Diabetes and hypertension, how are they diagnosed? Internal Medicine Specialist Ahn Ji-hyun

Diabetes and hypertension, how are they diagnosed? Internal Medicine Specialist Ahn Ji-hyun

Dec 17, 2024Ehotyshamull Joy

 

1. Classification of diabetes
What are the different types of diabetes?

Diabetes is broadly categorized into type 1 diabetes, type 2 diabetes, gestational diabetes, and other diabetes. Diabetes as we know it in general is type 2 diabetes. Type 1 diabetes is diabetes in which beta cells in the pancreas are destroyed in childhood, preventing them from producing insulin. Gestational diabetes is diabetes in which blood sugar rises due to substances secreted by the placenta during pregnancy. And other diabetes, unlike the previous diabetes, is caused by the rest of the causes.


There are many other causes of diabetesFirst, the surgery has caused a significant portion of the pancreas to be lost. Among the celebrities are comedian Bae Yeon-jung and Apple CEO Steve Jobs, who had pancreas resections. The pancreas helps us digest fatty foods, but its main role is to produce a hormone called insulin. Insulin is like gasoline in a car, allowing glucose in the blood vessels to enter the cells. But if you have surgery on the pancreas, you won't be able to produce enough insulin. Since glucose cannot be put into the cells, a lot of blood sugar remains in the blood vessels, leading to diabetes.


The second is when steroid drugs were used. Steroid injections and medications can also raise blood sugar and lead to diabetes.


Other chromosomal and genetic disorders that can raise blood sugar are also classified as other causes of diabetes.

 

2. Diagnostic criteria of diabetes
What are the criteria for diagnosing diabetes?

There are four diagnostic criteria for diabetes. First, the glycated hemoglobin (HbA1c)* level is greater than or equal to 6.5%. Second, plasma glucose after 8 hours of fasting is greater than or equal to 126 mg/dL. Third, after 2 hours of oral glucose load test, plasma glucose is more than 200 mg/dL. Fourth, in addition to the typical symptoms of diabetes (polyuria, polyphagia, weight loss), plasma glucose measured regardless of diet is more than 200 mg/dL. If only one of these is true, you will be diagnosed with diabetes.

*Glycosylated haemoglobin: A test performed by measuring the concentration of glycated A1c type haemoglobin by evaluating the average value of blood sugar over the past 2~3 months.


The name of diabetes means that sugar is present in the urine, but urine tests are not part of the diagnostic criteria for diabetes. This is because the glycemic threshold for sugar in the urine is quite high, which can be diagnosed too late, and it is difficult to distinguish it from cases where the blood sugar is not high but the sugar is only excreted in the urine.


As testing methods evolve, diagnostic criteria for diabetes may be added or changed. For example, in the past, the diagnosis of diabetes was based on a fasting blood glucose of 140 mg/dL or higher, which over time was strictly changed to a fasting blood sugar of 126 mg/dL or higher. A new glycated haemoglobin level criterion has also been added.

 

3. Diabetes FAQs: Frequently Asked Questions
I'm curious about diabetes!

1. Classification of diabetes
What are the different types of diabetes?

Diabetes is broadly categorized into type 1 diabetes, type 2 diabetes, gestational diabetes, and other diabetes. Diabetes as we know it in general is type 2 diabetes. Type 1 diabetes is diabetes in which beta cells in the pancreas are destroyed in childhood, preventing them from producing insulin. Gestational diabetes is diabetes in which blood sugar rises due to substances secreted by the placenta during pregnancy. And other diabetes, unlike the previous diabetes, is caused by the rest of the causes.


There are many other causes of diabetesFirst, the surgery has caused a significant portion of the pancreas to be lost. Among the celebrities are comedian Bae Yeon-jung and Apple CEO Steve Jobs, who had pancreas resections. The pancreas helps us digest fatty foods, but its main role is to produce a hormone called insulin. Insulin is like gasoline in a car, allowing glucose in the blood vessels to enter the cells. But if you have surgery on the pancreas, you won't be able to produce enough insulin. Since glucose cannot be put into the cells, a lot of blood sugar remains in the blood vessels, leading to diabetes.


The second is when steroid drugs were used. Steroid injections and medications can also raise blood sugar and lead to diabetes.


Other chromosomal and genetic disorders that can raise blood sugar are also classified as other causes of diabetes.


2. Diagnostic criteria of diabetes
What are the criteria for diagnosing diabetes?

There are four diagnostic criteria for diabetes. First, the glycated hemoglobin (HbA1c)* level is greater than or equal to 6.5%. Second, plasma glucose after 8 hours of fasting is greater than or equal to 126 mg/dL. Third, after 2 hours of oral glucose load test, plasma glucose is more than 200 mg/dL. Fourth, in addition to the typical symptoms of diabetes (polyuria, polyphagia, weight loss), plasma glucose measured regardless of diet is more than 200 mg/dL. If only one of these is true, you will be diagnosed with diabetes.

