Hemoglobin A1c (HbA1c) Test for Diabetes

What is a Hemoglobin A1c (Average Blood Sugar) Test?

The Hemoglobin A1C Test  is also called HbA1c, glycated hemoglobin test, or glycoslated hemoglobin test is a common blood test used to diagnose type 1 and type 2 diabetes to determine how well your diabetes is being controlled. 

According to American Diabetes Association, the test result of A1c reflects your average blood sugar level for the past two to three months. Specifically, the A1C test measures what percentage of your hemoglobin (a protein in red blood cells that carries oxygen) is coated with sugar (glycated). The higher your A1C level, the poorer your blood sugar control and the higher your risk of diabetes complications. 

Why Hemoglobin A1c Test  is Done?

Based on the international committee of experts from the European Association for the Study of Diabetes, American Diabetes Association, and International Diabetes Federation stated that they recommends the A1C test as the primary test used to diagnose prediabetes, type 1 diabetes and type 2 diabetes.

A1C test can help you manage your diabetes:

• to determine if your treatment plan is working properly
• to confirm self-testing results or blood test results by the doctor.
• to show you how healthy choices can make a difference in diabetes.

How to Prepare A1c Test?

A1c Test is a quite simple blood test. You just eat and drink normally before the test.

Expect your the A1c test

During the test, the health care team practitioner simply takes a sample of blood by inserting a needle into a vein in your arm or pricking the tip of your finger with a small, pointed lancet. The blood sample is sent to a lab for analysis. You can return to your usual activities immediately.

The Results

After the blood analysis, the results conclude for someone who doesn't have diabetes, a normal A1C level can range from 4.5 to 6 percent. Someone who's had uncontrolled diabetes for a long time might have an A1C level above 8 percent.

When the A1C test is used to diagnose diabetes, an A1C level of 6.5 percent or higher on two separate tests indicates you have diabetes. A result between 5.7 and 6.4 percent is considered prediabetes, which indicates a high risk of developing diabetes.

For most people who have previously diagnosed diabetes, an A1C level of 7 percent or less is a common treatment target. Higher targets may be chosen in some individuals. If your A1C level is above your target, your doctor may recommend a change in your diabetes treatment plan. Remember, the higher your A1C level, the higher your risk of diabetes complications.

Here's how A1C level corresponds to average blood sugar level, in milligrams per deciliter (mg/dL) and millimoles per liter (mmol/L):

A1C level        Estimated average blood sugar level
5 percent        97 mg/dL (5.4 mmol/L)
6 percent        126 mg/dL (7 mmol/L)
7 percent        154 mg/dL (8.5 mmol/L)
8 percent        183 mg/dL (10.2 mmol/L)
9 percent        212 mg/dL (11.8 mmol/L)
10 percent        240 mg/dL (13.3 mmol/L)
11 percent        269 mg/dL (14.9 mmol/L)
12 percent        298 mg/dL (16.5 mmol/L)
13 percent        326 mg/dL (18.1 mmol/L)
14 percent        355 mg/dL (19.7 mmol/L)

What are the limitations?

Although the A1C test is an important tool, it can't replace daily self-testing of blood glucose for those who need it. A1C tests don't measure your day-to-day control. You can't adjust your insulin on the basis of your A1C tests. That's why your blood sugar checks and your log of results are so important to staying in effective control.

Source & References:

1. A1c Test - mayoclinic.com Retrieved last March 3, 2013
2. Living with Diabetes  - diabetes.org. Retrieved last March 3, 2013 
3. The Hemoglobin A1c (HbA1c) Test for Diabetes - webmd.com . Retrieved last March 3, 2013 
4. Image source: http://www.dlife.com/diabetes/export/pics/dLife_Images/A1C_Levels_p1.jpg. Retrieved last March 3, 2013

Read More

Oral Glucose Tolerance Test (OGTT)

What is Oral Glucose Tolerance Test?

The oral glucose tolerance test (OGTT), also known as the glucose tolerance test, is a lab test to how your the body’s ability to metabolize glucose, or clear it out of the bloodstream. In this procedure the The patient is asked to take a glucose drink and their blood glucose level is measured before and at intervals after the sugary drink is taken. The test can be used to diagnose diabetes, gestational diabetes  or prediabetes.

The test is a more substantial indicator of diabetes than finger prick testing

Why OGTT is Done?

According to webmd.com the Oral Glucose Tolerance Test is done to:

• Check pregnant women for gestational diabetes. You have an increased chance of developing gestational diabetes if you:
• Have had gestational diabetes during a previous pregnancy.
• Have previously given birth to a baby who weighed more than 9 lb (4.1 kg).
• Are younger than age 25 and were overweight before getting pregnant.
• Diagnose prediabetes.
• Diagnose Insulin resistance, and
• Reactive hypoglycemia

How to Prepare the Test?

