What is Diabetes?
Diabetes is a condition caused by elevated blood sugar levels while the body’s tissues cannot use that sugar as energy normally. Normally, sugar enters the body’s cells under the control of the hormone insulin. When blood sugar levels rise, it eventually overflows into the urine, allowing sugar to be detected in the urine. Prolonged high blood sugar levels can cause complications in almost every organ system, such as the eyes, kidneys, nervous system, cardiovascular system, and more.
Diagnosis of Diabetes
Diabetes diagnosis can be made by testing plasma glucose levels as follows:
- In cases with clear symptoms of diabetes, a diagnosis is made if plasma glucose is greater than 200 mg/dL once.
- In asymptomatic cases, fasting plasma glucose after 8 hours must be greater than or equal to 126 mg/dL twice. The glycated hemoglobin (HbA1C) level ≥ 6.5 is also diagnostic. Glucose levels between 100-125 mg/dL are considered abnormal and indicate a high risk of developing diabetes and should be monitored regularly.
Principles of Diabetes Control
Diabetes control includes diet management, exercise, medication, and strict diabetes management to prevent symptoms and complications. Diabetic patients should have regular check-ups to adjust medication and detect complications early for treatment and symptom control from the initial stage.
Table showing target levels and frequency of necessary tests for diabetic patients
| Test Item | Frequency | Test Target |
| Pre-meal blood sugar level | Every 1-3 months | 80-120 mg/dL |
| Glycated hemoglobin HbA1c | Every 3 months | ≤ 7% |
| LDL cholesterol | At least once a year | < 100 mg/dL |
| Triglycerides | At least once a year | < 150 mg/dL |
| Urine albumin (Microalbumin) | At least once a year | No albumin detected |
| Creatinine | At least once a year | Normal range |
| Electrocardiogram (EKG) | At least once a year | Normal result |
| Retinal examination | At least once a year | Normal result |
| Blood pressure measurement | Every 1-3 months | < 130/80 mmHg |
| Foot examination | At least every 3-6 months | Normal result |
Glycated Hemoglobin (HbA1c)
Glycated hemoglobin is the amount of sugar bound to proteins in red blood cells. It reflects the average blood sugar level over the past 8-12 weeks before the test. It is a better indicator for evaluating diabetes control than blood sugar testing alone.
Urine Albumin
Early kidney damage does not cause symptoms. Laboratory urine tests can detect albumin or protein in the urine. Therefore, urine protein testing is very important for early detection of kidney abnormalities.
Creatinine
This blood test evaluates kidney function. The kidneys must be more than 70% damaged before the accumulation of toxins increases to a measurable level.
Retinal Examination
High blood sugar can cause damage to small blood vessels in the retina at the back of the eye, which may lead to blindness. Diabetic retinopathy can be treated with laser therapy. Early examination and treatment can prevent retinal damage.
Foot Examination
Diabetic patients may have nerve damage in their feet, which can cause them to be unaware of injuries. Additionally, blood vessels supplying the feet often become narrowed, reducing nutrients and oxygen to the area. Therefore, even minor injuries can become severe wounds that are difficult to heal. Without medical care, these wounds can become so severe that amputation is necessary.
LDL Cholesterol
Excess cholesterol accumulates in the walls of arteries throughout the body, such as in the brain and heart arteries, causing narrowing and leading to diseases like stroke, paralysis, and heart disease. LDL cholesterol is a major factor causing arterial hardening and narrowing. Higher LDL cholesterol levels increase the risk of heart disease.
