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Dear Sir,
Let us begin our talking about diabetes in brief:
== Fasting Blood Glucose or Fasting Plasma Glucose (FBG) is the blood specimen taken after the patient has not eaten for at least12 hrs.
Hyperglycemia is characterized by the increase in Plasma Glucose levels, and is caused by an imbalance of hormones.
== Diabetes Mellitus (DM) is actually a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin action, secretion, or both. DM is divided into two board categories, and other additional ones:
- Type1, Insulin – Dependent DM (IDDM); characterized by Beta-cell destruction, caused by autoantibodies attack, leading to absolute insulin deficiency
- Type2, Non-Insulin – Dependent DM (NIDDM); a hyperglycemia that is characterized by relative insulin deficiency and inappropriate hyperglycemia primarily a result of pancreatic islet Beta-cell destruction and tendency of ketoacidosis,, caused by insulin resistance with an insulin secretory defect.
- Other specific types of Diabetes; which are associated with secondary conditions, such as genetic defects of Beta-cell function, pancreatic diseases, endocrine disease, drug or chemical induction, .etc.
- Gestational DM (GDM);which is characterized by glucose intolerance pregnancy due to metabolic and hormonal changes.
== When an intermediate stage is formed – between IDDM and NIDDM types – who did not meet the criteria of DM, but had the fasting glucose at increased level above –normal limits but not to the level of DM, and has been named as Impaired Fasting Glucose or Borderline high FBG. When the upper limit of110 mg/dl, but lesser than126 mg/dl on the fasting plasma glucose can be defined and designated as the upper limit of normal blood glucose.
== The term Impaired Glucose Tolerance is used to indicate glucose tolerance values above normal but below diabetes level was retained.
== When FBG is above or equal to126 mg/dl, that will be one of famous criteria can be used to diagnose DM in suspected patients, and it must be confirmed on a subsequent day by any of the following methods:
1- Random blood glucose above or equal200 mg/dl + symptoms of DM.
2- Fasting plasma glucose as what is mentioned before, and the most preferred test for DM diagnosis.
3- Two-hour plasma glucose above or equal to200 mg/dl during the Oral glucose tolerance Test (OGTT), and this can be issued with2 hrs post – load (75 g glucose load)
== Insulin measurements are not required for the diagnosis of DM. However, in certain hypoglycemic states, it is important to know the concentration of insulin in the relation to plasma glucose concentration.
== As well as the hypoglycemia can be correlated to many causes – some are transient and relatively insignificant; others can be life threatening. Its observable symptoms are all related to the central nervous system. But the laboratory findings – whatever the cause behind the hypoglycemia – include decreased plasma glucose levels during hypoglycemia episode and extremely elevated insulin levels in patients with pancreatic Beta-cell tumors (Insulinoma).
== To investigate the Insulinoma, the patient is required to fast under controlled conditions. Men and women have different metabolic patterns in prolonged fasts.
- The healthy male will maintain plasma glucose of55 –60mg/dl for several days.
- Healthy females will produce ketones more readily and permit plasma glucose to decrease to40mg/dl or lower.
- Diagnostic criteria for Insulinoma includes a change in: glucose level of equal or higher than25mg/dl (FBG level) coincident with an insulin level of equal or higher than6 micromole/ml ( this test is referred as fasting Insulin level).
Best Regards,
Lubna Al-Sharif
It is called insulin resistance , it is a pre diabetes stage and is evaluated by HOMA score.
My understanding of the question !
Called is Diabetes and evaluated by HbA1c & MCV test