For those who taking the test to diagnose diabetes or prediabetes, you must need first to prepare before performing the diagnostic test:

• You must eat a balanced diet that contains at least 150 grams (g) of carbohydrate per day for 3 days before the test. Fruits, breads, cereals, grains, rice, crackers, and starchy vegetables such as potatoes, beans, and corn are good sources of carbohydrate.
• Fasting at least 8 to 12 hours before your first blood sample is taken. Do not eat, drink, smoke, or exercise strenuously during the fasting.
• Must tell your doctor about all prescription and nonprescription medicines you are taking, because it will affect the test results. You may be instructed to stop taking certain medicines before the test.

How is Done?

After the preparation, on the day of testing, the following steps will be done:

• A blood sample will be collected when you arrive. This is your first blood taken to measure your blood sugar (glucose) level before the test. 
• The next stage is to take a very sweet tasting, glucose drink. It is best to drink the liquid quickly. For the standard glucose tolerance test, you will drink 75 grams or 100 grams. Pregnant women drink 75 grams of glucose.
• Further blood samples will then be taken either at regular intervals of say 30 or 60 minutes or a single test after 2 hours. The test could take up to 3 hours.Since activity can interfere with test results, you will be asked to sit quietly during the entire test. Do not eat during the test. You may drink only water during this time.

The Blood Test

The health professional taking a sample of your blood will:

• Wrap an elastic band around your upper arm to stop the flow of blood. This makes the veins below the band larger so it is easier to put a needle into the vein.
• Clean the needle site with alcohol.
• Put the needle into the vein. More than one needle stick may be needed.
• Attach a tube to the needle to fill it with blood.
• Remove the band from your arm when enough blood is collected.
• Apply a gauze pad or cotton ball over the needle site as the needle is removed.
• Apply pressure to the site and then a bandage.

What Should the Test Result be?

For people without diabetes:

• Fasting value (before the test): under 6 mmol/L
• At 2 hours: under 7.8 mmol/L

For people with impaired glucose tolerance (IGT)

• Fasting value (before the test): under 6.0 to 7.0 mmol/L
• At 2 hours: under 7.9 to 11.0 mmol/L

For diabetic levels

• Fasting value (before the test): under 7.0 mmol/L
• At 2 hours: over 11.0 mmol/L

What do these OGT Test Results mean?

If you fall in the range within the impaired glucose tolerance, you will likely be advised to make lifestyle changes. In some cases, blood glucose lowering medication may be advised.

If you fall within the diabetic range, it is quite likely that blood glucose medication will be prescribed to help your body keep your blood glucose levels down.

National Institutes of Health (NIH) stated, that the OGTT it is better able to diagnose high blood glucose after a glucose challenge than the fasting blood glucose test. A doctor may recommend it if he or she suspects diabetes in cases where a patient’s fasting blood glucose level is normal. However, the test is more time-consuming and complicated than the fasting blood glucose test.

Source & References:

1. Glucose Tolerance Test - diabetes.co.uk Retrieved last February 26, 2013
2. Oral Glucose Tolerance Test  - Webmd.com. Retrieved last February 26, 2013 
3. Glucose Tolerance Test - nlm.nih.gov . Retrieved last February 27, 2013 
4. Image source: http://www.diabetesinfo.org.au/webdata/images/Glucose%20Tolerance%20Test.jpg. Retrieved last February 26, 2013

Read More

How is the Fasting Plasma Glucose test (FPG) done?

According to American Diabetes Association that the Fasting Plasma Glucose (FPG) test is the preferred method for diagnosing diabetes, because it is easy to do, convenient, and less expensive than other tests. The FPG test measures blood glucose in a person who has fasted for at least 8 hours and is most reliable when given in the morning.

The test results indicate whether your blood glucose level is normal or whether you have prediabetes or diabetes:

• Normal: Normal blood sugar levels measure less than 100 mg/dl (milligrams per deciliter) after the fasting glucose test.
• Prediabetes: Blood glucose levels of 100-125 mg/dl after an overnight or eight-hour fast may indicate prediabetes. People with these results are considered to have impaired fasting glucose (IFG).
• Diabetes: Diabetes is diagnosed when the blood glucose is 126 mg/dl or above.

In most cases, your doctor will repeat any abnormal test before confirming the diagnosis.

