An effort to diagnose the Diabetes Mellitus (DM) should not only base on the discovery of glucose in urine. Diagnosis is made by blood glucose levels from the veins. Meanwhile, to view and control the result of therapy can be done by checking the capillary blood glucose levels with a glucometer.
A person diagnosed with diabetes when he experienced one or more of the following criteria, such as:
- Experiencing the classic symptoms of diabetes and plasma glucose levels during ≥200 mg / dL
- Experiencing the classic symptoms of diabetes and fasting plasma glucose levels ≥126 mg / dL
- 2-hour plasma glucose levels after oral glucose tolerance test (oral glucose tolerance) ≥200 mg / dL
- Examination of HbA1c ≥ 6.5%
Specifications :
- Plasma glucose only examines only during the check-up day without regard to the patients last meals.
- Fasting means that the patient does not receive additional calories at least for last 8 hours.
- TTGO is an examination conducted by giving a special drinking glucose liquid to the patient. Before drinks that liquid, first the patient will pass the blood glucose levels checks and will be checked again at 1 hour and 2 hours after drinking that glucose liquid. But this examination is rarely practiced.
- If the blood glucose levels are higher than normal but not include into the DM criteria, so it must be include in the category of prediabetes. Which belongs are :
- Impaired Fasting Blood Glucose (GDPT), which is established when the results obtained fasting plasma glucose around 100-125 mg / dL and plasma glucose level, right after 2 hours drinking the glucose solution TTGO
- Impaired Glucose Tolerance (IGT), which is enforced when plasma glucose levels 2 hours after drinking the glucose solution TTGO between 140-199 mg / dL
Tables and blood glucose levels during fasting as a benchmark filter and diagnosis of diabetes mellitus:
Not DM
|
Not yet-DM
|
DM
| ||
| 1 time Blood glucose level (mg/dL) | Plasma vein |
< 100
|
100 - 199
|
≥ 200
|
| Blood capillaries |
< 90
|
90 - 199
|
≥ 200
| |
| Fasting Blood glucose level (mg/dL) | Plasma vein |
< 100
|
100 - 125
|
≥ 126
|
| Blood capillaries |
< 90
|
90 - 99
|
≥ 100
|
Complications of Daibetes Mellitus
Blood glucose levels in patients with diabetes mellitus will drive a variety of complications, both acute and chronic. Therefore, it is important for patients to control their blood glucose levels regularly.
Acute Complication
Circumstances that are included in the acute DM complication relates with diabetic is ketoacidosis (DKA) and hyperosmolar hyperglycemic status (SHH). In this two-state blood glucose levels are very high (at KAD 300-600 mg / dL, the SHH 600-1200 mg / dL) and patients are usually unconscious. Because of the high mortality rate, the patient should be immediately taken to the hospital for proper handling.
The Hypoglycemic circumstances also include DM acute complication where there is a decrease in blood glucose levels to Symptoms of hypoglycemia include a lot of sweating, palpitations, trembling, hunger, dizziness, restlessness and if severe can lose consciousness bring to coma. When patient get conscious, they can be given a sweet drink containing glucose. If the patient's condition does not improve or the patient is unconscious should be immediately taken to the hospital for treatment and subsequent monitoring.
Chronic compilation
The uncontrolled DM in a long period will cause the damage in blood vessels and nerves. Blood vessels can be damaged divided into two types, namely large and small blood vessels.
Are included in the large blood vessels, such are:
- The blood vessels of the heart, which if it broken will leads to coronary heart disease and cardiac sudden death
- Peripheral blood vessels, especially in the legs, which if broken would cause ischemic leg injury.
- The blood vessels of the brain, which if damaged could cause a stroke.
Damage to the small blood vessels (microangiopathy) such as the blood vessels of the retina and can cause blindness. In addition, there can be damage to kidney blood vessels which will lead to diabetic nephropathy. For more details, read the article renal failure.
The most frequently damaged nerve is peripheral nerves, which causes feelings of numbness or numbness in the fingertips. Because of numbness, especially in the legs, then the DM patients are often not aware of the injury to the foot, thus increasing the risk of becoming deeper wounds (leg ulcers) and the need to perform amputation. In addition to numbness, patients may also experience leg burn and vibrate itself, more sore at night, and weakness in the hands and feet. In patients with peripheral nerve damage, then it should be taught about proper foot care, thereby reducing the risk of injury and amputation.
