Pre-diabetic - Several Screening Tests to Take

Diabetes or Pre diabetes or Normal - Screening Tests

If you belong to a group of people that have a higher than normal risk for developing diabetes you need to consult with a Diabetologist for screening. African Americans, Latinos, Native Americans and Asian Americans are groups that are at risk.

As one ages you are susceptible for developing pre diabetes as the groups above.

All of these blood glucose tests, mentioned below,determine whether you are normal, pre diabetic or diabetic.

One test is the A1C. If your percent value is less than 5.7% you are normal. If your percent value is equal to or greater than 5.7% but less than 6.5% you are pre diabetic. If the percent value is equal to or above 6.5% you are diabetic.

The second test is the fasting plasma glucose test (FPG.) Less than 100 mg/dl is normal. If it is equal to or greater than 100 mg/dl but below 126 mg/dl you are pre diabetic. If it is equal to or greater than 126 mg/dl you are diabetic.

The third test is the oral glucose tolerant test ( OGTT. ) If your blood glucose is less than 140 mg/dl you are normal. If greater than 140 mg/dl but less than 200 mg/dl you are pre diabetic. If you are equal to or greater than 20 mg/dl you are diabetic.

A Diabetologist can interpret these results, from your specific test results and history, to determine whether you are normal, pre diabetic or diabetic.  

Please check with the American Diabetes Association if a Diabetologist is not available in your area.

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Diabetic Foot Problem - Charcot Joint Disease

A Serious Diabetic Foot Problem

Charcot Joint Disease

Charcot Foot is the degeneration of a weight bearing joint in the foot. It is a process of bone destruction, bone resorption and eventual deformity.

If it is left unchecked it could lead to ulceration, superinfection, loss of function of the foot , possible amputation and death.

Diabetes mellitus neuropathy (the most common in the U.S. today, resulting in destruction of foot and ankle joints), with Charcot joints in 1/600-700 diabetics. The neuropathy is related to long-term poor glucose control.

One mechanism is the loss of peripheral sensations where you can't sense touching on the ankle surface. This can lead to minute further damage to the joint called microtrauma.

The damage to the ankle is unnoticed by a diabetic. This results in inflammatory resorption of traumatized bone that causes weakness in the effected weight-bearing joint that, in turn, makes the joint susceptible to further trauma. It is a vicious cycle.

It results, from the decline in fine motor control of the joint and unnatural pressure on some joints. This leads to more microtrauma. Desensitized nerves in the ankle joint cause an increase in the blood flow to the joint. This leads to hyperimia which leads to further resorption of bone tissue. The bone resorption along with mechanical stress will cause destruction of the ankle.

If untreated or unrecognized the final result may be amputation. In the serious states infection could set in and result in death.

Please continue to consult with a Diabetologist and ask questions if you suspect numbness in the foot and ankle could lead to complications.

Pituitary Gland and Diabetes Insipidus

Diabetes Insipidus

When the Pituitary Gland is involved there are three types of diabetes insipidus: 

Central Diabetes Insipidus a deficiency of the hormone ADH (Anti-Diuretic Hormone) in the Posterior Pituitary Gland. The urine is very dilute but without the sugar taste of the urine associated with diabetes mellitus.

Neurogenic Diabetes Insipidus is an insensitivity of the kidneys to ADH that controls excretion of body fluid. The urine is very diluted sense the inability of the hormone ADH to restrict water loss. Again, like in Central Diabetes Insipidus, no glucose is present in the urine.

Iatrogenic Diabetes Insipidus - an artifact of medical drug use that causes the kidneys to excrete large amounts of urine. There is no glucose in the urine.

Diabetes Insipidus is characterized by excessive thirst and the excretion of large amounts of severely diluted urine, that, with a reduction of fluid intake, that has no effect on the concentration of the urine. This means the patient needs to continually take fluids into their body to prevent dehydration from the fluid loss excreted from the body. You need reserve water if you are exposed to conditions where excess water is lost normally.

Diabetes Mellitus and Diabetes Insipidus are two entirely separate conditions with unrelated mechanisms. Both cause the production of large amounts of urine (Polyuria). Diabetes Mellitus causes polyuria by a process called osmotic diuresis due to high blood sugar leaking into the urine and  carrying excess water with it. 

Osmosis is the process where water moves through a selectively permeable membrane from an area of low solute concentration to an area of high solute concentration. When leakage of blood glucose from the blood capillaries into the tubular ducts takes place it increases the solute concentration in the tube above that in the blood capillaries. Water, therefore, flows into the tubule by osmosis. Since this causes diuresis excretion from the kidneys along with the sugar the taste of urine in diabetes mellitus is sweet to the taste.