Diabetes: Key Symptoms, HbA1c, and Future Treatments

Q: Diabetes: Key Symptoms, HbA1c, and Future Treatments

Hello, in response to your questions： <br>1. <br>The normal fasting plasma glucose level for healthy individuals ranges from 70 to 110 mg/dL, while the postprandial glucose level two hours after a meal should be between 80 and 140 mg/dL. <br>Clinically, one of the criteria for di

The three polys of diabetes refer to polyuria (excessive urination), polydipsia (excessive thirst), and polyphagia (excessive hunger). Glycated hemoglobin, also known as HbA1c, is a form of hemoglobin that is chemically linked to glucose. It is used as a marker to

Hello Dr.
Hsiao, I have a few questions to ask you.
Could you please clarify the standards for polyuria, polydipsia, and polyphagia? Are there specific numerical values for these conditions? What is glycated hemoglobin (HbA1c), and can I purchase a device to measure it myself? If blood sugar levels fluctuate between normal and abnormal, is it more accurate to test blood sugar or glycated hemoglobin? How many hours should I fast before testing blood sugar? Can future biochemical technologies help treat diabetes? If so, which countries are leading in this area? What would the costs be? If possible, could you please inform me via email? I am very grateful, but I still want to thank you.
Wishing you all the best! ^.^

Xiao Lin, 30~39 year old female. Ask Date: 2005/05/06

Dr. Xiao Yongxun reply Internal Medicine

Hello, in response to your questions:
1.
The normal fasting plasma glucose level for healthy individuals ranges from 70 to 110 mg/dL, while the postprandial glucose level two hours after a meal should be between 80 and 140 mg/dL.
Clinically, one of the criteria for diagnosing diabetes is a fasting plasma glucose level of 126 mg/dL or higher after fasting for eight hours or more.
Another diagnostic criterion includes the presence of symptoms such as polydipsia, polyuria, polyphagia, and weight loss, along with a random plasma glucose level of 200 mg/dL or higher.
2.
This addresses two questions.
First, fasting blood glucose generally refers to a period of fasting for eight hours or more.
Second, polydipsia and polyuria refer to symptoms; clinically, there are no specific numerical values.
Instead, it is assessed based on individual and observational reports, noting whether these symptoms are more severe or pronounced than usual.
3.
Glycated hemoglobin refers to the binding of glucose to hemoglobin in red blood cells, resulting in what is known as glycation, termed glycated hemoglobin (HbA1c).
For most diabetic patients, we aim for an HbA1c level of below 7%, and ideally below 6.5%.
Clinically, HbA1c is not used as a diagnostic standard for diabetes; furthermore, due to the challenges in testing techniques and quality control, there is currently no widespread use or promotion of devices similar to "blood glucose meters."
4.
Future biochemical technologies may hold the key to diabetes treatment, but at present, aside from a few medical centers that offer pancreas or islet cell transplants, there are no viable biochemical or gene therapies that can cure diabetes.

Reply Date: 2005/05/06

More Info

Understanding diabetes is crucial for managing the condition effectively, especially given its prevalence and potential complications. Diabetes is characterized by elevated blood sugar levels, which can lead to a variety of symptoms and long-term health issues.

Key Symptoms of Diabetes
The classic symptoms of diabetes, often referred to as the "three P's," include:
1. Polyuria (Frequent Urination): This occurs when excess glucose in the blood spills over into the urine, leading to increased urination. A common threshold for glucose in urine is around 180 mg/dL, which is when the kidneys can no longer reabsorb glucose effectively.

2. Polydipsia (Increased Thirst): Due to the loss of fluids from frequent urination, individuals often feel dehydrated and experience increased thirst.

3. Polyphagia (Increased Hunger): Despite eating more, individuals may feel hungry because their bodies cannot utilize glucose effectively due to insulin deficiency or resistance.

Understanding HbA1c
Glycated Hemoglobin (HbA1c) is a blood test that reflects average blood glucose levels over the past two to three months. It is expressed as a percentage, with higher percentages indicating poorer blood sugar control. The American Diabetes Association recommends an HbA1c target of less than 7% for most adults with diabetes, although individual targets may vary based on personal health conditions.

Blood Sugar Testing
When it comes to monitoring blood sugar levels, both fasting blood glucose and HbA1c tests are important. Fasting blood glucose should be measured after at least 8 hours of fasting, and normal levels are generally below 100 mg/dL. For those with diabetes, fasting levels can be higher, and consistent monitoring is essential.

Self-monitoring blood glucose can be done using home glucose meters, which provide immediate results. However, HbA1c testing is typically performed in a clinical setting, although some home testing kits are available. HbA1c is generally considered more reliable for long-term monitoring, while daily blood glucose tests can help manage day-to-day fluctuations.

Future Treatments and Technologies
The future of diabetes management is promising, with advancements in biotechnology and pharmacology. Research is ongoing in areas such as:
- Continuous Glucose Monitoring (CGM): Devices that provide real-time glucose readings, helping patients manage their levels more effectively.

- Artificial Pancreas Systems: These systems automate insulin delivery based on glucose readings, reducing the burden of constant monitoring.

- Gene Therapy: Research is exploring the potential of gene editing to correct the underlying causes of diabetes.

- New Medications: Innovations in drug development, such as GLP-1 receptor agonists and SGLT2 inhibitors, provide additional options for managing blood sugar levels.

Countries like the United States, Germany, and Japan are at the forefront of diabetes research and treatment innovations. The costs of these treatments can vary widely based on the technology and healthcare system, but many new therapies are becoming more accessible.

Conclusion
In summary, understanding the symptoms of diabetes, the significance of HbA1c, and the advancements in treatment options are vital for effective management of the condition. Regular monitoring, lifestyle changes, and staying informed about new technologies can significantly improve outcomes for individuals with diabetes. If you have further questions or need personalized advice, consulting with a healthcare professional is always recommended.

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