Source & References:

1. How are diabetes and prediabetes diagnosed? - niddk.nih.gov Retrieved last February 26, 2013
2. What is prediabetes   - Webmd.com. Retrieved last February 26, 2013 
3. Image source: http://www.elainelau0612.com/stopprediabetes/images/collect_blood_sample.jpg. Retrieved last February 26, 2013

Read More

How is Prediabetes Diagnosed?

Blood tests are used to diagnosis prediabetes because early in the disease type 2 diabetes may have no symptoms. All diabetes blood tests involve drawing blood at a health care provider’s office or commercial facility and sending the sample to a lab for analysis. Lab analysis of blood is needed to ensure test results are accurate. Glucose measuring devices used in a health care provider’s office, such as finger—stick devices, are not accurate enough for diagnosis but may be used as a quick indicator of high blood glucose.

In June 2009, an international committee composed of experts from the American Diabetes Association, the European Association for the Study of Diabetes and the International Diabetes Federation recommended that prediabetes testing include the:

1. Fasting Plasma Glucose (FPG)
2. Oral Glucose Tolerance Test (OGTT)
3. Hemoglobin A1C (average blood sugar) Test

<< Prevention of Prediabetes || Prediabetes >>

Source & References:

1. How are diabetes and prediabetes diagnosed? - niddk.nih.gov Retrieved last February 26, 2013
2. What is prediabetes   - Webmd.com. Retrieved last February 26, 2013 

Read More

Prevention of Prediabetes

How to Prevent Prediabetes?

In preventing prediabetes in your body, you must have a healthy lifestyle. It can help you to prevent prediabetes and its progression to type 2 diabetes even if your family history has already runs diabetes.

Here are some tips to prevent prediabetes:

• Watch your weight. Being overweight or obese significantly increases your risk for prediabetes, so taking off extra weight is very important. Losing 5% to 10% of your body weight may help you prevent or at least delay type 2 diabetes.2 For example, if you weigh 200 pounds, losing 10 to 20 pounds can reduce your risk. Losing weight can be hard, but you can do it. The easiest way to start is by cutting calories and getting more active. 
• Be active / Exercise regularly. Working out can help you peel off extra pounds if you need to lose or help you maintain your weight if you're at a healthy weight. When you're active, your body uses glucose. The more active you are, the more glucose your body uses for energy. This keeps the sugar from building up in your blood. Exercise can also improve insulin resistance. Walking is a great way to start.
• Enjoy healthy food choices. It can be hard to make big changes in the way you eat. It's okay to start small, by limiting the amount foods that are low in fat, sugars, and sodium.  Choose low or zero-calorie beverages over sweetened drinks.  Replace white carbohydrates (i.e. white bread, white rice) with whole grains, brown rice and etc. that are rich in fiber.  
• Keep blood pressure and cholesterol under control. When you have prediabetes, you are more likely to get heart disease than someone with normal blood sugar levels. If you have high cholesterol, take an active role in controlling it: Aim to exercise at least 30 minutes most days, eat a diet low in saturated fats and don’t smoke. The American Diabetes Association (ADA) recommends maintaining your blood pressure below 130/80 mmHg to prevent the complications that often accompany diabetes.
• If you smoke, quit. Quitting smoking can help you reduce your risk of getting type 2 diabetes and other health problems. Quitting can also reduce your risk of heart attack and stroke.

Take a simple steps to prevention

The National Diabetes Education Program's "Small Steps, Big Rewards" program shows ways you can make small changes to your lifestyle that can have a big impact on preventing prediabetes and type 2 diabetes.

These changes include:

• Setting weight-loss goals.
• Adding exercise to your life.
• Tracking your progress.

For more information, see the National Diabetes Education Program Web site at www.ndep.nih.gov.

<< Complication of Prediabetes || How is Prediabetes Diagnosed? >>

Source & References:

1. Preventing pre-diabetes from becoming diabetes - Foxnews.com Retrieved last February 26, 2013
2. Prediabetes - Prevention - Mayoclinic.com. Retrieved last February 26, 2013 
3. Prevention - Webmd.com. Retrieved last February 26, 2013 

Read More

Complications of Prediabetes

Complications of Prediabetes

Progression into type 2 diabetes is the most serious consequence of untreated prediabetes.

Type 2 diabetes complications include:

• Amputation
• Blindness
• Diabetic Ketoacidosis
• Diabetic Neuropathy
• Diabetic Retinopathy
• Eating Disorders
• Erectile Dysfunctions
• Foot & Skin Problems
• Gastroparesis
• Gum Disease
• Heart Problems
• High Blood Pressure
• Infertility
• Insulin Shock
• Kidney Problems
• Seizures & Coma
• Peripheral Artery Disease
• Sexual Problems
• Urologic Problems
• Weight Gain
• Weight Loss

<< Risk Factors of Prediabetes || Prevention of Prediabetes >>

Source & References:

1. Medical and Health Disorders Associated With Pre-Diabetes and Insulin Resistance - Pre-diabetes.com Retrieved last February 21, 2013
2. Prediabetes - Complication - Mayoclinic.com. Retrieved last February 21, 2013 

Read More

Risk Factors of Prediabetes

What Factors Increase the Risk of Prediabetes?

