Endocrinology · Diabetology
Diabetes mellitus and its complications
Management of type 1 and 2 diabetes, prediabetes and gestational diabetes. Treatment is individual; the goal is not just today's number but long-term metabolic control.
Diagnosis
How is diabetes confirmed?
One of the criteria is enough.
| Test | Diabetes diagnosis |
|---|---|
| Fasting glucose (≥8 h fast) | ≥ 126 mg/dl (7 mmol/l) |
| Any time of day (with symptoms) | ≥ 200 mg/dl (11.1 mmol/l) |
| OGTT (2nd hour) | ≥ 200 mg/dl |
| HbA1c | ≥ 6.5% (48 mmol/mol) |
What does HbA1c show?
| HbA1c | Interpretation |
|---|---|
| ≤ 5.6% | Normal |
| 5.6 – 6.4% | Prediabetes |
| ≥ 6.5% | Diabetes mellitus |
| < 7% | General target in people with diabetes (individual) |
Note: HbA1c reflects the average sugar over 3 months; fasting or not does not matter. In pregnant women and certain groups the target is lower.
Management & complications
Diabetes services
Management
- Type 1 and 2 diabetes
- Prediabetes and prevention
- Gestational diabetes
- Diabetes insipidus
- Insulin and tablet adjustment
- HbA1c and 24-hour profile
Complications & acute care
- Diabetic neuropathy
- Diabetic foot
- Hypoglycaemia management
- Diabetic ketoacidosis
- Hyperglycaemic crises
- Glucagon and first aid
What you should know
Accurate information
Diabetes requires daily control
"My sugar rose one day, nothing happened" is a misconception. Today's high numbers can show up later as complications. Normal is always normal.
Low sugar is more dangerous than high
If sugar often falls below 4 mmol/l (72 mg/dl), be sure to contact your doctor. Hypoglycaemia damages organs faster than hyperglycaemia.
Don't stop treatment early
When medication runs out or sugar temporarily normalises, do not stop treatment on your own. Returning for follow-up on time is the key to keeping the results.
Sugar control may be disrupted after COVID-19
Disrupted eating and steroids used in treatment can push sugar out of control. Limiting carbohydrates, 30-40 minutes of daily activity and endocrinologist follow-up are important.
FAQ
Frequently asked questions about diabetes
My sugar is slightly above normal. Is treatment necessary?
Fasting glucose of 100 mg/dl and above is a signal; 110 mg/dl and above is a reason to book an endocrinologist. HbA1c 5.5-6% means monitoring, above 6% means it is time to seek care. At the prediabetes stage, intervention can prevent full diabetes.
I have diabetes. Can I stop the medication myself?
No. Diabetes medication must not be stopped without the doctor's permission. Temporary normalisation of sugar means the treatment is working, not that medication is no longer needed. Dose changes are made only under supervision.
Is HbA1c taken fasting?
No. HbA1c reflects the average blood sugar over the last three months; fasting or not makes no difference. Up to 5.6% is normal, 5.6-6.4% is prediabetes, above 6.5% is a diabetes diagnosis.
What to do during hypoglycaemia (low sugar)?
Sugar below 70 mg/dl is hypoglycaemia. Cold sweat, trembling and weakness are key signs. Take 15-20 g of sugar immediately (3-5 cubes in water or a glass of juice). If consciousness is lost, glucagon is given and the patient is taken to hospital.
Diabetes runs in my family. Is preventive screening important?
Yes. If first-degree relatives have diabetes, the risk is higher. Checking fasting blood sugar is a simple and effective preventive step.
Book diabetes management
If your sugar is high, you have a family history, or you want to review your treatment, message on WhatsApp.