Raised Blood Sugar Levels Research Articles

A cross-sectional study on diabetes self-management practice and its association with glycemic control among type 2 Diabetes patients.

Diabetes has emerged as a major chronic public health problem throughout the world. Self-management by diabetes patients is very important for controlling blood sugar levels and preventing complications of diabetes. The present study was conducted to study self-management practices among diabetes patients and to analyse socio-demographic factors associated with them. A cross-sectional analytical study was conducted among 230 randomly selected diabetes patients in the Andaman and Nicobar Islands. The self-management practices were measured by the diabetes self-management questionnaire (DSMQ). The association of the DSMQ score with socio-demographic factors and blood sugar level was analysed by statistical tests like the T-test, analysis of variance (ANOVA) test, Tukey's honestly significant difference, and Chi-square test. The mean DSMQ score of the diabetes patients was 29.55 ± 5.98. There was a significant difference between the mean DSMQ score and the educational level (P value = 0.009), residential status (P value = 0.037), and duration of diabetes (P value = 0.006). The subcomponent analysis of the DSMQ score revealed that the glucose management score of rural people (9.38 ± 3.36) was significantly higher (P value = 0.006) than that of urban people (8.32 ± 2.46), and the diet control score was significantly higher (P value = 0.02) in patients with normal post-prandial blood sugar (PPBS) (7.64 ± 2.18) than in patients with raised PPBS (6.96 ± 2.12). Higher educational level, rural background, and long duration of diabetes were associated with better self-management practices. The patients with normal blood sugar levels showed higher diet control scores than the patients with raised blood sugar levels.

Lifestyle Modification for Prediabetes through Ayurvedic Interventions – A Case Study

Diabetes Mellitus is a metabolic disorder caused by an unhealthy lifestyle. Pre-diabetes is an asymptomatic condition, where blood sugar levels are elevated but are not high enough to be classified as T2DM and is considered a high-risk state for the development of diabetes. The estimated prevalence of prediabetes in India is 14 %. Early diagnosis and intervention with lifestyle modification can reduce the risk of Diabetes Mellitus. In the present case study 53 yrs. female patient with a raised blood sugar level and HbA1C is 6.4% which shows a prediabetic condition is treated with Ayurvedic medicine and Lifestyle modification. Diet and Yoga were advised. Ayurvedic Intervention reduces the elevated blood sugar level with an HbA1C value is 5.6% in 3 months. Lifestyle modification prevents the further progression of disease. Ayurvedic Interventions with lifestyle modification effectively control blood sugar levels in prediabetic conditions without any oral hypoglycaemic medication.

Comparison of metformin and repaglinide monotherapy in the management of newly diagnosed diabetes mellitus type 2: a prospective study

Comparison of metformin and repaglinide monotherapy in the management of newly diagnosed diabetes mellitus type 2: a prospective study

Study of HbA1c levels in non-diabetic individuals recovered from Covid-19.

To study the glycemic control by estimating HbA1c levels among previously non-diabetic individuals aged above 40 years, who recovered from coronavirus disease 2019 (Covid-19) infection. This is an analytical cross-sectional study of people affected with Covid-19 infection, who were home-isolated, hospitalized, and discharged. The simple random sampling technique was used for the study group. Tirupati City, Andhra Pradesh State, India. We assessed socio-demographic profiles, hba1c levels, RBS, and severity of infection. The obtained laboratory reports were analyzed by using means and proportions after entering data in MS Excel and converted to SPSS software new version. The study participants comprised mostly middle age group males and females (mostly 40-60 years, with 60% of them being females). Most of the study subjects were healthy, and 58% of them have normal hba1c levels. 32% of them are in border line diabetic. The prevalence of diabetes post Covid-19 infection is 10%. The majority of participants have normal random blood sugar levels (around 92%), and very less individuals have abnormal random blood sugar levels (2% of the subjects). There is no significant association between hypertension and raised blood sugar levels post Covid-19 infection. Based on the study, Covid-19 infection has an impact on blood sugar levels and altered glycemic control, switching a few individuals into diabetic and a significant number of individuals into the pre-diabetic state, who are non-diabetic individuals before Covid-19 infection.