*Glycosylated haemoglobin: A test performed by measuring the concentration of glycated A1c type haemoglobin by evaluating the average value of blood sugar over the past 2~3 months.


The name of diabetes means that sugar is present in the urine, but urine tests are not part of the diagnostic criteria for diabetes. This is because the glycemic threshold for sugar in the urine is quite high, which can be diagnosed too late, and it is difficult to distinguish it from cases where the blood sugar is not high but the sugar is only excreted in the urine.


As testing methods evolve, diagnostic criteria for diabetes may be added or changed. For example, in the past, the diagnosis of diabetes was based on a fasting blood glucose of 140 mg/dL or higher, which over time was strictly changed to a fasting blood sugar of 126 mg/dL or higher. A new glycated haemoglobin level criterion has also been added.


3. Diabetes FAQs: Frequently Asked Questions
I'm curious about diabetes!
Q. I have pain in my side below my left ribs, is it a pancreatic problem?

The pancreas is located in the middle of the stomach. If you feel pain slightly below the pubic tooth, it is possible. However, when it comes to pancreatic problems, the symptoms are often vague. Pain can also occur when the stomach is uncomfortable or indigestion, and there are also cases of pain in the back.
Q. Can pancreatic abnormalities be diagnosed through CT scans?
 
In most cases, it can be diagnosed with a CT scan. Apple CEO Steve Jobs also had a lump in his pancreas through a CT scan. However, unless it is unavoidable, we do not recommend that you have too many CT scans. This is because CT scans emit a certain level of radiation, which can cause cancer to develop if exposed to a large amount.
Q. Can I stop taking my diabetes medication?

It depends on what type of medication you take, how much your blood sugar rises when you stop taking it, and how many medications you take. However, it is rare for people to stop taking their diabetes medications.
Q. What should I do if my current diabetes medication doesn't control my blood sugar?

Depending on the patient's blood sugar level, the dose of the medicine may be increased or a new medication may be added. It may also be helpful to take insulin injections, exercise, and adjust your diet.


4. Classification of hypertension
What are the different types of hypertension?

Hypertension is generally classified into essential hypertension and secondary hypertension. The hypertension we know is usually essential hypertension, while secondary hypertension is high blood pressure caused by rare causes, such as a lump in the body that raises blood pressure or a narrowing of blood vessels.


Essential hypertension is sometimes referred to as primary or idiopathic. This is because using the term essential can give the misconception that it is healthy and natural for blood pressure to rise with age.


The name "Essential" was given in conjunction with the argument against taking blood pressure medications in the past. Even eminent physicians such as Otto Frank and Muhammad thought that high blood pressure caused by old age was a compensatory response caused by the constriction of arteries to prevent less blood from flowing to the body's tissues. However, people with high blood pressure are at risk because they can develop cerebrovascular and cardiovascular problems. In fact, many people, including former President Roosevelt in the United States, died from neglect of high blood pressure, and now it is a common perception that essential hypertension also needs treatment.

 

5. Diagnostic criteria for hypertension
What are the diagnostic criteria for hypertension?


When the heart is squeezed, the high pressure that occurs when it hits the blood vessel wall is called systolic blood pressure, and the pressure that is measured when the blood vessel is stretched is called diastolic blood pressure. In Korea, a systolic blood pressure of 140 mmHg or higher, or a diastolic blood pressure of 90 mmHg or higher, that is, a reading of either is disturbed, is classified as hypertension. Of course, this is going to have to happen repeatedly.


It is important to note that the diagnostic criteria for hypertension may change depending on the measurement method. In particular, blood pressure measured at home is lower than blood pressure measured in the doctor's office, so a systolic blood pressure of 135 mmHg or higher, or a diastolic blood pressure of 85 mmHg or higher, is classified as hypertension.

 

7. High Blood Pressure FAQs: FAQs
I'm curious about high blood pressure!

Q. What should I do if I have a difference in blood pressure in both arms?

There may also be a blood pressure difference of close to 10 mmHg between the right and left arms. However, if there is a difference in blood pressure of more than 20 mmHg, you should see your primary care physician for a diagnosis. This is because there is a possibility of narrowing of the blood vessels in one arm.

Q. Can blood pressure be genetically predisposed to?

Yes, if you have a family history of it, you are likewise at a higher risk of developing high blood pressure.

 

Q. Is there a big difference between systolic and diastolic blood pressure?

The difference between systolic and diastolic blood pressure is called pulse pressure, and when the elasticity of blood vessels decreases, the pulse pressure can increase. Especially with age, systolic blood pressure continues to rise, while diastolic blood pressure decreases, and the gap often widens. If the gap is significant, it may be a health risk.




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