Diagnosis of Diabetes | Criteria for Diabetes

Diagnosis of Diabetes Mellitus is based on testing of Glucose tolerance. Degree of glucose tolerance is determined by a fixed criteria. Based upon the degree of tolerance, results are grouped as normal glucose homeostasis, impaired glucose homeostasis or Diabetes Mellitus. Impaired glucose hemostasis is a condition also popularly known as Pre-Diabetes, Impaired Fasting Glucose IFG, Intermediate Hyperglycemia (WHO). The tests have to be often repeated once or twice to confirm the diagnosis as the disease has profound implications on future lifestyle of the patient.  

Who should be be tested? Screening is recommended in following conditions.

1. Obese or overweight individuals 
2. Those having positive family history or have siblings with Diabetes.
3. Persons with Hypertension (>140/90)or other cardiovascular conditions
4. Individuals known to have high triglycerides (> 250 mg/dL (2.82 mmol/L)) or low HDL cholesterol level < 35 mg/dL (0.90 mmol/L).
5. Those having repeated infections, wounds healing poorly or dental conditions.
6.  Any other medical or genetic conditions known to be associated with Diabetes.
7. Women suffering from Polycystic ovarian syndrome (PCOS) or those who have given birth to a large baby. (wt > 4kg/9lb)
8. Based on ethnicity (African American, Latino, Native American, Asian American, Pacific Islander).

Glucose tolerance can be tested in 3 ways :-

• Fasting plasma glucose (FPG) - Person should not have taken food or drink in the past 8 hours.
• Oral Glucose tolerance test - Person is tested twice for plasma glucose levels - fasting (as above) & post prandial (2 hrs after a glucose containing meal or a beverage)
• Random plasma glucose - Also known as casual plasma glucose test as it is done as when needed.

Glycated hemoglobin (HBA1C) test - This test measures the glycemic control of the person over the past 8 weeks & hence gives a complete picture about glycemic levels over a sustained period. It is also helpful in known diabetics to test the effectiveness of medications.

Diagnostic Criteria :-

  Abnormal glucose homeostasis is defined as :-

a) FPG = 5.6–6.9 mmol/L (100–125 mg/dL), which is defined as IFG.  
     World Health Organization uses an FPG of 6.1–6.9 mmol/L(110–125 mg/dL)

b) Plasma glucose levels between 7.8 and 11 mmol/L (140 and 199 mg/dL) following an oral glucose challenge.

 Further we will discuss about the treatment of diabetes. If you like this post please share it with your friends on facebook, twitter or other platforms with buttons given below.