Article by Master, Doctor Bui Minh Duc – Head of Unit resources Civil general hospital, international Vinmec Times City.
Screening for diabetes mellitus to detect early those who suffer from diabetes mellitus but no clinical symptoms.
1. Screening for diabetes mellitus type 1
Diabetes mellitus type 1 autoimmune origin with the presence of other types of autoantibodies . People don’t put the issue of screening for diabetes mellitus type 1 because of the acute onset of symptoms, most cases of type 1 diabetes is diagnosed very soon after the symptoms progress.
M ost of the cases of type 1 diabetes is diagnosed very soon after the symptoms progress.
The test screening for the detection of cases have antibodies without symptoms is not recommended because:
- The threshold value for the diagnosis of the test marker of immunity has not really unified;
- Yet to achieve consensus should act, how if the results show autoantibodies positive;
- The rate of diabetes mellitus type 1 is very little, so if there is screening, the number of people who can detect is very small, below 0.5 %, the effect of economic is not high.
2. Screening diabetes mellitus type 2
On the contrary, diabetes mellitus type 2 very common (accounts for 90 to 95% of patients with diabetes mellitus) and practice about more than a third of patients with diabetes mellitus type 2 have not been diagnosed. Diabetes mellitus type 2 progression insidious and more when new patients are diagnosed that there were complications of the disease, even patients with the first diagnosed disease was acquired complications heaviness of diabetes mellitus.
Hyperglycemia chronic in people with diabetes mellitus usually causes the damage late, the dysfunction or failure of the organs, especially the complications eye, kidney, nerves, heart and blood vessels. Patients with diabetes mellitus type 2 that are not diagnosed are at risk for heart disease-coronary, stroke and peripheral vascular disease is higher than those who do not suffer from diabetes mellitus. They are also often prone to dyslipidemia, hypertension and obesity, are risk factors for coronary disease.
Therefore, the early detection of diabetes mellitus type 2 to help alleviate the burden of treatment reduced the severity of the disease and prevention an effective complications, chronic heavy of diabetes mellitus.
The recommendations about screening for diabetes mellitus type 2:
All subjects over 45 years of age, especially those who are overweight or obese (with BMI > 25 kg/m2), should be screening. If blood sugar test results in the normal range should try back blood sugar once every 3 years.
The subjects have the risk factor the following must be blood sugar test to screening at a younger age than:
- Sedentary people
- Have daddy or mother tongue is diabetes mellitus
- People of race have a higher risk (black, native American, Asian-American, Asian, pacific).
- Birth to, the birth weight of the child greater than 4 kg or have been diagnosed ĐTĐ pregnancy.
- Hypertension (Blood pressure greater than or equal to 140/90 mmHg).
- Have HDL-C ≤ 35mg/dl (0.9 mmol/l) or the concentration of triglycerides ≥ 250mg/dl (2.82 mmol/l)
- People with the syndrome of polycystic ovaries.
- Have been diagnosed with disorders glucose tolerance or blood sugar disorder when hungry.
- There is pathological condition associated with insulin resistance (such as stock, lesbian, black, polycystic ovaries).
- Have a history of diseases of the blood vessels.
- Can use both test fasting blood glucose and increase blood glucose in screening for diabetes mellitus, but fasting blood sugar or be applied because of economic, convenient, and easily done.
3. Screening diabetes mellitus type 2 in children
The percentage of children with diabetes mellitus type 2 recent years rising very high as the children with obesity and children of some races at high risk.
All children are overweight and have from two of the following risk need screening for diabetes mellitus type 2:
- Have parents or grandparents with diabetes mellitus
- Racial high-risk
- Expression, insulin resistance or condition associated with insulin resistance (stock black spikes, hypertension, lipid metabolism disorders, polycystic ovary bearing)
- Mother with a history of gestational diabetes mellitus
Screening for the first time in about 10 years, try again in puberty, if early puberty. If results normal try again 2 years 1 times.