As I said in previous articles, people with prediabetes don’t have any signs or symptoms, it is important to be aware of the risk factors and have your blood glucose levels tested by your doctor if you are at risk. 

Risk Factors Under Your Control

Many risk factors to consider for prediabetes upon your weight. Here's the following beyond your control:

• Your Eating Habits: Eating more calories than you need to maintain a healthy weight puts you at risk for pre-diabetes. A diet high in total fat and saturated fat, or too low in complex carbohydrates and fiber may lead to insulin resistance.
• Inactivity: Lack of physical activity limits the muscles' ability to use insulin, making it more likely that you will become insulin resistant.
• Observed Abdominal Fat: Having an "apple-shaped" figure with a large waist circumference is the strongest risk factor for prediabetes. Abdominal fat is associated with insulin resistance. Females are at risk when the waist circumference is 35 inches or more. For males, risk increases when the waist is at least 40 inches. Losing weight by changing your eating habits and increasing your physical activity will help you shrink your waist.
• Your Weight: Obese people with a BMI of 30.0 and above are five times as likely to develop prediabetes when compared with people in the normal weight range. Risk starts to increase at a BMI of 25.
• Lack of Sleep. Several recent studies have linked a lack of sleep or too much sleep to an increased risk of insulin resistance. Research suggests that regularly sleeping fewer than six hours or more than nine hours a night might up your risk of prediabetes or type 2 diabetes.

Risk Factors You Cannot Change

There are a things that we can't control. These are factors which we have no control in developing prediabetes:

• Your Age: As you get older, your body produces less insulin and becomes less sensitive to the insulin you have. You are at greater risk for prediabetes if you are over 45 years old and overweight, with a BMI of 25 or 23 for Asian Americans. If you are under 45, but are overweight, your risk increases if you have either high blood pressure, a low HDL ("good") cholesterol, high triglycerides, or some combination of the three.
• Ethnicity / Races: While prediabetes occurs in people of all races, certain ethnic groups have a higher risk than others. Diabetes is more common in African Americans, Latinos, Native Americans, and Asian Americans/Pacific Islanders.
• Genetics / Family History: If either of your parents have/had type 2 diabetes, then you are more likely to get diabetes too.
• Gestational Diabetes: If you had diabetes while you were pregnant, but it went away after delivery, you have a 20 percent to 50 percent chance of developing full-blown diabetes in the next 5 to 10 years. Whether or not you had gestational diabetes, you are at greater risk if you had a baby born weighing more than 9 pounds.
• Polycystic Ovary Syndrome. For women, having polycystic ovary syndrome, is  a common condition characterized by irregular menstrual periods, excess hair growth and obesity will increases the risk of diabetes.

<< Causes of Prediabetes || Complications of Prediabetes >>

Source & References:

1. Prediabetes - Mayo Clinic. Retrieved last February 21, 2013 
2. Are You at Risk for Pre-diabetes? - CalorieCount.About.com. Retrieved last February 21, 2013 

Read More

Causes of Prediabetes

Causes of Prediabetes?

Prediabetes occurs when your body isn't able to keep your blood sugar (glucose) at a normal level. Your sugar is higher than normal, but it's not high enough to be diabetes.

The exact cause of prediabetes is still unknown, although researchers have discovered some genes that are related to insulin resistance. Excess fat and inactivity are to be considered as the important factors in the development of prediabetes.

Most of the glucose in your body comes from the foods you eat, specifically foods that contain carbohydrates can affect your blood sugar levels, not just sweet foods. 

Normally, during digestion, sugar enters your bloodstream and with the help of insulin is then absorbed into the body's cells to give them energy. But when your body can't use insulin the right way, the sugar doesn't move into cells. It stays in your blood instead. This is called insulin resistance.

Insulin is a hormone that comes from the pancreas, a gland located just behind the stomach. When you eat, your pancreas secretes insulin into your bloodstream. As insulin circulates, it acts like a key that unlocks microscopic doors that allow sugar to enter your cells. Insulin lowers the amount of sugar in your bloodstream. As your blood sugar level drops, so does the secretion of insulin from your pancreas.