11.F. Workshop: Health examination surveys to support decision making and for monitoring risk factors

Abstract Non-communicable diseases (NCDs) contribute for 74% of all deaths globally. They are also major cause of morbidity and disability. Many of the NCDs could be prevented with timely lifestyle changes and treatment of biological risk factors. Several NCDs, such as diabetes, cardiovascular diseases, chronic respiratory diseases and several cancers share same risk factors namely smoking, harmful alcohol use, unhealthy diet and lack of physical activity which impact on biological risk factors such as obesity, elevated blood pressure, elevated blood cholesterol and raised blood sugar levels. Up-to-date, representative, and high-quality health information is needed to support evidence-informed policy making and innovative research. Monitoring of lifestyles and biological risk factors affecting the NCDs is needed, to identify current the situation among different population groups and to plan and target required actions for prevention and treatment. Information on lifestyles is usually collected through survey questions about smoking habits, alcohol use, diet and physical activity. For biological risk factors, self-reported information tends to be biased. For example, elevated blood pressure, blood cholesterol and blood sugar levels are asymptomatic for a long time and people often don’t know about their condition. For obesity, stigma and societal pressure may lead to misreporting. For health care registers, information on biological risk factor is not systematically recorded and whenever data is available, it represents only patients. Therefore, for biological risk factors, the only reliable source for information about population level situation are health examination surveys (HES). At the European level, European Health Examination Survey (EHES) has provided a standardized protocols for measurement of key biological risk factors. These recommendations are in line with the WHO Stepwise approach for NCD risk factor surveillance. In the past ten years, less than half of the EU Member States have conducted at least one national HES. This workshop will include four presentations providing a general overview of why we need to be monitoring NCD risk factors and how broadly this is done in Europe. Three case examples showcase how the monitoring is conducted in different countries. Finland has done NCD risk factor monitoring regularly since 1960's and has the longest time series in Europe, Germany has conducted several comprehensive multi-year cross-sectional surveys since early 2000's and is piloting more flexible methods, and Portugal had their first health examination survey in 2015-2016 and is now planning the next one. How these countries have organized their monitoring and how the data obtained have been used to support actions targeting to improve population health will be discussed. Key messages • Health examination surveys are needed to obtain reliable and representative information about NCD risk factors at the population level. • Standardized protocols for measurements of biological risk factors are needed to ensure cross-country and over time comparison of the outcomes.

Prevalence of non-communicable diseases and risk factors of pre-eclampsia/eclampsia in four local government areas in Nigeria: a cross-sectional study

ObjectivesTo assess the prevalence of non-communicable diseases (NCDs) and risk factors associated with pre-eclampsia and eclampsia (PE/E) in women of reproductive age (WRA) in Nigeria.DesignA cross-sectional survey was administered to...

Molecular pathways and nutrigenomic review of insulin resistance development in gestational diabetes mellitus.

Gestational diabetes mellitus is a condition marked by raised blood sugar levels and insulin resistance that usually occurs during the second or third trimester of pregnancy. According to the World Health Organization, hyperglycemia affects 16.9% of pregnancies worldwide. Dietary changes are the primarily alternative treatment for gestational diabetes mellitus. This paper aims to perform an exhaustive overview of the interaction between diet, gene expression, and the metabolic pathways related to insulin resistance. The intake of foods rich in carbohydrates can influence the gene expression of glycolysis, as well as foods rich in fat, can disrupt the beta-oxidation and ketogenesis pathways. Furthermore, vitamins and minerals are related to inflammatory processes regulated by the TLR4/NF-κB and one carbon metabolic pathways. We indicate that diet regulated gene expression of PPARα, NOS, CREB3L3, IRS, and CPT I, altering cellular physiological mechanisms and thus increasing or decreasing the risk of gestational diabetes. The alteration of gene expression can cause inflammation, inhibition of fatty acid transport, or on the contrary help in the modulation of ketogenesis, improve insulin sensitivity, attenuate the effects of glucotoxicity, and others. Therefore, it is critical to comprehend the metabolic changes of pregnant women with gestational diabetes mellitus, to determine nutrients that help in the prevention and treatment of insulin resistance and its long-term consequences.

