Diabetes: Key Questions About Diagnosis and Management - Internal Medicine

Dr. Xiao Yongxun reply Internal Medicine

---

Dear Miss Wang Su-Chen:
1.
According to the diagnostic criteria for diabetes set by the American Diabetes Association, a.
a fasting plasma glucose level ≥126 mg/dL after fasting for more than 8 hours, b.
a 2-hour plasma glucose level ≥200 mg/dL during an oral glucose tolerance test, c.
an HbA1c ≥6.5% (with no disproportionate hyperglycemia and using a testing method that meets the international certification standards of NGSP and DCCT), any of the above a, b, or c must be confirmed by two separate tests.
d.
If there are clinical symptoms of diabetes (such as polyuria, polydipsia, polyphagia, and weight loss), a single plasma glucose level ≥200 mg/dL is sufficient for diagnosis.
Therefore, based on the information you provided, it is possible that your son may be diagnosed with diabetes.
Of course, the attending physician will make a definitive diagnosis based on other clinical presentations and physical examinations.
2.
The prevention or management of diabetes primarily involves dietary control and regular exercise; medication is only necessary when required.
Dietary control includes eating until 80% full, avoiding eating too quickly or overeating, and steering clear of high-sugar, high-fat, and high-calorie foods or beverages, as well as instant coffee mixes, cakes, and fried foods.
Dinner should not be too heavy, and moderate activity should be undertaken after meals before going to bed.
Regular exercise is equally important, with a recommendation of at least three times a week for about an hour each session; otherwise, at a minimum, one should take a walk after meals and avoid sitting down to work immediately.
Additionally, ensuring adequate sleep and reducing life stress can also help in blood sugar control.
However, the importance of medication should not be overlooked.
Particularly when blood sugar levels are very high or poorly controlled, relying solely on dietary control and regular exercise is unlikely to yield ideal results; medication will then be necessary to prevent complications such as hyperglycemic ketoacidosis or hyperglycemic hyperosmolar state, which can lead to severe acute complications and pose a risk to life.
Therefore, diet, exercise, and medication remain the primary methods for diabetes management.
3.
Risk factors for developing diabetes include a family history of diabetes, obesity, hypertension, dyslipidemia, lack of exercise, overeating, alcohol abuse, use of certain medications, poor lifestyle choices, and excessive stress.
Moderating diet and engaging in regular exercise can indeed effectively lower blood sugar levels; in some cases, individuals may even restore normal blood sugar levels.
However, practical challenges often arise.
For instance, a family history of diabetes cannot be changed.
Weight loss is difficult and often hard to maintain.
Long-standing habits of eating too quickly, overeating, or excessive drinking in adulthood are also challenging to correct.
The modern sedentary work lifestyle is difficult to change.
While regular exercise may be feasible in the short term, maintaining a good exercise habit for a lifetime is not so easy.
On the other hand, the development of type 2 diabetes does not occur overnight; it often develops gradually over time.
Once symptoms appear, it usually indicates that there are issues with insulin secretion or insulin receptor sensitivity in the body; in other words, maintaining stable blood sugar levels becomes challenging.
Therefore, dietary moderation and regular exercise can potentially restore normalcy; however, long-term medication management is often safer.
4.
Please ensure that your son discusses his condition and challenges thoroughly with his attending physician to collaboratively make informed decisions, as this is the best approach to finding solutions.

---

Reply Date: 2017/08/01