The buildup of sugar in the blood causes prediabetes. When you have prediabetes, this process begins to work improperly. Instead of fueling your cells, sugar builds up in your bloodstream. This occurs when your pancreas doesn't make enough insulin or your cells become resistant to the action of insulin or both, prediabetes can turn into type 2 diabetes.

People who are overweight, aren't physically active, and have a family history of diabetes are more likely to get prediabetes. Women who have had gestational diabetes are also more likely to get prediabetes. 

<< Symptoms of Prediabetes || Risk Factors of Prediabetes >>

Source & References:

1. Prediabetes - Mayo Clinic. Retrieved last February 19, 2013 
2. Prediabetes Cause - Emedicinehealth.com. Retrieved last February 19, 2013 

Read More

Symptoms of Prediabetes

What are the Symptoms of Prediabetes?

Although most people with prediabetes have no symptoms at all, symptoms of diabetes may include:

• Increased thirst
• Frequent urination
• Fatigue
• Blurred vision

Darkened areas of skin, a condition called acanthosis nigricans, is one of the few signs suggesting you are at risk for diabetes. Common areas that may be affected include the neck, armpits, elbows, knees and knuckles.

The doctor can test your blood to find out if your blood glucose levels are higher than normal. If you are 45 years old or older, your doctor may recommend that you be tested for pre-diabetes, especially if you are overweight.

Who Should be Tested for Prediabetes?

Consult your doctor if you're concerned about diabetes or if you notice any type 2 diabetes signs or symptoms — increased thirst and frequent urination, fatigue, and blurred vision.

Being overweight is a key contributor, along with inactivity, to prediabetes. If your body mass index (BMI) is higher than 25, you are overweight. BMI is a measure of your weight relative to your height. If you’re not sure if you are overweight, ask your doctor.

Even if you are younger than 45, consider getting tested for prediabetes if you are overweight and

• are physically inactive
• have a parent, brother, or sister with diabetes
• have high blood pressure or high cholesterol—blood fat
• have abnormal levels of High-density lipoprotein (HDL) , or good, cholesterol or triglycerides—another type of blood fat
• had gestational diabetes—diabetes that develops only during pregnancy—or gave birth to a baby weighing more than 9 pounds
• are African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, or Pacific Islander American
• have polycystic ovary syndrome, also called PCOS
• have a dark, velvety rash around your neck or armpits
• have blood vessel problems affecting your heart, brain, or legs

If your test results are normal, you should be retested in 3 years. If you have prediabetes, ask your doctor if you should be tested again in 1 year.

<< What is Prediabetes || Causes of Prediabetes >>

Source & References:

1. Prediabetes - MayoClinic.com. Retrieved last February 18, 2013 
2. Prediabetes - Symptoms - webmd.com. Retrieved last February 18, 2013 
3. Diagnosis of Diabaetes and Prediabetes - diabets.niddk.nih.gov. Retrieved last February 18, 2013 

Read More

What is Prediabetes?

What is Prediabetes?

Prediabetes also known as "impaired glucose tolerance" or “impaired fasting glucose,” is the state of  blood sugar (glucose) level is higher than normal, but it's not yet high enough to be classified as type 2 diabetes. Still, without intervention, prediabetes is likely to become type 2 diabetes in 10 years or less. And, a person with prediabetes don't have symptoms, but they are considered to be at high risk of developing heart disease and stroke.

Prediabetes can be an opportunity to a person to improve  himself, because progression from prediabetes to type 2 diabetes isn't inevitable. With healthy lifestyle changes such as eating healthy foods, including physical activity in daily routine and maintaining a healthy weight,  may be able to bring blood sugar level back to normal.

<< Home || Symptoms of Prediabetes >>

Source & References:

1. Prediabetes - Mayo Clinic. Retrieved last February 18, 2013 
2. What is Prediabetes - webmd.com. Retrieved last February 18, 2013 
3. Prediabetes - Amercan Diabetes Association. Retrieved last February 18, 2013 

Read More

Gestational Diabetes

What is Gestational Diabetes?

Gestational diabetes develops during pregnancy (gestation) - usually around the 24th week. About 2 and 10 percent of expectant mothers develop this condition, making it one of the most common health problems of pregnancy. Like other types of diabetes, gestational diabetes affects how your cells use sugar (glucose) in your body's main fuel. 

What causes Gestational Diabetes in Pregnancy? 

When you eat, your digestive system breaks most of your food down into a type of sugar called glucose. The glucose enters your bloodstream and then, with the help of insulin (a hormone made by your pancreas), your cells use the glucose as fuel. However, if your body doesn't produce enough insulin too much glucose remains in your blood instead of moving into the cells and getting converted to energy.

