Importance of Screening For Diabetes and it's Associated Complications

Diabetes has become a major health threat to the whole world; indeed, the greatest increase will be contributed by India, which has already been declared by the World Health Organization (WHO) as the country with the largest number of diabetics in the world. Diabetes is frequently not diagnosed until complications appear, and approximately one third of all people with diabetes may be undiagnosed, though diagnosed many people are not aware of their condition.



Late detection of diabetes often means that at the time of diagnosis complications have already damaging the eyes, kidneys and nerves. These complications are costly in the physical, financial and psychosocial sense. Early detection and treatment of diabetes may not only improve glycemic control, but also improves blood pressure and lipids.
Who should be screened? In general all adults should be screened at regular intervals
o Family history of diabetes (i.e., parents or siblings with diabetes)
o Overweight (Body Mass Index >25 kg/m2)
o Age >45 years
o Previously identified impaired fasting glucose (IFG) or impaired glucose tolerance (IGT)
o Hypertension (>140/90 mmHg)
o Hyperlipidemia (HDL - 250 mg/dL or both)
o History of gestational diabetes or delivery of a baby over 9 lb (4.1 kg) (ADA -Diabetes Care 2004)



What are the Screening test for Diabetes



Fasting Plasma Glucose: The fasting plasma glucose (FPG) test is the standard test for diabetes. It is a simple blood test taken after eight hours of fasting. The FPG test is not always reliable, so a repeat test is recommended if the initial test suggests the presence of diabetes.



Oral Glucose Tolerance Test: The glucose tolerance test may be more accurate than the FPG in certain groups (e.g., women with a history of gestational diabetes). The test uses the following procedures: I) after an overnight fast Fasting Plasma Glucose test is performed. ii) After this test a person receives 75 g of glucose (100 g for pregnant women) blood samples are taken every half an hour {(fasting-30mts-60mts-90mts-120mts-(five times)} to measure the blood glucose. It not only helps in detecting diabetes but also help to detect the pre-diabetic status, Impaired Fasting Glucose (IFG) & Impaired Glucose
Tolerance (IGT))



Is it important to detect pre-diabetic stage? Yes! Because it is "preventable"
Criteria for the diagnosis of diabetes mellitus



Normal DIABETES



Symptoms of diabetes + Random plasma glucose o Blood pressure check up, regular at every visit for Hypertension (High blood pressure) - should be 40
o An electrocardiogram (ECG), that provides information about the status of heart
o Chest X ray, information about the lungs and shape of the heart and vascular system (aorta and blood vessels)
o Carotid Intima-media Thickness (IMT), marker of early atherosclerosis



Diabetic Nephropathy (Kidney Damage): Person with diabetes are several times more prone to kidney disease than the general population. The earliest manifestation of kidney damage is microalbuminuria, (tiny amounts of protein called albumin are found in the urine). Symptoms include Protein in the urine, High blood pressure, burning during urination, frequent urination, puffiness and swelling around the eyes, hand & feet, excessive itching, nausea, vomiting & weakness.



About 20% of type 2 patients show evidence of microalbuminuria upon diagnosis of diabetes, however, only a small percentage of type-2 diabetics eventually develops kidney disease. Microalbuminuria typically shows up in type 2 diabetics who have high blood pressure. Normal: 15yrs will develop diabetic retinopathy in their lifetime.
Who are more prone to Diabetic retinopathy? : Uncontrolled blood sugar, longstanding diabetes, Hypertension with diabetes & Genetic predisposition.



What are the stages of retinopathy? : Mild non proliferative diabetic retinopathy (NPDR), Moderate-non proliferative diabetic retinopathy, severe retinopathy, Maculopathy and Proliferative diabetic retinopathy. Treatment: Retinopathy can be treated through laser photocoagulation. Screening test: Patients with diabetes should have an initial dilated and comprehensive eye examination by an ophthalmologist or optometrist right from the day of diagnosis of diabetes and every year thereafter. Early detection, timely treatment, appropriate screening and care reduce the risk of vision loss & 90% of diabetes related blindness.



All patients should be regularly screened for risk factors and encouraged at each health care visit to pursue a healthy lifestyle that includes a healthy diet, adequate exercise, weight control and stress reduction. 'Try for good control to be sure, but don't try for perfection. Perfection lasts for a moment, and diabetes lasts a lifetime'. The main theme is to be focus on to 'live a Healthy Life Despite Diabetes'.

Deter America's Daunting Disease of Diabetes! Screening, Treatment and Facts to Keep You Healthy

These days receiving general screening for diabetes is very important. Diabetes is a word you hear in the news and on the street with startling frequency but what exactly is everyone talking about? Diabetes comes up in serious discussion and also in jokes-but diabetes is nothing to laugh about.



We have a huge problem with diabetes in this country. In fact, it is estimated that almost ten percent of the population is has this potentially fatal disease. The total amount of individuals infected with diabetes is over twenty five million. That's a lot of junk food! Screening is thankfully easy and affordable and is available at a host of different clinics around our fair city.



What exactly is diabetes? Well, there are two different types of diabetes. Generally, diabetes is an autoimmune disease. In type 1 diabetes, the body's immune system mistakenly attacks the insulin producing cells of a person's pancreas. In type 2, the disease comes on later in life and is different than type 1 in that the cells of the body no longer react to insulin the way they should. Basically, there is an insulin resistance in the body. Type 1 diabetes affects only ten percent of the total amount of diabetes patients. Blood sugar screening is easily available for both types of the disease.



What exactly is insulin and why is it so important to the human body? Insulin is a hormone that regulates the glucose levels in the body. Glucose is basically sugar and is one of the top energy sources the body has. This is why regulating the levels of it is so important to retaining your good health.



When should screening be administered? As with tests for different illnesses, screening should be part of your general health regimen. If diabetes runs in the family, it makes sense to receive screening earlier than others would. Diabetes' main underlying causes are genetic in nature.



There are some symptoms everyone should be aware of that may be a tip-off that diabetes has reared its ugly head. The symptoms that should prompt immediate screening procedures are:



Extreme thirst
Frequent urination
Drowsiness
Increased appetite
Sudden Weight loss
Sudden vision changes
Sweet odor on breath
Heavy breathing



If experiencing any of these symptoms, screening at walk in clinic is highly recommended. For those who have type 1 diabetes injections of insulin via a personal hypodermic needle or specialized "pen" is the main mode of treatment. It is through this introduction of glucose with a balancing of daily dietary intake that one can live a healthy life. Type 2 diabetes can be treated through a variety of different medications that balance insulin levels in the blood stream. Either way, screening first, medication next-and hopefully, a healthy life with minimal side effects from the medicine.



The fact is there is so much in our daily lives that we need to keep on top of in order to retain our health and live a long satisfying life. The obvious things like no smoking, minimal junk food, and exercise are up to you. Controlling a disease like diabetes is helped through your trusted doctor and the medicines he or she provides.