Diabetes Prediction Using Machine Learning

Chronic diseases like diabetes have the potential to wreck the world's health care system. According to the International Diabetes Federation, there are 382 million diabetics worldwide. By 2035, this will increase to 592 million. Diabetes is a disease characterised by high blood glucose levels. The signs of this raised blood sugar level include increased thirst, appetite, and frequency of urinating. Diabetes is a significant contributing factor to heart failure, stroke, kidney failure, amputations, blindness, and kidney failure. When we eat, our bodies turn the food we consume into sugars like glucose. Then, we anticipate insulin to be released from our pancreas. Insulin functions as a key to unlock our cells, allowing glucose to enter and be used as fuel by us. However, in diabetes, this mechanism does not work. The most common types of diabetes are type 1 and type 2, but there are others, including gestational diabetes, which develops during pregnancy. Machine learning is a new area in data science that investigates how machines learn from experience. The purpose of this work is to develop a system that, by combining the findings of different machine learning algorithms, can more correctly identify early diabetes in a patient. Some of the approaches used include Logistic Regression, Random Forest, Support Vector Machine, and the Nave Bayes Algorithm. The accuracy of each algorithm is computed alongside.

A modified inertial viscosity extragradient type method for equilibrium problems application to classification of diabetes mellitus: Machine learning methods

<abstract><p>Diabetes is one of the four major types of noncommunicable diseases (cardiovascular disease, diabetes, cancer and chronic respiratory diseases). It is chronic condition that occurs when the body does not produce enough insulin therefore results in raised blood sugar levels. Insulin is a hormone that regulates the blood sugar when food consumption. If the proper treatment is not received organs of the body like kidneys, nervous system and eyes can deteriorate. Therefore, it is better to predict diabetes as early as possible because lead to serious damage to many of the body's systems. In this paper, we modify extragradient method with an inertial extrapolation step and viscosity-type method to solve equilibrium problems of pseudomonotone bifunction operator in real Hilbert spaces. Strong convergence result is obtained under the assumption that the bifunction satisfies the Lipchitz-type condition. Moreover, we show choosing stepsize parameter in many ways, this shows that our algorithm is flexible using. Finally, we apply our algorithm to solve the diabetes mellitus classification in machine learning and show the algorithm's efficiency by comparing with existing algorithms.</p></abstract>

Knowledge and attitudes regarding effect of diabetes mellitus on eyes and community-based screening for diabetes, hypertension, and visual impairment in central India- a community-based cross-sectional study

Background: Ocular complications associated with DM are progressive and rapidly becoming the world’s most significant cause of morbidity and are preventable with early detection and timely treatment. This study was planned to assess knowledge regarding diabetes mellitus and their views and perspectives on diabetes and diabetes related eye diseases and to screen for diabetes, hypertension, and visual impairment in central India.Methods: A cross sectional study was conducted during annual holy celebrations in the metropolitan city of Mumbai. A large cohort underwent habitual visual acuity assessment (HVA), diabetes screening by random finger prick blood sugar, blood pressure screening. A questionnaire survey was administered to every 5th participant who registered for the free screening. All the variables were analysed using descriptive statistics to calculate frequencies, mean, range and chi-square test was used for analytical statistics.Results: A total of 6300 participants were surveyed. More than two third of the study participants (79.5%) know about diabetes and raised blood sugar level causes problem. Around 87.3% had good knowledge about diabetes. Around 42.7% of the study participants never had eye examination in their lifetime. Nearly 40% of participants were screened positive for hypertension and 23.9% had raised blood sugar level. Unfortunately, 6.0% had visual impairment on visual acuity examination.Conclusions: Despite our study shows that majority of the participants had knowledge about diabetes mellitus and importance of eye screening, only half of the people with diabetes mellitus underwent routine eye examination or screening.

A16791 Prevalence of hypertension and co-morbidities – an urban aspect in India

Objectives: To study the prevalence of hypertension and incidence of co-morbidities among a population group in a city of India. To study relation between diabetes and hypertension in urban India. Methods: Adults were screened for hypertension in Latur city of India.There were camps for hypertension screening in the city at three locations. A questionnaire including questions for history of hypertension, diabetes filled up from the participants.Blood pressure (BP) was measured by digital apparatus in sitting position,three times;5 minutes apart of each recording.Weight, height were measured.A theme of hypertension awareness was designed at the place of blood pressure screening. Results: n = 656.The mean age was 46 years.Men were 63 % while women were 37%.Seventy one percent people were checking BP first ever time in life.Prevalence of hypertension (BP > 140/90mmHg) was 32.78%.There were 24.28 % people who denied history of hypertension but had high BP.Seven percent people gave history of hypertension among them 50% had controlled BP. Diabetics were 8.56% .There were 4 % people with diabetes who had raised BP (>140/90).34% people were overweight; among them 27.14% had hypertension; 41.5% had hypertension among obese (BMI > 30). Seven percent gave history of diabetes,among them 60% had controlled blood sugars. Of the total population 8.87% had raised blood sugar levels(Random capillary sugar > 200).Among those who had BMI > 25 and < 29.9; 28% had raised sugars while 43% of those whose BMI was > 30 had raised blood sugars. Conclusion: Latur city in India is a mixture of rural and urban people its a mixture of industrialization and hub of agriculturists.Hypertension is a major concern in the city as is the diabetes and obesity.The changing lifestyle can be attributable to the higher prevalence.