We don't know what causes gestational diabetes, but we have some clues. The placenta supports the baby as it grows. Hormones from the placenta help the baby develop. But these hormones also block the action of the mother's insulin in her body. This problem is called insulin resistance. Insulin resistance makes it hard for the mother's body to use insulin. She may need up to three times as much insulin. When insulin is not much sufficient to produce, the blood glucose levels rise too high, resulting in gestational diabetes.

Most women with gestational diabetes don't remain diabetic after the baby is born. Once you've had gestational diabetes, though, you're at higher risk for getting it again during a future pregnancy and for developing diabetes later in life.

How Gestational Diabetes can Affect your Baby?

Gestational diabetes affects the mother in late pregnancy, after the baby's body has been formed, but while the baby is busy growing. Because of this, gestational diabetes does not cause the kinds of birth defects sometimes seen in babies whose mothers had diabetes before pregnancy.

However, untreated or poorly controlled gestational diabetes can hurt your baby. When you have gestational diabetes, your pancreas works overtime to produce insulin, but the insulin does not lower your blood glucose levels. Although insulin does not cross the placenta, glucose and other nutrients do. So extra blood glucose goes through the placenta, giving the baby high blood glucose levels. This causes the baby's pancreas to make extra insulin to get rid of the blood glucose. Since the baby is getting more energy than it needs to grow and develop, the extra energy is stored as fat.

This can lead to macrosomia, or a "fat" baby. Babies with macrosomia face health problems of their own, including damage to their shoulders during birth. Because of the extra insulin made by the baby's pancreas, newborns may have very low blood glucose levels at birth and are also at higher risk for breathing problems. Babies with excess insulin become children who are at risk for obesity and adults who are at risk for type 2 diabetes.

Chances of Getting Gestational Diabetes

According to the American Diabetes Association your chances of getting gestational diabetes are higher if you...

• you're over 35 years old
• you're overweight
• have had gestational diabetes before
• have given birth to a baby weighing more than 9 pounds
• have a strongly family member with history of diabetes
• have high blood pressure
• have sugar in your urine.
• have too much amniotic fluid
• have had an unexplained miscarriage or stillbirth

A small number of women might be considered at such low risk that they might not have to get tested. You're part of this group if you meet all of the following criteria:

• You're younger than 25.
• Your weight is in a healthy range.
• You're not a member of any racial or ethnic group with a high prevalence of diabetes, including people of Hispanic, African, Native American, South or East Asian, Pacific Island, and indigenous Australian ancestry.
• None of your close relatives have diabetes.
• You've never had a high result on a blood sugar test.
• You've never had an overly large baby or any other pregnancy complication usually associated with gestational diabetes.

Symptoms of Gestational Diabetes

Usually there are no symptoms, or the symptoms are mild and not life threatening to the pregnant woman. The blood sugar (glucose) level usually returns to normal after delivery.

Symptoms may include:

• Blurred vision
• Fatigue
• Frequent infections, including those of the bladder, vagina, and skin
• Increased thirst
• Increased urination
• Nausea and vomiting
• Weight loss despite increased appetite

How will I Know if I have Gestational Diabetes?

Gestational diabetes usually has no symptoms. That's why almost all pregnant women have a glucose-screening test between 24 and 28 weeks.

However, if you're at high risk for diabetes or are showing signs of it (such as having sugar in your urine), your caregiver will recommend this screening test at your first prenatal visit and then repeat the test again at 24 to 28 weeks if the initial result is negative.

By the way, if you get a positive result on a glucose-screening test, it doesn't necessarily mean that you have gestational diabetes. It does mean that you'll need to take a longer follow-up test (a glucose tolerance test, or GTT) to find out.

References

1. Diabetes Basics Retrieved February 15, 2013
2. Gestational diabetes. Retrieved February 16, 2013 
3. Gestational diabetes. Retrieved February 18, 2013  

Read More

Type 2 Diabetes

Overview

Type 2 diabetes mellitus, (formerly noninsulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes), according to World Health Organization (WHO) Type 2 diabetes is the most common form of diabetes, comprises 90% of people with diabetes around the world, and is largely the result of excess body weight and physical inactivity. Until recently, this type of diabetes was seen only in adults but it is now also occurring in children.

In this article, you'll learn the basics about type 2 diabetes, including symptoms, causes and prevention.

What is Type 2 Diabetes?

In type 2 and other types of diabetes, you have too much glucose, also called sugar, in your blood. People with diabetes have problems converting food to energy. After a meal, food is broken down into glucose, which is carried by your blood to cells throughout your body. With the help of the hormone insulin, cells absorb glucose from your blood and use it for energy. Insulin is made in the pancreas, an organ located behind the stomach.

