Tests to diagnose diabetes

The article was written by a doctor of Biochemistry, Laboratory Department - Vinmec Ha Long International Hospital

Diabetes (diabetes) is more and more common in Vietnam as well as in the world. Early detection of the disease condition, especially in the pre-diabetes stage, is extremely important. If timely adjustment of lifestyle and nutrition regimens and treatment can be prevented, disease progression can also be prevented. such as preventing dangerous complications caused by the disease.

Diagnosing diabetes is not difficult. In Vietnam, the Ministry of Health has issued specific guidance on diagnosis and treatment of diseases in Decision No. 3319/QD-BYT dated July 19, 2017 of the Minister of Health on the issuance of professional documents. "Guidelines for the diagnosis and treatment of type 2 diabetes". In it, the main tests used in the diagnosis of diabetes and pre-diabetes are the quantitative blood glucose and HbA1C tests, as follows:

Criteria for diagnosis of diabetes (according to the American Diabetes Association - ADA) is based on 1 of the following 4 criteria:
a) Fasting plasma glucose (FPG) ≥ 126 mg/dL ( ≥ 7 mmol/L)
In order to get the test results that best reflect the "fasting" glucose concentration, test takers should note that they must fast for at least 8 hours (including Do not drink soft drinks or water containing energy-providing ingredients, only filtered or cooled boiled water).
The best blood sample for testing is a blood sample taken in the morning on an empty stomach (usually fasting from the previous night's meal to the time of blood collection) and after resting (sleeping) overnight , or:
b) Plasma glucose at 2 hours after oral glucose tolerance test (OGTT) ≥ 200 mg/dL (or ≥ 11.1 mmol/L) Tolerance test Oral glucose must be taken according to the guidelines of the World Health Organization: Fasting for at least 8 hours before the test, using a quantity of glucose (75g) dissolved in 250-300ml of water, taken for 5 minutes; for the previous 3 days the patient ate a diet containing about 150-200 grams of carbohydrates per day.
c) HbA1c concentration ≥ 6.5% (≥ 48 mmol/mol)
This test must be performed in a laboratory standardized to international standards.
d) In patients with classic symptoms of hyperglycemia or plasma glucose levels at any time ≥ 200 mg/dL (or 11.1 mmol/L)
If no classic clinical symptoms of Hyperglycemia (including frequent urination, drinking, eating a lot, unexplained weight loss), the diagnostic tests in items a, b, d mentioned above should be repeated for a second time to confirm the diagnosis. guess. The time to perform the second test after the first one can be from 1 to 7 days.
In practice, it is recommended that a simple and effective method for the diagnosis of diabetes be performed quantitatively twice as fasting plasma glucose ≥ 126 mg/dL (or 7 mmol/L). If HbA1c is measured in an internationally standardized laboratory, double HbA1c can be used to diagnose diabetes.

Diagnosis of pre-diabetes when one of the following disorders is present:
a) Impaired fasting glucose (IFG):
Fasting plasma glucose concentration from 100 -125 mg/dL ( 5.6 - 6.9 mmol/L), or
b) Impaired glucose tolerance (IGT):
Plasma glucose concentration during oral glucose tolerance test (75g Glucose) at 2 hours after oral administration in the range 140-199 mg/dL (7 to 11mmol/L), or
c) HbA1C from 5.7 - 6.4 (39 -47 mmol/mol).
Vinmec International General Hospital offers a package of Diabetes Screening - Dyslipidemia for customers with signs of diabetes, type 2 diabetes for the purpose of diagnosing and screening diseases based on Quantitative blood tests, oral tolerance test (for customers with doubtful fasting blood sugar results)...... From there, the doctor will draw conclusions and give advice disease prevention as well as appropriate and scientific treatment for the patient.