Proportion of Raised Blood Pressure and Raised Blood Sugar Level in Newly Diagnosed Attention Deficit Hyperactivity Disorder in Children

Proportion of Raised Blood Pressure and Raised Blood Sugar Level in Newly Diagnosed Attention Deficit Hyperactivity Disorder in Children

A study on diabetes mellitus among diabetic foot ulcer patients in a tertiary care centre

Background: Diabetes mellitus is a chronic disease which occurs either when the pancreas does not reproduce enough insulin, the hormone that regulates blood sugar level or when the body cannot effectively use the insulin it produces. Hyperglycemia or raised blood sugar level is a common effect of uncontrolled diabetes and over time leads to serious damage to many of the system of the body especially nerves and blood vessels. Diabetes mellitus has become the cause for growing public health concern in developing countries as it has been for a long time in most developed ones. The reason for increase in prevalence of diabetes mellitus in developing countries may include unhealthy life style, rapid westernization, poor knowledge, negative attitude and poor practice towards diabetes mellitus among general population. Objective of the study was to find out the knowledge, and awareness towards diabetes mellitus among diabetic foot ulcer patients attending in a tertiary care Centre.Methods: A cross sectional study was carried out in the surgical outpatient department of a tertiary care Centre. All diabetic foot ulcer patients attending surgical outpatient department for the period of two months was included. Juvenile diabetic patients, Type II diabetes mellitus patients with co morbidities are excluded.Results: Out of the 100-study participant’s majority are males (61%). 55% of the study participants are not aware of the major cause of diabetes mellitus. 92% of the population knew the accurate method of monitoring diabetes mellitus. 70.6% of people are aware of normal blood sugar level. 51% of people are aware of the complications of diabetes mellitus and 84.3% of people know the symptoms of diabetes mellitus. 68.6% of the population knew regular exercise can control diabetes mellitus yet only 50.8% of population exercise regularly.Conclusions: This study reflects that there is a need to improve diabetic knowledge among the patients which can be achieved through health education.

WORLD HEALTH DAY–DIABETES, A GROWING MENACE

World Health day, celebrated each year on 7th of April is all about creating awareness regarding health issues confronting the global population. The theme this year is Diabetes — a metabolic disorder of menacing proportion. There are a host of misconceptions and lack of understanding amongst the general public regards its exact etiology, prevention, control and socio-economic impact. As of 2015 the prevalence of the disease worldwide is estimated around 415 million affectees1. This number is expected to rise to 592 million by 2035 2. The incidence and resultant mortality secondary to this epidemic is on the rise in low and middle economy countries such as Pakistan, with the disease expected to be the 7th leading cause of death by 2030 3 . Diabetes occurs when the pancreas loses its ability to produce the required insulin or the body fails to utilize the later resulting in raised blood sugar levels 4. As a consequence, malfunctioning of various organ systems ensues and various life threatening illnesses including heart attacks, strokes, nerve damage, kidney failure, blindness, impotence and infections takes a toll on the patient's health. Broadly it is classified into 3 types - Type I or Insulin dependent diabetes mellitus also referred to as 'juvenile diabetes' in which the production of insulin is affected - Type II or Non insulin dependent diabetes mellitus characterized by insulin resistance, and having a strong correlation with increased body weight and lack of exercise 5. It is also called `adult onset 'diabetes'. - Gestational diabetes affecting pregnant women with no past history of the disease, usually in the 2Ild or 3rd trimester 6. The disease usually manifests with the symptoms of frequent urination, thirst and hunger. Once a diagnosis is made based on Blood sugar estimation and monitoring levels of glaciated hemoglobin - HbAl c, management ensues directed at achieving optimum level of blood glucose and avoiding systemic complications. This goal is achieved by introducing life style changes from a sedentary to more active and less stressful way of living, supplemented with a balanced diet and regular exercise. This is especially helpful in Type II DM. Treatment is offered by means of Oral hypoglycemic or injectable insulin as guided by the physician/endocrinologist. More recently bariatric Surgery has shown considerable promise as an effective measure to control blood sugar levels.7 This year the main objective of observing the world health day is to enhance awareness about prevention, care and surveillance of this disease. This will form the basis for launching the first ever global report on Diabetes. The core functions of WHO in this regard are as follows: - To frame internationally acceptable standards and guidelines for prevention, diagnosis and treatment of Diabetes and its associated complications - To closely monitor the morbidity and mortality associate with this disease. - Capacity building at different levels to address different aspects of this disease - To project diabetes as a global health issue and identify the population at risk Efforts to prevent and treat diabetes are essential to achieve the global sustainable development goal target of reducing premature mortality from non communicable diseases by one third by 2030. The community at large and the health care professionals and organizations in particular have a key role to play in highlighting the steps to be taken in this regard through organizing seminars and lectures and making use of the media to effectively communicate their message to the masses.Globalhealth dayfocusing onDiabetes certainlypromises tobe akeyeventin raising awareness andproposing effective measures supplementing themanagement of this disease ona globalstage.