The type 2 diabetes is a metabolic disorder that is characterized by high blood glucose in the context of insulin resistance and relative insulin deficiency. This is in contrast to diabetes mellitus type 1, in which there is an absolute insulin deficiency due to destruction of islet cells in the pancreas.

People with type 2 diabetes produce insulin; however, either their pancreas does not produce enough insulin or the body cannot use the insulin adequately. This is called insulin resistance. When there isn't enough insulin or the insulin is not used as it should be, glucose (sugar) can't get into the body's cells. When glucose builds up in the blood instead of going into cells, the body's cells are not able to function properly. Other problems associated with the buildup of glucose in the blood include:

• Damage to the body. Over time, the high glucose levels in the blood may damage the nerves and small blood vessels of the eyes, kidneys, and heart and predispose a person to atherosclerosis (hardening) of the large arteries that can cause heart attack and stroke.
• Dehydration. The buildup of sugar in the blood can cause an increase in urination. When the kidneys lose the glucose through the urine, a large amount of water is also lost, causing dehydration.
• Diabetic Coma (Hyperosmolar nonketotic diabetic coma). When a person with type 2 diabetes becomes very ill or severely dehydrated and is not able to drink enough fluids to make up for the fluid losses, they may develop this life-threatening complication.

Causes of Type 2 Diabetes?

People can develop type 2 diabetes at any age, even during childhood, however, those at highest risk for the disease are those who:

• Are over 45 of age
• Are obese or overweight
• Have had gestational diabetes 
• Have family members who have type 2 diabetes
• Have prediabetes
• Are inactive
• Have low HDL cholesterol or high triglycerides levels
• Have high blood pressure
• Are members of certain racial or ethnic groups

Signs and Symptoms of Type 2 Diabetes

People with type 2 diabetes may not have symptoms for years or decades, but as the disease progresses and blood sugar levels rise, symptoms develop. Here is the list of signs and symptoms for people with type 2 diabetes :

• Blurred sight
• Dry, itchy skin
• Increased thirst 
• Increased hunger (especially after eating)
• Frequent need to urinate
• Decreased sensation or numbness in the hands and feet
• Frequent bladder and vaginal infections
• Male impotence (erectile dysfunction)
• Slow healing of cuts or sores
• Tiredness
• Leg cramps

Preventing of Type 2 Diabetes

Many people with type 2 diabetes go undiagnosed for several years and are not diagnosed until they go to the doctor with complications of diabetes. But up to 60% of type 2 diabetes can be prevented. People at risk of type 2 diabetes can delay and even prevent this disease by following a healthy lifestyle. This includes:

• Maintaining a healthy weight
• Regular physical activity
• Making healthy food choices
• Managing blood pressure
• Managing cholesterol levels
• Not smoking.

References

1. "Diabetes" Retrieved January 05, 2013
2. "Am I at Risk for Type 2 Diabetes?" Retrieved February 01, 2013
3. "Type 2 Diabetes" Retrieved February 01, 2013

Read More

Type 1 Diabetes

Overview
Type 1 diabetes (also called juvenile-onset diabetes mellitus and insulin-dependent diabetes mellitus)  is occurs when the body's own immune system destroys the insulin- producing  beta cells of the pancreas. In this article, you'll learn the basics about type 1 diabetes, including symptoms and causes and complications.

Two forms of the Type 1 Diabetes

• Idiopathic type 1 - refers to rare forms of the disease with no known cause.
• Immune-mediated diabetes - an autoimmune disorder in which the body's immune system destroys, or attempts to destroy, the cells in the pancreas that produce insulin, Immune-mediated diabetes is the most common form of type 1 diabetes

Type 1 Diabetes and Insulin

Normally the hormone insulin is secreted by the pancreas in low amounts. When you eat a meal, sugar (glucose) from food stimulates the pancreas to release insulin. The amount that is released is proportional to the amount that is required by the size of that particular meal.

The main role of insulin is to help and move certain nutrients especially sugar or glucose  into the cells of the body's tissues. Cells use sugars and other nutrients from meals as a source of energy to function.

The amount of sugar in the blood decreases once it enters the cells. Normally that signals the beta cells in the pancreas to lower the amount of insulin secreted so that you don't develop low blood sugar levels (hypoglycemia). But the destruction of the beta cells that occurs with type 1 diabetes throws the entire process into disarray.

