Diabetes Mellitus - Diagnosis To Management

A fasting plasma glucose level of 6.8mmol/L and a two-hour postprandial plasma glucose level of 11.6mmol/L indicate elevated blood sugar levels. According to the diagnostic criteria, a fasting plasma glucose level of 7.0mmol/L or higher and a two-hour postprandial plasma glucose level of 11.1mmol/L or higher are indicative of diabetes. Therefore, based on the given values, this person should be suspected of having diabetes.

Yes, there are laboratory tests available to distinguish between Type 1 and Type 2 diabetes. These tests include measuring the levels of insulin and C-peptide in the blood. In Type 1 diabetes, there is a lack of insulin production, so the levels of insulin and C-peptide are usually low. On the other hand, in Type 2 diabetes, there may be normal or high levels of insulin initially, but over time, insulin resistance develops. These tests can help healthcare providers determine the type of diabetes a person has and guide appropriate treatment decisions.

The onset of new diabetes can be prevented or delayed through various lifestyle modifications and interventions. These may include maintaining a healthy weight, engaging in regular physical activity, adopting a balanced and nutritious diet, avoiding tobacco and excessive alcohol consumption, and managing stress levels effectively. Additionally, individuals at high risk for developing diabetes can benefit from participating in diabetes prevention programs that focus on education, behavior change, and support. By implementing these measures, the progression towards diabetes can be slowed down or even prevented altogether.

The statement is true because the glycosylated hemoglobin value, also known as HbA1c, is a measure of a person's average blood sugar levels over the past 2-3 months. It is commonly used to assess the effectiveness of diabetes management and to make decisions about treatment options, including the need for insulin therapy. A higher HbA1c value indicates poorer blood sugar control and may indicate the need for additional interventions, such as insulin, to achieve target blood sugar levels.

According to the World Health Organisation guidelines, a fasting plasma glucose level between 6.1 and 6.9mmol/L is considered impaired fasting glucose, and a two-hour postprandial plasma glucose level between 7.8 and 11.0mmol/L is considered impaired glucose tolerance. Since the woman's values are below these thresholds, they are considered normal according to the World Health Organisation guidelines.

A person with impaired glucose tolerance has an increased risk of developing diabetes because their blood glucose levels are higher than normal but not high enough to be classified as diabetes. This condition indicates that the person's body is not effectively using insulin to regulate blood sugar levels, which can lead to the development of diabetes over time. Additionally, impaired glucose tolerance is also associated with an increased cardiovascular risk. High blood sugar levels can damage blood vessels and increase the risk of heart disease and other cardiovascular complications. Therefore, both diabetes and cardiovascular risk are significant concerns for a person with impaired glucose tolerance.

The correct answer is "Insulin should be given IV until the acidotic state is controlled." Diabetic ketoacidosis is a life-threatening complication of diabetes characterized by high blood sugar levels and the presence of ketones in the blood. Insulin is used to lower blood sugar levels and correct the acidotic state. Once the acidotic state is controlled, insulin therapy can be adjusted accordingly. Normalizing blood sugar levels and ensuring proper hydration are important aspects of treatment, but the primary goal is to control the acidotic state.

Patients with Type 2 diabetes should be initiated on basal insulin alone because basal insulin provides a steady release of insulin throughout the day and helps control fasting blood glucose levels. Prandial insulin, on the other hand, is used to control post-meal blood glucose spikes. Since patients with Type 2 diabetes typically have insulin resistance and may still produce some insulin on their own, initiating them on basal insulin alone is a more appropriate approach. Prandial insulin may be added later if needed to further control blood glucose levels.

Insulatard insulin is a long-acting insulin that provides a steady release of insulin over a longer period of time. It does not cause a rapid drop in blood sugar levels, making it safe to be taken at bedtime without the need for a bedtime snack. On the other hand, Mixtard insulin is a combination of short-acting and long-acting insulin. The short-acting component of Mixtard insulin may cause a rapid drop in blood sugar levels, making it important to have a bedtime snack to prevent hypoglycemia. Therefore, the statement that is true is "Insulatard insulin can be given at bedtime without the need for a bedtime snack."

When initiating insulin in a Type 2 diabetic who is already on Metformin and Glibenclamide, Glibenclamide must be stopped or the dose reduced. This is because Glibenclamide belongs to a class of medications called sulfonylureas, which stimulate the pancreas to produce more insulin. When insulin therapy is initiated, there is a risk of hypoglycemia (low blood sugar) if both Glibenclamide and insulin are taken together. Therefore, it is necessary to either stop Glibenclamide or reduce its dose to prevent hypoglycemia.

The question does not provide any reference range or criteria to determine whether a plasma glucose level of 8mmol/L is normal or not. Without additional information, it is not possible to determine if the value falls within the normal range or if it indicates any abnormality.

Metformin must be stopped before the procedure because it can potentially cause a rare but serious condition called lactic acidosis, especially in patients with kidney problems. This condition can be exacerbated by the contrast dye used during the angiogram. Therefore, it is safer to discontinue Metformin temporarily and control blood sugar levels with other methods, such as insulin, during the procedure. Glibenclamide, on the other hand, does not pose the same risk and can be continued.

The best method of controlling blood sugar in a diabetic who cannot take orally is by giving insulin intravenously along with dextrose and potassium. Intravenous administration allows for precise control and immediate effect on blood sugar levels. Dextrose is given to prevent hypoglycemia, as insulin can lower blood sugar too much. Potassium is given to maintain electrolyte balance and prevent imbalances caused by insulin therapy. This method ensures that the diabetic patient receives the necessary insulin and glucose to regulate their blood sugar levels effectively.