Diabetes - Indications, Procedure, Risk Factors

According to the classification of the Polish Diabetes Association, diabetes is a group of metabolic disorders characterized by hyperglycemia, i.e., high blood glucose levels (according to the Author). This situation results from a deficiency in the secretion and/or action of insulin. Chronic hyperglycemia can lead to damage, impairment of functioning, and failure of various organs, such as the eyes, kidneys, nerves, heart, and blood vessels. Insulin is a hormone involved in the regulation of blood glucose levels - its presence allows cells to take up glucose and reduces the amount of glucose circulating in the blood. Insulin is produced in the pancreas and is released in response to an increase in blood glucose levels, e.g., as a result of digestion after a meal. The medical specialty concerned with the problem of diabetes is diabetology, and doctors specializing in the treatment of diabetes are diabetologists, while those suffering from diabetes are diabetics.

There are several types of diabetes that differ in their causes, course, or treatment methods. The most commonly diagnosed are: – Type 1 diabetes, an autoimmune disease in which the immune system attacks and destroys the insulin-producing beta cells in the pancreas, leading to an absolute deficiency of insulin. It is usually diagnosed early in life, in childhood, adolescence, or young adulthood (under 30 years of age). – Type 2 diabetes, which is associated with a gradual decline in the ability of beta cells to produce insulin, as well as insulin resistance, a condition in which the body does not respond properly to insulin, leading to an increase in blood sugar levels. It accounts for 80–90% of all diabetes cases and primarily affects adults, although it is increasingly being diagnosed in children and adolescents. – Gestational diabetes or diabetes during pregnancy, which is a complication of pregnancy that significantly affects the functioning of the body. Pregnant women between the 24th and 28th week of pregnancy are sent for an oral glucose tolerance test, which enables the diagnosis of gestational diabetes. In some cases, another type of diabetes is diagnosed during pregnancy for the first time – in this case, it is referred to as diabetes during pregnancy. – Other types of diabetes caused by genetic disorders, the use of certain medications, or the occurrence of other diseases (e.g., cystic fibrosis) or infections.

Diabetes mellitus (especially type 2) is a disease that can develop over many years. Its symptoms can therefore also get worse over time or appear suddenly, with great intensity. What are the warning signs that may indicate the occurrence of the disease? The most common are: - significantly increased thirst - patients can consume up to several liters of fluids per day, - constant and increased urination - can be related to high fluid intake, but also to kidney disorders caused by the presence of glucose in the blood, - even unintentional weight loss - increased appetite - weakness and feeling of fatigue, especially after meals.

Not all individuals with diabetes exhibit symptoms, which may only manifest at a later stage of the disease. Consequently, based on the analysis of available information, so-called predisposing factors have been identified – situations in which the risk of developing the disease is increased. Those affected by these factors should undergo diagnostic tests for diabetes systematically (annually) – even in the absence of visible symptoms.

If diabetes is suspected, it is best to consult with a general practitioner in a POZ facility. During the visit, the doctor can decide on the next steps and perform diagnostic tests, which may include: – measurement of blood glucose level at any time of the day, which does not require prior preparation; a value of ≥ 200 mg/dl (11,1 mmol/l) and the presence of symptoms can confirm the diagnosis of diabetes, – measurement of fasting blood glucose level, which is measured in the morning after about 8–14 hours without food or fluid intake; obtaining a value of ≥ 126 mg/dl (≥ 7,0 mmol/l) twice can confirm the diagnosis of diabetes, – determination of the HbA1c level, which allows for the determination of the average blood glucose level over the past 3 months; the value is expressed as a percentage and values of ≥ 6,5% (48 mmol/mol) can confirm the diagnosis of diabetes, – performing an oral glucose tolerance test (OGTT), which requires taking blood on an empty stomach, drinking a solution of 75g glucose within 5 minutes, and taking blood after 1 and 2 hours; a value of ≥ 200 mg/dl (11,1 mmol/l) after 2 hours can confirm the diagnosis of diabetes. All diagnostic tests must be performed with venous blood. It is also important not to interpret the results on your own and not to take any therapeutic measures without consulting a physician.