Report on phylloplane mycoflora Associated with Catharanthus roseus (L.) G. Don – A herbal medicinal plant in Bangladesh

Abstract not availableBangladesh J. Sci. Res. 27(2): 201-207, December-2014

Use of growth hormone in the treatment of pediatric burns

Hypermetabolic response is characterized by a hyperdynamic circulatory response, with increased body temperature; increased oxygen and glucose consumption; increased carbon dioxide production; hyperglycemia (raised blood sugar levels); peripheral insulin resistance; glycogenolysis, proteolysis, and lipolysis (i.e. the breakdown of glycogen, protein, and lipids, respectively); the loss of lean body mass; and muscle and bone wasting. These symptoms can last for 1-2 years after the burn injury. Failure to satisfy overwhelming energy and protein requirements results in multiorgan dysfunction and an increased susceptibility for infection and death. Immunocompromization and delayed wound healing usually result in severe sepsis, which is the most common direct cause of death in these patients. Nevertheless, providing adequate caloric and protein requirements alone was found to be insufficient to attenuate the hypermetabolic response efficiently. Thereby, various pharmacologic modalities to modulate metabolic response have become a corner stone in the management of severely burned patients. Recombinant growth hormone is the most frequently prescribed agent in pediatrics. This review will focus on the metabolic and immune responses to the use of recombinant growth hormone in pediatric burn patients. It will explore what is beyond growth hormone and the role of insulin-like growth factor-1 in modulation of immunity and apoptosis.

Prevalence of cardiovascular disease (CVD) risk factors

Various studies conducted across the country have shown a high prevalence of known risk factors of cardiovascular disease (CVD) (like mean body mass index (BMI), systolic BP and raised cholesterol levels) but no exhaustive data is available pertaining to armed forces personnel. This study was conducted to assess the prevalence of raised BMI, blood pressure, cholesterol and blood sugar among serving armed forces personnel ≥35yrs of age. The study was carried out between Jan 2013-Jun 2013. The study included all individuals ≥35yrs of age deployed/posted in specific districts of northern part of the country (N=5143) instead of a limited sample size. In this study, obesity was observed in 3.42% (95% CI: 2.96%-3.95%), raised BP in 14.07% (95% CI: 13.15%-15.05%) and raised blood sugar levels in 1.71% (95% CI: 1.39%-2.10%). Additionally, 67.72% (95% CI: 66.43%-68.99%) were pre-obese and 82.65% (95% CI: 81.60%-83.67%) were pre-hypertensives. Lower prevalence of hypertension, hyperglycemia and dyslipidemia was observed in armed forces personnel in comparison to country specific data. However, high prevalence of pre-obese and pre-hypertension suggests a need for concerted efforts towards preventive activities in this field.

Prevalence of vitamin d deficiency among Indian menopausal women and its correlation with diabetes: A first Indian cross sectional data.

