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In order to determine if a person has diabetes, there are some blood tests that can be performed.
To perform the fasting glucose test, the doctor will take blood from a vein in the patient's arm, but it is important that the patient has not eaten in the last 8 hours. The red blood cells are separated from the sample, and in the remaining plasma it is measured the amount of glucose. Diabetes can be indicated by a plasma level of 7.8 mmol/L or greater. To confirm the results, this test must be taken again in another day.
In postprandial glucose test, the blood must be taken right after the patient has eaten a meal.
In what concerns the oral glucose tolerance test, there are taken blood samples from a vein before and after a patient drinks a thick, sweet syrup of glucose and other sugars. It is known that in a non-diabetic, immediately after the drink the glucose level in the blood goes up, but then decreases gradually, because the insulin is used by the body to metabolize or absorb the sugar. In a diabetic, the things are different: the glucose level in the blood goes up and stays high after drinking the liquid. When it had passed two hours after drinking the syrup, and also at a point during the two-hour test period, a plasma glucose level of 11.1 mmol/L or higher confirms the diagnosis of diabetes.
The doctors can say a patient has diabetes if there are symptoms of diabetes and a plasma glucose level of at least 11.1 mmol/L, a fasting plasma glucose level of at least 7 mmol/L, or a two-hour plasma glucose level of at least 11.1 mmol/L during an oral glucose tolerance test.
Patients with diabetes can monitor their own blood glucose levels with the help of some home blood glucose monitoring kits.
It is known that there is no cure for diabetes, but patients can live a relatively normal life if they are carefully managing the condition. The treatment for diabetes has as main purposes preventing the long-term complications, and keeping blood glucose within normal range.
The use of insulin or oral medications are important in preventing complications of diabetes, but a careful monitored diet and exercise are also important.
In many cases of type II diabetes, loosing weight is important. There must be followed a diet that consists in 50-60% of calories from carbohydrates, approximately 10-20% of calories from protein, and calories from fat should be less than 30%. It is known that the number of calories depends on the age of the patient, but also depends on the activity level and weight.
A nutritionist or dietitian should be consulted, and there can be made a diet plan for each individual.
In order to lower the blood glucose levels in type II diabetes, there can be used oral medications. Usually, the first drugs prescribed for type II diabetes are in a class of compounds called sulfonylureas. We can mention tolbutamide, tolazamide, acetohexamide, and chlorpropamide. Glyburide, glimeperide, and glipizide are some newer drugs, that are included in the same class mentioned before. Seems that the role of these drugs is to stimulate pancreas cells to produce more insulin.
There also appeared some new medications to treat diabetes: metformin, acarbose, and troglitizone. It is known that all drugs have side effects: can stimulate weight gain, cause stomach irritation, or present increased risk in other situations.
It is known that there are made constant advances in the development of new oral medications for patients with diabetes. For example, in 2003 was developed Metaglip, a combination between glipizide and metformin. There was approved another drug, Avandamet, which combines metformin and rosiglitazone.
There exist a lot of drugs nowadays, and the doctor will decide which suits best for every individual.
It is known that patients with type I diabetes need daily insulin injections, to help their body use glucose; the amount and type of insulin depends on every individual. In what concerns the patients having type II diabetes, some of them may need to take insulin injections if they cannot control their diabetes with diet, exercise, and oral medication.
Usually, the most commonly used is the purified human insulin, but there exists also insulin from beef and pork. There can be mixed different types of insulin and given in one dose or split into two or more doses during a day. Also, insulin pump can be used in patients who need multiple injections over a day. Regular insulin is fast-acting, starts to work within 15-30 minutes, has a peak- effect at about 2 hours after it is injected, and the effect lasts 4-6 hours. Neutral protamine Hagedorn and Lente insulin are intermediate-acting, start to work within one to three hours, and last for 18-26 hours; ultra-lente, a long lasting form of insulin starts to work within four to eight hours and lasts 28-36 hours.
Alcohol consumption, too much insulin, too little food or increased exercise can lead to hypoglycemia, and the person having this may be hungry, cranky, confused, and tired. There ca appear other symptoms as well.
In what concerns surgery, the transplantation of a healthy pancreas into a diabetic patient is a successful treatment, but it is not clear if the potential benefits outweigh the risks of the surgery and drug therapy needed.
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