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Main tests to detect and monitor diabetes – Portal Diabetes & Você

    Main tests to detect and monitor diabetes - Portal Diabetes & Você

    In a research carried out in brazilin 2018, carried out by the SAÚDE magazine and by the Market Intelligence area of ​​Grupo Abril, curated by the endocrinologist Carlos Eduardo Barra Couri, interviewed 1,050 people with or without diabetes to understand.

    according to dr mailEven those patients who have access to the most modern treatments have difficulty controlling blood glucose levels, as they suffer from “lack of information syndrome”.

    A recurring doubt is related to the tests for both the detection of diabetes and the monitoring of the disease. As always, I went looking for good references: medical and multidisciplinary societies linked to diabetes, in order to better explain what is really needed.

    The test commonly requested when diabetes is suspected, when the person is in the so-called risk group or even for prevention, is fasting blood glucose. If a result higher than 100 mg/dl is confirmed (normal is up to 99 mg/dl, for prediabetes from 111 to 125 mg/dl), the doctor should request a new examination and a tolerance test. glucose, also known as the glycemic curve.

    You can also order glycosylated hemoglobin. Both fasting blood glucose and glycosylated hemoglobin will be constantly requested tests for monitoring diabetes. Some doctors also ask for fructosamine to be measured.

    To check for complications, doctors also order microalbuminuria (24-hour urine) and an annual fundus exam.

    And what does each of these tests mean?

    fasting blood sugar

    Fasting blood glucose is the test performed in a clinical analysis laboratory that measures the level of glucose (or sugar) in our blood and is therefore the test that confirms the diagnosis of diabetes.

    People with characteristic symptoms such as extreme thirst, extreme hunger, weight loss, dry mouth, and increased urination should seek medical attention. He will order a blood glucose test, among other things. – Source Medcenter

    There are also professionals who request it as a preventive routine.

    Oral glucose tolerance test or glycemic curve

    The glycemic curve, or oral glucose tolerance test, is considered the gold standard for the diagnosis of Diabetes Mellitus. For this, the administration of 75 g of glucose orally (or 1.75 g/kg of weight in children) is recommended, and the glucose doses are on an empty stomach and after 120 minutes of overload.

    Both a blood glucose value between 100 and 125 mg/dL, found fasting, and levels between 140 and 200 mg/dL, two hours after overload, show glucose intolerance (prediabetes). A blood glucose greater than or equal to 200 mg/dL at 120 minutes confirms the diagnosis of Diabetes Mellitus. Source: Anad – National Association for Diabetic Assistance

    Glycosylated hemoglobin

    Of enormous importance in the evaluation of diabetes control. It is capable of summarizing for the specialist and for the patient under treatment whether glycemic control was effective or not, in a previous period of 60 to 90 days. This is because during the last 90 days, hemoglobin incorporates glucose, depending on the concentration in the blood. If glucose levels show high levels in the period, there will be an increase in glycosylated hemoglobin. It is always necessary to individualize the A1C (glycated hemoglobin) value, taking into account various clinical data such as age, the presence of other diseases and/or the risk of frequent hypoglycemic events.

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    Clinical studies, conducted in large centers, were able to show that keeping A1C values ​​as close to normal as possible was accompanied by a significant reduction in the occurrence and progression of micro- and macrovascular complications. This occurred in people with type 1 (DCCT) and type 2 (UKPDS) diabetes.

    By national and international consensus, the A1C value maintained below 7% promotes protection against the onset and progression of microvascular complications of diabetes (retinopathy, nephropathy, and neuropathy). Source: SBD – Brazilian Society of Diabetes

    What is the difference between glycemia and glycosylated hemoglobin?

    Fructosamine Dosage

    Test capable of showing glycemic control for the last 4 to 6 weeks. It can be useful for the evaluation of changes in diabetes control at shorter intervals, to judge the effectiveness of therapeutic change, as well as in the follow-up of pregnant women with diabetes. Fructosamine dosing may also be indicated when, for technical reasons, A1C is not considered a good monitoring parameter (hemoglobinopathies and in the presence of anemia). Source site of the SBD – Brazilian Society of Diabetes

    Microalbuminuria (24-hour urine)

    For 24 hours, the person collects the urine and takes it to the laboratory. The test measures the amount of albumin protein eliminated through urine. It is very important to have this protein in the body, as it helps in the recovery of the body. People with kidney failure, due to diabetes, eliminate high amounts of this protein in the urine. Source: ADJ – Juvenile Diabetes Association

    Understanding diabetic nephropathy

    eye fundus

    Carried out in the office, by the ophthalmologist, it checks the conditions of the retina. People with prolonged hyperglycemia may develop retinal problems. About 40% of diabetics have some alteration. And diabetic retinopathy is responsible for 8% of cases of blindness in Brazil. Annual monitoring and good control can prevent complications.

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    Understanding diabetic retinopathy

    Need to better understand your treatment?

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    Knowledge is the best medicine to treat diabetes!

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