In people with type 1 diabetes, sugar isn't moved into the cells because insulin is not available. When sugar builds up in the blood instead of going into cells, the body's cells starve for nutrients and other systems in the body must provide energy for many important bodily functions. As a result, high blood sugar develops and can cause:

• Dehydration. The build up of sugar in the blood can cause an increase in urination (to try to clear the sugar from the body). When the kidneys lose the glucose through the urine, a large amount of water is also lost, causing dehydration.
• Weight loss. The loss of sugar in the urine means a loss of calories which provide energy and therefore many people with high sugars lose weight. (Dehydration also contributes to weight loss.)
• Diabetic ketoacidosis (DKA). Without insulin and because the cells are starved of energy, the body breaks down fat cells. Products of this fat breakdown include acidic chemicals called ketones that can be used for energy. Levels of these ketones begin to build up in the blood, causing an increased acidity. The liver continues to release the sugar it stores to help out. Since the body cannot use these sugars without insulin, more sugars piles into the blood stream. The combination of high excess sugars, dehydration, and acid build up is known as "ketoacidosis" and can be life-threatening if not treated immediately.
• Damage to the body. Over time, the high sugar levels in the blood may damage the nerves and small blood vessels of the eyes, kidneys, and heart and predispose a person to atherosclerosis (hardening) of the large arteries that can cause heart attack and stroke.

Incidence 
Type 1 diabetes can occur at any age, but it usually starts in people younger than 20. Symptoms are usually severe and occur rapidly.

The exact cause of type 1 diabetes is not known. Type 1 diabetes accounts for 3% of all new cases of diabetes each year. There is 1 new case per every 7,000 children per year. New cases are less common among adults older than 20. Accounting for only about 5% of the people with diabetes. The condition is more common in whites than in blacks and occurs equally in men and women.

Incidence varies from 8 to 17 per 100,000 in Northern Europe and the U.S. with a high of about 35 per 100,000 in Scandinavia to a low of 1 per 100,000 in Japan and China.

Causes
Diabetes type 1 is induced by one or more of the following:

• Genetic susceptibility - Doctors don't know all the factors that lead to type 1 diabetes. Clearly, the susceptibility to the condition can be inherited.
• Environmental -  Doctors have identified that an environmental trigger plays a role in causing the disease. Type 1 diabetes appears to occur when something in the environment -- a toxin or a virus 
• Diabetogenic trigger  - Some researchers believe that the cow's milk has been implicated as a possible trigger of the autoimmune response that destroys pancreatic beta cells in genetically susceptible hosts, thus causing diabetes mellitus. 
• Exposure to a driving antigen - Some chemicals and drugs preferentially destroy pancreatic cells that lead to loss of insulin production.

Symptoms
The classical symptoms of type 1 diabetes include:

• Increased thirst
• Increased hunger (especially after eating)
• Dry mouth
• Nausea and occasionally vomiting
• Abdominal pain
• Frequent urination
• Unexplained weight loss (even though you are eating and feel hungry)
• Fatigue (weak, tired feeling)
• Blurred vision
• Heavy, labored breathing (Kussmaul respiration)
• Frequent infections of the skin, urinary tract, or vagina

Image source: wikipedia.org

Before a person knows they have diabetes, blood sugar levels can be in a very high range for long periods of time which could cause diabetic ketoacidosis. These symptoms could be:

• Dry skin
• Rapid deep breathing
• Drowsiness
• Fruity smeel to the breath
• Abdominal pain
• Vomiting
• Loss of consciousness(rare)

Tests
The following tests can be used to diagnose diabetes:

• Urinalysis shows glucose and ketone bodies in the urine, but a blood test is required for diagnosis
• Fasting blood glucose is 126 mg/dL or higher
• Random (nonfasting) blood glucose exceeds 200 mg/dL (this must be confined with a fasting test)
• Insulin test (low or undetectable level of insulin)
• C-peptide test (low or undetectable level of the protein C-peptide, a by-product of insulin production)

Complications

Type 1 diabetes can cause different problems, but there are three key complications:

1. Hypoglycemia (low blood sugar; sometimes called an insulin reaction) occurs when blood sugar drops too low.
2. Hyperglycemia (high blood sugar) occurs when blood sugar is too high, and can be a sign that diabetes is not well controlled.
3. Ketoacidosis (diabetic coma) is loss of consciousness due to untreated or under-treated diabetes.

References

1. "Type 1 Diabetes Mellitus". Retrieved 2008-08-04.
2. "Type 1 Diabetes". Retrieved 2013-02-12
3. Kasper, Dennis L; Braunwald, Eugene; Fauci, Anthony; et al. (2005). Harrison's Principles of Internal Medicine (16th ed.). New York: McGraw-Hill. ISBN 0-07-139140-1.
4.  "content.nejm.org". content.nejm.org. Retrieved 29 February 2013.
5. "Endocrinology Health Guide".Retrieved 29 February 2013.

Read More