When we want to know if we have diabetes we think that the fasting blood glucose test is the first thing; however, it may be that even if it comes out normal, it may be that the postprandial blood glucose, two hours after ingesting a load of 75 g of carbohydrates, is elevated, then our patient has diabetes mellitus 2. We must remember that a patient has normal glycemia when fasting for at least 8 hours is between 60 and 100 mg/dl and if it is between 100 and 110 mg/dl we say that he has a metabolic syndrome or prediabetes and when it is more than 110 mg/dl we say that he has diabetes mellitus 2.If a patient has less than 110 mg/dl fasting; but with very high insulin, which means that the pancreas is making a great effort to maintain normal glycemia, caused by insulin resistance, we check this with a formula to calculate the HOMA and if it is more than 2.5 then that patient has insulin resistance. There is delay in diagnosis and poor adherence to treatment in all its requirements.But the socioeconomic and cultural situation of the Ecuadorian community prevents effective adherence to treatment....
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