of DM need to be considered when there is a classic complaint DM as below:
-The classic Complaint DM be: poliuria, polydipsia, polifagia, and weight loss unexplained is why
Other symptoms may include: lethargy, itching, tingling, blurred eyes, and erectile dysfunction in men, as well as pruritus vulvae in women
The diagnosis of DM can be enforced through three ways:
1. If the complaint is found, then the classic examination of plasma glucose during > 200 mg/dL is enough to uphold a diagnosis of DM
2. Examination of the fasting plasma glucose ≥ 126 mg/dL with a classic complaint.
3. oral glucose tolerance Tests (TTGO). Although TTGO with a load of 75 g of glucose is more sensitive and specific than the fasting plasma glucose checks, but checks it has its own limitations. TTGO hard to do over and over again and in practice very rarely done because it requires special preparation.
DM diagnostic steps and impaired glucose tolerance can be seen at bagan1.
DM diagnosis criteria for adults not pregnant can be seen in table-2.
When examination results do not meet the normal criteria or DM, depending on the results obtained, it can be classified into a group of impaired glucose tolerance (TGT) or impaired fasting blood glucose (GDPT).
1. Diagnosis: TGT TGT enforced when after examination TTGO obtained glucose 2 hours after plasma loads between 140 – 199 mg/dL (7.8-11.0 mmol/L).
2. GDPT: Diagnosis of the GDPT enforced when fasting plasma glucose after the inspection is obtained between 100 – 125 mg/dL (5.6 – 6.9 mmol/L) examinations and blood sugar 2 hours TTGO < 140 mg/dL.
Table 2. DM diagnosis criteria
1. the classic symptom of DM + plasma glucose during the 200 mg/dL (11.1 mmol/L) plasma Glucose during inspection was the result of a momentary one day without regard to meals last
Or
2. the classical symptoms of DM + fasting plasma glucose levels 126 mg/dL (7.0 mmol/L). Fasting refers patients cannot get extra calories at least 8 hours
Or
3. plasma sugar levels 2 hours at TTGO 200 mg/dL (11.1 mmol/L) TTGO performed with the standard of the WHO, using a glucose load equivalent to 75 g glucose anhidrus dissolved into the water.
* Examination of HbA1c (6.5%) by > THERE is 2011 already entered into one of the criteria for a diagnosis of DM, if done at a lab facility has been well terstandardisasi
Way of implementing TTGO (WHO, 1994):
• Three days before the examination, the patient still eat like daily habits (with enough carbohydrates) and still do physical activities as usual
• Fast for at least 8 hours (night) before the examination, the drinking water without sugar still allowed
• Fasting blood glucose levels Checked
• Administered 75 grams of glucose (adults), or g/1.75 kgBB (children), dissolved in 250 mL water and drink in 5 minutes
• Fast back to the blood sampling for examination 2 hours after drinking a glucose solution is complete
• Review blood glucose levels two hours after glucose load
• During the review process, the subject of the review still breaks and not smoking
II. 1.2. Examination of filter
Filter inspection done on those who have the risk of DM (as seen on page 33), but does not indicate the presence of symptoms of DM. Examination of filter aims to find patients with DM, TGT, or GDPT, so it can be dealt with more appropriately early.
Patients with TGT and GDPT also known as glucose intolerance, constitute stages while heading the State. both the DM is also a risk factor for the occurrence of DM and cardiovascular disease in the future.
Filter inspection can be done through examination of blood glucose levels during fasting blood glucose levels or. Scheme of inspection measures on the group that has the risk of DM can be seen at bagan1.
The filter checks for the purpose of networking of mass (mass screening) not recommended given the expensive cost, which is generally not followed by a follow-up plan for the merekayang found the presence of abnormalities. Recommended filter checks carried out at the time of examination for other diseases or general check-ups.
Blood glucose levels during fasting blood glucose and as benchmark can be seen to filter pad.
Blood glucose levels during fasting blood glucose and as a benchmark filter can be seen in table 3.
Table 3. Blood glucose levels during fasting as a benchmark and a filter and a diagnosis of DM (mg/dL)
Table 3 when fasting blood glucose levels as a benchmark and a diagnosis of DM filters (mg/dL)
Note:
For high risk groups who did not show abnormalities of the results, done repeat each year. For those aged 45 years > without other risk factors, the filter checks can be done every 3 years.
Diabetes Clinic Complaint
DM diagnosis steps and impaired glucose tolerance
Hopefully helpful
