想了解以下的三種情況要作甚麼檢驗？

let me generally give you a very brief picture on how diabetic progress.

for some reason, you body is no longer effectively transporting glucose to your cell, as a result accumulating in the blood, when this glucose reach a certain level, that your kidney is no longer able to reabsorb it from the urine, then it will be excreted in urine, hence the name 糖尿病.

there are two way, either
your body is no longer producing insulin or
your body is not responding to insulin

and it is probably a bit of both.
you can not detect insulin because it has a very short half life.
what you can do is to detect the precursor and the metabolite of insulin, this way you can tell whether you are producing insulin, I think the precursor for insulin is c-peptide, not too sure for the metabolite.

if you are producing the insulin normally, then it is probably the insulin receptor is not working probably, i.e that the cell is not responding to insulin, as a result accumulating glucose in blood. Hence the word insulin resistance. I am sure that nowadays they must have develops some method in measuring insulin resistance with all these new drug, (drug like avandia, actos), I don't know how they are measure.

So you body is somehow not producing enough insulin, or somehow you body is resistance to insulin, in both case, you body will command the beta cell to produce more insulin, in any case, when the cell are overwork, it tends to die young, just like us, when it is dead, you no longer produce any insulin.

again, you can tell whether you body is producing insulin by measuring the precursor and metabolite of insulin. if there is a lot of precursor, i.e you body is commanding to produce insulin, but not many insulin metablite, then you can conclude the beta cell is dyeing. On the other hand, if there is no precursor, then once may conclude that this diabetic is due to central issue, not periphery's issue!




2010-05-22 14:37:22 補充：
I hope my answer is helpful!

2010-05-22 14:38:38 補充：
yes, by blood test!