Aim and Objective:To evaluate prevalence of Vitamin D deficiency and establish any correlation between diabetes and vitamin D deficiency among postmenopausal women.Materials and Methods:The 25-hydroxy vitamin D [25 (OH) D] concentrations were measured by competitive in-vitro quantitative immunoassay. The subjects were classified as vitamin D-deficient, insufficient or sufficient on the basis of 25 (OH) D concentrations of < 20 ng/mL, 20–30 ng/mL or > 30 ng/mL respectively. The apparently normal postmenopausal women (PMW) were subjected to fasting blood sugar levels to analyse any correlation between vitamin D deficiency and diabetes.Results:Vitamin D deficiency was observed in 53.35% of the population, 19.48% had insufficiency and 26.83% had adequate Vitamin D levels. In 12.14% of the study population fasting blood glucose was > 110 mg/dl and rest of the subjects were between the normal range which is 70–110mg/dl. Correlation between raised blood sugar levels and Vitamin D deficiency among PMW was non-significant (P = 0.324).Conclusion:High prevalence of vitamin D deficiency exists among apparently healthy Indian PMW. However, the current study failed to show any statistical correlation between vitamin D deficiency and existence of diabetes, which may be due to small sample size.

Some Haematological Parameters in Patients with Type-1 Diabetes in Sokoto, North Western Nigeria

Problem statement: Diabetes mellitus is a global public health problem with increasing prevalence. The purpose of this study was to investigate changes in some haematological parameters in patients with type 1 diabetes (T1D) in Sokoto, North Western Nigeria and to compare the results with non-diabetics. Material and methods: A total of 100 consecutively recruited confirmed T1D patients constituted the subjects for this case-control study. Subjects included 52 males (52%) and 48 females (48%). The age range and mean range was 25-60 years and 42.45 years ± 12.23 years respectively. Forty age and gender-matched non-diabetics were monitored as controls. The packed cell volume, platelet and total white cell count and blood glucose level was determined using standard methods and results were compared statistically with values obtained from non-diabetic controls. Results: The mean PCV was significantly lower among subjects with (T1D) (36.93 ± 2.19) compared to the non-diabetic controls (39.80 ± 2.24), p=0.003. Diabetics with poor glycaemic control had lower packed cell volume compared to those with lower blood sugar level. The mean platelet and total white cell count was significantly higher among diabetics compared to non-diabetic controls (464.76 ± 158.66 and 8.48 ± 3.27) compared to (297.13 ± 94.25 and 6.48 ± 2.12) p=0.0001 and 0.001 respectively. Platelet and total white cell count increased with increasing hyperglycaemia (t=7.66 and 6.33, p-value=0.001). We observed a significant positive correlation between high platelet and total white cell count count and raised blood sugar level among the diabetic subjects studied (r=0.52 and 0.45) respectively. There were no statistically significant differences between haematological values based on the gender of diabetic subjects. Conclusion: The packed cell volume is lower among diabetic patients compared to non-diabetics. Platelet and total white cell count are significantly higher among diabetic subjects compared to non-diabetic controls. Anaemia, thrombocytosis and leucocytosis were associated with raised blood sugar levels among patients with type 1 diabetes. We recommend the routine haematological monitoring of patients with type 1 diabetes to prevent complications associated with deranged haematological values in this patient group.

Psychiatric aspects of diabetes--a physician's view.

A raised blood sugar level no more defines a single entity than does a raised bilirubin or a low haemoglobin. Diabetes is a heterogenous group of disorders whose only common factor is hyperglycaemia (Tattersallet al, 1980). The classification of diabetes is being revised, although the changes are of more relevance to epidemiologists than clinicians. Previous standards of normal glucose tolerance were set too low, so that some people were labelled diabetic who had no symptoms and have proved on follow-up not to be at risk of developing complications such as retinopathy (i.e. they had a non-disease). Epidemiological evidence suggests that the cut-off point for ‘true’ diabetes (i.e. a condition which leads to complications and shortening of life span) is a blood glucose level two hours after a 50 G oral glucose load of 11.1 mMol/L (National Diabetes Data Group, 1979). This corresponds to a fasting blood glucose level of 7 mMol/L or below. Hence, a single blood glucose value, either in the fasting state or two hours after a 50 G glucose load, is enough to diagnose diabetes and glucose tolerance tests should hardly ever be necessary.