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Living with Diabetes
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Diabetes

What is Diabetes?

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First of all, diabetes mellitus, often just called ‘diabetes’, is a chronic, metabolic disease, which means that it is a long-lasting disease that affects the way food is digested inside the body. As food is processed into small molecules that can be used as a source of energy by the body’s cells, carbohydrates mainly turn into glucose, which is released into the bloodstream.

The amount of sugar in the blood, called the glycemia, is regulated by insulin, a hormone produced by the pancreas, an abdominal organ. To put it simply, insulin acts like a key that makes blood sugar enter the body’s cells, hence lowering blood sugar. This effect is said to be hypoglycemic.

In case of diabetes, either insulin production is insufficient, or your body is unable to use the insulin it makes as well as it should, a phenomenon called insulin resistance. In either case, there is an excess of sugar in your bloodstream that can cause serious harm.1

How is diabetes diagnosed?

Diagnosis relies on blood sugar tests, sometimes in different situations: when fasting, before and after drinking a glucose-containing liquid, the HbA1c test measuring your average blood sugar over the past 2 to 3 months, or a random blood sugar test. In case of diabetes types other than type 2, other tests are required.2

How can type 2 diabetes be diagnosed?

There are several ways to diagnose diabetes. Each way usually needs to be repeated on a second day to diagnose diabetes. Testing should be carried out in a health care setting (such as your doctor's office or a lab). If your doctor determines that your blood glucose level is very high or if you have classic symptoms of high blood glucose in addition to one positive test, your doctor may not require a second test to diagnose diabetes. Here are the three common ways of diagnosing diabetes:
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HbA1C : The HbA1C test measures your average blood glucose for the past 2 to 3 months. The advantages of being diagnosed this way are that you don’t have to fast or drink anything. Diabetes is diagnosed at an HbA1C ≥6.5%
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Fasting plasma glucose (FPG) : This test checks your fasting blood glucose levels. Fasting means after not having anything to eat or drink (except water) for at least 8 hours before the test. This test is usually done first thing in the morning, before breakfast. Diabetes is diagnosed at a fasting blood glucose ≥126 mg/dL
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Oral glucose tolerance test (OGTT) : The OGTT is a 2-hour test that checks your blood glucose levels before and 2 hours after you drink a special sweet drink. It tells the doctor how your body processes glucose. Diabetes is diagnosed at a 2-hour blood glucose ≥200 mg/dL

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References

4
WHO. Global report on diabetes. 2016.
6
CDC. Type 1 Diabetes – Basics – Diabetes. 2019
7
WHO. FAQs -Frequently Asked Questions on Diabetes. 2016