Diabetes Diagnostics

What Is Diabetes?

Diabetes is a common metabolic disease, and the main character is elevated blood sugar. About 7.5 million people in Germany have diabetes - that's almost one in ten. Two main types of diabetes occur type 1 diabetes and type 2 diabetes.

Type 1 diabetes can already occur in childhood and adolescents, but also as late as in adulthood. In this form of diabetes, the insulin-producing ß-cells of the pancreas are destroyed by an autoimmune reaction, i.e., the patient's immune system attacks the ß-cells. The hormone insulin ensures that sugar (glucose) is absorbed from the blood into the body cells after food intake. If too little insulin is produced, less sugar is absorbed, and the blood sugar level rises.

Type 2 diabetes is far more common than type 1 diabetes. More than 90 percent of people with diabetes have type 2 diabetes, mainly adults who develop the disease. In this form of diabetes, the ß-cells initially produce enough insulin, but the body's cells become less sensitive to it. This is known as insulin resistance. In addition to a genetic predisposition, an unhealthy lifestyle is the main factor contributing to the development of type 2 diabetes: This includes being overweight, eating a high-fat diet, lack of exercise, and nicotine and alcohol consumption.

Why Is it Important to Detect Diabetes as Early as Possible?

The body can initially compensate for insulin resistance by producing more insulin so that blood glucose levels remain within the normal range for a long time. However, even when blood glucose levels eventually rise, symptoms are often nonspecific, so the disease often goes unnoticed in the early years.

However, before the blood glucose levels rise in diabetes, the metabolic situation is already altered. Therefore, even in this early phase of the disease, the first consequential damage can occur. Over time, permanently elevated blood glucose levels damage the organs. This has effects on many organ systems. Frequent consequences of diabetes are vascular and heart diseases, high blood pressure, and damage to the nerves, kidneys, and eyes.

How Do You Know If You Have Diabetes?

Symptoms that may indicate diabetes are increased thirst, frequent urination, fatigue, tiredness, lack of concentration, and pressure in the head. Loss of appetite and cravings occur. Deterioration of vision and skin changes can also be an indication of diabetes. Other possible complaints include potency disorders, muscle cramps, sensory disturbances, nausea, abdominal pain, and susceptibility to infections.

In type 1 diabetes, weakness and sudden loss of consciousness can also be the first sign of diabetes.

The symptoms develop insidiously, especially in type 2 diabetes. Therefore, it is common for patients not to notice the disease at first. For this reason, people over the age of 45 and younger people with an increased risk of diabetes should have regular check-ups.

How Can A Doctor Diagnose Diabetes?

There are several ways to detect diabetes:

Fasting Blood Glucose

Since blood glucose is elevated after food intake, blood glucose is determined in a fasting state to diagnose diabetes, even in healthy people. Before blood sampling, the patient is not allowed to eat for 8 hours. Usually, fasting blood glucose is 100 mg/dl or less. Fasting blood glucose is elevated at values between 100 and 126 mg/dl. Doctors then speak of prediabetes, a preliminary stage of diabetes. People with prediabetes have an increased risk of developing diabetes. A value of 126 mg/dl or higher indicates diabetes.

Glucose Tolerance Test

The glucose tolerance test can determine how much sugar can be absorbed from the blood by the body's cells. Therefore, the test is particularly suitable for diagnosing impaired glucose tolerance in prediabetes.

For the test, the patient should have eaten a high-carbohydrate diet for at least three days and then abstain from eating for 10 to 16 hours. The physician first determines the blood glucose on an empty stomach. Then the patient drinks a glucose solution. Two hours later, blood glucose is measured again. The values should be below 100 mg/dl fasting and below 140 mg/dl after taking the glucose solution. In prediabetes, the values are between 100 and 126 mg/dl fasting and 140 to 200 mg/dl after taking the solution. In diabetes, blood glucose levels are above 126 mg/dl and 200 mg/dl, respectively.

Diabetes Urine Test

If there is a lot of sugar in the blood, sugar can also be detected in the urine. Sugar is excreted through the kidneys from a blood sugar concentration of 160 to 180 mg/dl. However, the method is quite inaccurate and is therefore rarely used in practice.

Blood Glucose Test HbA1c Value

The HbA1c value is a long-term blood glucose value and measures the average blood glucose concentration over the last 8 to 12 weeks. This value is less than 5.7 percent in healthy people and 6.5 percent or more in people with diabetes.

Diabetes Self-Tests: How Do They Work and How Safe Are They?

Sugar in the urine is an indication of diabetes. However, you can use a simple test strip to check for sugar in your urine yourself. These self-tests are available at pharmacies. To determine the sugar level, you need to collect urine in a cup and dip the test strip into it. When the sugar level is elevated, a field on the test strip changes its color.

However, the method is not accurate, and no exact blood glucose values can be derived. An only slightly elevated blood glucose level is not detectable. The test should, therefore, not replace a visit to the doctor's practice.

Diabetes Risk Test Online

Several factors increase the likelihood of developing type 2 diabetes. These include a family history of diabetes, lack of exercise, a high-fat diet, smoking, alcohol, older age, certain medications, hormonal disorders, pregnancy, and depression.

You can also test online whether you have an increased risk of diabetes yourself. The German Institute of Human Nutrition Potsdam-Rehbrücke has developed a test for this purpose. Go to https://drs.dife.de/ on your internet browser to take the test. With the help of questions on eating habits, physical activity, body weight, and age, the individual risk of diabetes is calculated.

Preventing Diabetes

If you have an increased risk of diabetes, there are several things you can do to prevent the disease. These include, above all, a healthy diet, plenty of exercise, and giving up smoking.

The diet should be high in fiber and low in fat and include whole grains, fruits, vegetables, legumes, and small amounts of low-fat meat and dairy products.

Also, at least 150 minutes of easy exercise or at least 75 minutes of exercise per week is recommended.

Sources:

• Helmholtz Zentrum München, Deutsches Zentrum für Diabetesforschung, Deutsches Diabetes-Zentrum. Diabinfo – Das Diabetesinformationsportal. www.diabinfo.de. Aufgerufen am 27.05.2021
• Hien, Böhm, Claudi-Böhm, Krämer, Kohlhas. Diabetes- Handbuch, 7.Auflage, 2013
• Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen (IQWiG). Gesundheitsinformation.de. Wie man Blutzucker und Zucker im Urin selbstmisst. Aufgerufen am 27.05.2021