• Who is at Risk for diabetes Type 2?
• Reasons to screen for diabetes
• How do I prepare for diabetes screening?

First, know there are two main types of diabetes, Type 1 and Type 2, although the focus of this blog will be on Type 2.

Individuals with diabetes Type 1 are generally diagnosed between the ages of four to 14 years however, the cut off is anyone who us unable to produce insulin under the age of 40 years. Insulin is a hormone that acts like a key opening the door for sugar molecules to pass from the blood vessels into cells providing energy. In diabetes Type 1 there is no key so the blood sugar level can become very high.

Individuals with diabetes Type 2 are normally diagnosed over 35 years of age. These individuals have difficulty getting sugar into the cell due to one or a combination of two factors: 1) the door of the cell won’t open even with the correct key (known as insulin resistance); 2) there is not enough insulin produced (not enough keys). Due to these factors the blood sugar level can fluctuate becoming increasing high if left untreated.
 

Who is at Risk for diabetes Type 2?

Globally it is estimated that 425 million individuals are affected by diabetes. Knowing the risk factors, participating in screening, prevention or early detection, and treatment activities are the critical things everyone can do to maintain health. In individuals diagnosed with high blood pressure and/or high cholesterol diabetes should always be screened for. Common risk factors include:
 

• Obesity, where the body mass index is greater than 25kg/m2
• Storing fat on the abdomen
• A family history of type 2 diabetes i.e. parent or sibling
• A history of gestational diabetes (diabetes during pregnancy)
• Women with a history of Polycystic Ovarian Syndrome (PCOS)
• Increasing age (where screening may be recommended as early as 35 years)
• Prediabetes
• Infrequent exercise or regular activity

 
When blood sugar levels are consistently high, individuals who are unaware that they have diabetes or who are pre-diabetic will experience symptoms such as frequent urination, being thirsty, poor wound healing, blurred vision and recurrent infections. However, many individuals do not realize they have elevated blood sugar levels. What makes diabetes such a dangerous disease is the long term complications associated with poor blood sugar level control.


The sugar molecule can be considered relatively large in the blood stream and when the level is too high these molecules cause damage to specific areas of the body:
 

• Small blood vessels located on the back of the eyes, which can result in retinopathy, cataracts and glaucoma
• Small blood vessels located in the kidneys, which results in nephropathy
• Nerves located in the feet and potentially leading to numbness or pain, which results in neuropathy. Foot care is very important as healing is impaired and an unnoticed injury may become seriously infected.
• Narrowing of arteries that carry blood to the feet thereby reducing the blood flow, which can result in peripheral arterial disease (PAD)
• Heart disease and stroke are also associated with diabetes especially when in conjunction with high blood pressure.

 
Therefore, screening for diabetes is necessary to encourage healthy lifestyle behaviors that will prevent diabetes from developing or detect elevated sugar levels early and begin treatment so long term complications do not occur.


Translating blood glucose results into how diabetes is diagnosed:
 

	Normal	Prediabetes		Diabetes
		Impaired Fasting Glucose	Impaired Glucose Tolerance Test
Fasting blood sugar levels	< 100 mg/dl	100 - 125 mg/dl		>= 126 mg/dl
Blood sugar levels after drinking 75 g of glucose	< 140 mg/dl		140 - 199 mg/dl	>= 200 mg/dl
Blood sugar levels at any time regardless of symptoms				>= 200 mg/dl
HbA1C (result of blood sugar level over last three months)	<5.7%	5.7 – 6.4%		>= 6.5%

 

Reasons to screen for diabetes

1. Prevention is better than cure
2. Type 2 diabetes is a disease that may be prevented or at least delayed in some people
3. Normalizing blood sugar levels early will prevent the complications associated with diabetes

 

How do I prepare for diabetes screening with Bumrungrad?

1. Schedule an appointment by calling 1378 (within Thailand)
2. No food and beverages for 12 hours (can drink water as usual)
3. No alcoholic beverages of any kind for at least 24 hours
4. Continue to take medication for high blood pressure if prescribed
5. Please come 2 hours before your appointment to take a blood test