How do you diagnose diabetes?

Peeps Mcarthur · Jan 20, 2004

Look up diabetes insipidus AND diabetes mellitis.

The patient that presents with insulin deficiency is mellitus.

Good direction to go in but useless to you without the bookwork.

BadBird, BSN, RN · Jan 20, 2004

In one word, Yes, she is diabetic, type 2, many type 2 diabetics don't have all the symptoms you mentioned. Organ damage can occur with blood sugars over 200 so the nonchalant attitude is only hurting her. As far as a diet goes, the doctor is probably speaking of a diet low in carbs since they convert to simple sugar and raise the blood glucose. Sounds like you and your friend could benefit from some diabetic teaching. Is there a educator at the hospital? There are many wonderful organizations on the web too. I myself am a type 2 diabetic, no symptoms at all, it was found on a routine exam. I take glucophage and watch my carbs and my glucose is well controlled. I wish your friend luck. She may want to change doctors if hers isn't supportive or giving good information.

BarbPick · Jan 20, 2004

Originally posted by Peeps Mcarthur
Look up diabetes insipidus AND diabetes mellitis.

The patient that presents with insulin deficiency is mellitus.

Good direction to go in but useless to you without the bookwork.

A fasting blood glucose > 110 is called glucose intolerant.

Greater than 140 on 3 fasting blood glucose lab tests Is clinically diabetes.

Guess the 350's to 500something qualifies.

The reason she is not thirsty is she has been gloucose Intolerant /Diabetic for a very long time and has tolerated it till right now.

Peeps Mcarthur · Jan 21, 2004

By Barbpick

The reason she is not thirsty is she has been gloucose Intolerant /Diabetic for a very long time and has tolerated it till right now.

The reason she is not thirsty is because her plasma is not hyperosmolar. Thirst, or lack therof, is a measure of compartmental fluid balance. If she lost her thirst mechanism by ignoring it she would die from dehydration 2nd to apathy:chuckle

I think the original poster was confusing two general types of diabetes.

Thirst is a halmark sign of diseases that have an etiology of an edocrine nature such as..........................ah heck, crack a book will ya.

Dave ARNP · Jan 21, 2004

Not making a dx's but I would go with DM type II. Start with an oral, but strongly consider Lantus.

Dave

Big Bab's · Jan 21, 2004

I see patients like your friend in the office all the time...Some of them NEVER have symptoms......Your friend definitly needs some meds for this!!......Don't let him/her wait too long to get started, its not worth the consequences!

karenG · Jan 21, 2004

the WHO have laid down (in stone it would seem!) diagnosis criteria for diabeties............ not going to put it here- you seem to talk different blood ranges to me so dont think it would make any sense!! But it is not uncommon to have diabeties and be asymtomatic.

Karen

marilynmom, LPN, NP · Jan 21, 2004

Both my parents are diabetic. My dad is type 1 and my mother is type 2, neither had *any* symptoms.

M

passing thru · Jan 22, 2004

Hi y'all, thanks for the information.

I was talking about diabetes mellitus, not insipidus.

Without cracking a book, (I'm too apathetic-tired-etc),

but, as well as I recall,

the 3 classic symptoms of diabetes mellitus are:

1.) a very thirsty person - pt.'s frequently comment- "I drink GALLONS of water a day" (My own brother made this comment to me and .....no light bulb clicked on... )

2.) excessive voiding

3.) weight loss

So, I was really stumped when my co-worker described her 300-500 blood glucose ranges and no symptoms at all !

She had a 325 fingerstick the day she told me all this.

I will keep you all tuned in to what she tells me the doctor said.

I haven't worked around a newly diagnosed diabetic in quite a while, I think I do need a "refresher."

We used to always use the glucose tolerance test GTT as the test to positively diagnose a diabetic.

Is this test still the standard for diagnosis??

Thanks for the info about glucose intolerance... that is very interesting. I couldn't figure out why she is asymptomatic.

southern rn · Jan 22, 2004

the above range of fasting sugar greater than 140 times 3 is one way i have seen. also a hgbaic which is a quantitative measure of blood glucoses over a 3 month period, helpful if diabetes is just suspected, like with one or two abnormal sugars. also used to measure true diabetics glucose control. i don't think your friend needs either one though with a sugar in the 300's she is definately diabetic!sometimes just a well followed diet and an oral agent will be enough, but she will have to be very careful and vigilant about her self management. a diabetic info class would definately be a big help. good luck to her.

Dave ARNP · Jan 22, 2004

A HBA1c would be the "Gold Seal" IMHO.

As far as having sx'. My mother kept a bs in the 300's-500's and NEVER knew it.

Dave