Diabetes: Navigating Family History and Health Concerns

Q: Diabetes: Navigating Family History and Health Concerns

Hello： I would like to respond as follows：<br>1. <br>According to the "Physical Classification Standards" published by the Ministry of National Defense on December 31, 2007, individuals diagnosed with diabetes are classified as unfit for military service. <br>However, this diagno

Diabetes mellitus?

Hello doctor, my family has a history of hereditary diabetes, and I had protein in my urine when I was younger.
I visited various doctors until one time when I tested negative for protein in my urine and thought I was cured, so I stopped paying attention.
During a health check in college, I was found to have protein in my urine again, and a private testing facility confirmed the same.
Now that I have graduated from college and underwent a military service physical examination, I was found to have glucose in my urine, but the military examination facility stated that while I have glucose in my urine, my blood sugar levels are normal, so I am considered fit for service.
I would like to know whether I truly have diabetes or not, and what I should do about it...
The military facility does not take my concerns seriously when I explain my situation.

Guagua, 20~29 year old female. Ask Date: 2008/08/03

Dr. Xiao Yongxun reply Internal Medicine

Hello: I would like to respond as follows:
1.
According to the "Physical Classification Standards" published by the Ministry of National Defense on December 31, 2007, individuals diagnosed with diabetes are classified as unfit for military service.
However, this diagnosis must be made by an endocrinologist, who will issue a diagnostic certificate.
Similarly, the diagnosis of nephritis related to proteinuria also requires evaluation and certification by a nephrologist, including the rationale for the diagnosis.
If necessary, tests on urine, blood, and pathological samples may be required.
(Note: This is in accordance with the Ministry of the Interior's Order No.
0960830450, which has been amended and published.)
2.
From a theoretical perspective, there are many causes of proteinuria, including nephritis, infections, drug-induced conditions, and normal variations, thus further differential diagnosis is necessary.
The diagnosis of diabetes is primarily based on blood glucose levels; urine glucose tests can only serve as a reference, as there are numerous factors that can affect urine glucose levels, and it should not be used as a diagnostic criterion.
3.
It is advisable for you to discuss this matter with your family physician or directly consult a relevant specialist for diagnosis.

Reply Date: 2008/08/03

More Info

Understanding diabetes, particularly in the context of family history and personal health concerns, is crucial for managing your risk and maintaining overall well-being. Given your family history of diabetes and your own experiences with protein and sugar in your urine, it’s understandable to feel anxious about your health status.

Firstly, diabetes, particularly Type 2 diabetes, has a significant genetic component. If you have family members, such as parents or siblings, who have diabetes, your risk of developing the condition is indeed higher. Studies suggest that if one parent has Type 2 diabetes, the risk for their children is about 20%, and if both parents are affected, the risk can rise to 40-50%. However, genetics is only one piece of the puzzle. Lifestyle factors such as diet, physical activity, weight, and overall health also play a critical role in the development of diabetes.

Your history of protein in your urine (proteinuria) is a concern, as it can be an early sign of kidney issues, which are often associated with diabetes. The presence of sugar in your urine (glycosuria) typically indicates that your blood sugar levels are elevated, but it can also occur when your blood sugar is within normal limits, especially if your kidneys are excreting excess glucose. The fact that your blood sugar levels have been normal is reassuring, but it does not completely rule out the possibility of developing diabetes in the future, especially given your family history.

It’s essential to monitor your health closely. Regular check-ups with your healthcare provider can help track your kidney function and blood sugar levels. If you have concerns about your urine tests, it would be wise to discuss these with a healthcare professional who can provide a more comprehensive evaluation and possibly recommend further testing, such as a fasting blood glucose test or an HbA1c test, which measures your average blood sugar levels over the past two to three months.

In terms of lifestyle changes, adopting a healthy diet and regular exercise can significantly reduce your risk of developing diabetes. Focus on a balanced diet rich in whole grains, fruits, vegetables, lean proteins, and healthy fats. Limiting processed foods, sugars, and saturated fats is also beneficial. Aim for at least 150 minutes of moderate-intensity aerobic activity each week, such as brisk walking, cycling, or swimming.

It’s also crucial to manage stress and ensure you get adequate sleep, as both can impact your overall health and blood sugar levels. If you find yourself feeling anxious about your health, consider speaking with a mental health professional who can help you navigate these feelings.

Lastly, if you feel that your concerns are not being taken seriously by the military health facility, it may be beneficial to seek a second opinion or consult with a specialist, such as an endocrinologist or a nephrologist, who can provide more targeted advice regarding your kidney health and diabetes risk.

In summary, while your current blood sugar levels are normal, your family history and previous health concerns warrant ongoing vigilance. Regular monitoring, lifestyle modifications, and open communication with healthcare providers are key steps in managing your health and reducing your risk of diabetes.

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