Part 2: Diagnosis and Daily Management of Diabetes

Managing diabetes effectively starts with an accurate diagnosis and a structured daily routine to keep blood sugar levels stable. Understanding how diabetes is diagnosed, monitored, and treated is crucial for preventing complications and maintaining a high quality of life. In this section, we will explore the key aspects of diabetes diagnosis, self-monitoring, medications, and the importance of regular medical check-ups.

How Diabetes is Diagnosed

Diabetes is diagnosed through a series of blood tests that measure how well the body regulates blood glucose levels. If high blood sugar levels persist over time, a doctor will confirm a diabetes diagnosis. The most common tests used include:

1. A1C Test (Glycated Hemoglobin Test)

The A1C test measures the average blood sugar level over the past 2-3 months by assessing the percentage of sugar attached to hemoglobin in red blood cells.
A1C Levels and What They Mean:
- Normal: Below 5.7%
- Pre-Diabetes: 5.7% to 6.4%
- Diabetes: 6.5% or higher
The A1C test is a preferred method because it does not require fasting and provides a long-term view of blood sugar control.
People with diabetes should get their A1C levels checked every 3-6 months to track progress.

2. Fasting Blood Sugar Test (FBS)

This test measures blood sugar levels after fasting for at least 8 hours (typically done in the morning before breakfast).
Fasting Blood Sugar Levels:
- Normal: Below 100 mg/dL
- Pre-Diabetes: 100-125 mg/dL
- Diabetes: 126 mg/dL or higher (on two separate tests)

3. Oral Glucose Tolerance Test (OGTT)

Measures how the body processes sugar over time.
The patient drinks a glucose solution, and blood sugar levels are tested two hours later.
Results:
- Normal: Below 140 mg/dL
- Pre-Diabetes: 140-199 mg/dL
- Diabetes: 200 mg/dL or higher

4. Random Blood Sugar Test

A blood sample is taken at a random time during the day, regardless of when food was last eaten.
A result of 200 mg/dL or higher suggests diabetes.

5. Gestational Diabetes Screening

Pregnant women undergo glucose screening between 24-28 weeks of pregnancy.
If glucose levels are high, further testing is done to confirm gestational diabetes.

Self-Monitoring Blood Sugar and Interpreting Results

Once diagnosed, self-monitoring blood sugar is an essential part of diabetes management. Regular checks help individuals understand how food, exercise, stress, and medication affect their blood sugar levels.

How to Monitor Blood Sugar

Using a Glucometer (Finger-Prick Test)
- A small drop of blood is taken from the fingertip and placed on a test strip inserted into a glucometer.
- The device gives a real-time blood sugar reading.
Continuous Glucose Monitoring (CGM) Devices
- A sensor is placed under the skin to measure glucose levels throughout the day and night.
- Provides alerts for high or low blood sugar.

Recommended Blood Sugar Targets

Time of Test	Target for Non-Diabetics	Target for Diabetics
Fasting (Before Breakfast)	70-100 mg/dL	80-130 mg/dL
Before Meals	70-100 mg/dL	80-130 mg/dL
2 Hours After Eating	Below 140 mg/dL	Below 180 mg/dL
Before Bedtime	80-120 mg/dL	90-150 mg/dL

Interpreting Blood Sugar Results

High Blood Sugar (Hyperglycemia): Symptoms include excessive thirst, frequent urination, fatigue, and blurred vision.
Low Blood Sugar (Hypoglycemia): Symptoms include shakiness, dizziness, sweating, irritability, and confusion.

Tips for Effective Blood Sugar Monitoring

Check blood sugar at the same times each day for consistency.
Keep a blood sugar log to track trends.
Adjust medication, diet, and activity levels based on readings.
Speak to a healthcare provider if blood sugar remains consistently high or low.

Medications and Insulin Therapy

Diabetes medications help regulate blood sugar levels and prevent complications. The type of medication prescribed depends on the severity of diabetes, individual health conditions, and how the body responds to treatment.

Oral Medications (For Type 2 Diabetes)

Metformin (First-Line Treatment)
- Reduces glucose production in the liver.
- Improves insulin sensitivity.
- May cause mild digestive issues initially.
Sulfonylureas (Glipizide, Glyburide)
- Stimulates the pancreas to produce more insulin.
- Risk of hypoglycemia (low blood sugar).
SGLT2 Inhibitors (Empagliflozin, Canagliflozin)
- Helps kidneys remove excess sugar through urine.
- May lower heart disease risk.
DPP-4 Inhibitors (Sitagliptin, Linagliptin)
- Enhances the body’s ability to lower blood sugar.
- Mild side effects, including joint pain.

Insulin Therapy (For Type 1 and Severe Type 2 Diabetes)

Types of Insulin:
- Rapid-acting (before meals)
- Short-acting (30-60 minutes before meals)
- Intermediate-acting (covers half-day or overnight)
- Long-acting (once daily, stable release)
Insulin Administration Methods:
- Insulin injections (syringe or insulin pen)
- Insulin pump (delivers small doses continuously)
Side Effects of Insulin Therapy:
- Hypoglycemia (if too much insulin is taken)
- Weight gain (due to improved sugar metabolism)

Importance of Routine Check-ups and Screenings

Regular medical check-ups help prevent complications and ensure diabetes is managed effectively.

Essential Check-Ups for People with Diabetes

A1C Test: Every 3-6 months to assess long-term blood sugar control.
Blood Pressure Check: Every doctor’s visit to monitor heart health.
Cholesterol Test: Once a year to prevent cardiovascular disease.
Kidney Function Test: Annually to detect early signs of kidney damage.
Foot Exams: Every 3-6 months to check for nerve damage or infections.
Eye Exams: Yearly screening for diabetic retinopathy.

Why Regular Check-Ups Matter

Helps detect early complications like nerve damage, heart disease, and kidney issues.
Allows for medication adjustments based on blood sugar control.
Provides education and support from healthcare professionals.

Key Takeaways

Diabetes is diagnosed using blood tests like the A1C, fasting glucose, and OGTT.
Self-monitoring blood sugar helps manage daily glucose levels effectively.
Medications and insulin therapy are essential for controlling diabetes, with different treatments available based on individual needs.
Routine check-ups prevent complications and ensure long-term health.

In the next section, we will explore lifestyle changes that can help manage diabetes naturally, including diet, exercise, and stress reduction techniques.

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Guide to Diabetes: Diagnosis and Daily Management of Diabetes – Part 2