New Advances in the Diagnosis and Treatment of Diabetes Mellitus DM , December 27, 2000

New Advances in the Diagnosis and Treatment of Diabetes Mellitus (DM), December 27, 2000

In China, as living standards continue to rise, the incidence of diabetes is also increasing. Individuals with fasting blood glucose and postprandial blood glucose levels higher than normal but below the diagnostic threshold for DM are considered to have impaired glucose tolerance. According to statistics, 3%–20% of the Chinese population has impaired glucose tolerance (IGT). Currently, it is believed that all patients with type 1 diabetes go through the IGT stage before onset.

1. Classification of Diabetes

Type 1: Destruction and dysfunction of pancreatic islet cells; Type 2: Insulin resistance or insufficient insulin secretion. In addition, there are gestational diabetes, gestational IGT, and symptomatic diabetes.

2. Diagnosis of DM is related to the following factors:

Family history, obesity (especially central obesity), hypertension, middle-aged and elderly individuals, recurrent infections, habitual miscarriages, premature births, and unexplained prolonged fatigue. Anyone experiencing these conditions should have their blood glucose and urine glucose tested to rule out the disease. Fasting blood glucose less than 5.6 mmol/L can be ruled out, while greater than 7.0 mmol/L confirms the diagnosis. If fasting blood glucose is between 5.6 mmol/L and 7.0 mmol/L, a glucose tolerance test should be performed: fast for 8 hours, then drink 75 g of glucose, and measure blood glucose after 2 hours. If blood glucose is between 8.0 mmol/L and 11.0 mmol/L, a classic glucose tolerance test must be conducted. Four hours after oral glucose intake, if blood glucose remains elevated for 3 hours, it indicates DM; if elevated for 2 hours, it indicates IGT. Some elderly individuals may have normal fasting blood glucose but show elevated levels 2 hours after meals, requiring continuous monitoring.