Friday, July 20, 2012

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Diabetes Mellitus - Definition / Criteria for diagnosis

Definition:
It is a group of metabolic disorders that is characterized by hyperglycemia which is due to a relative or absolute deficiency in insulin. There is usually a defect in insulin secretion, a defect in insulin action or a combination of both. 


Criteria for diagnosis:
1) An Fasting Plasma Glucose ≥ 7.0 mmol/L (126 mg/dL), 
2) A Plasma Glucose  ≥ 11.1 mmol/L (200 mg/dL) 2 h after an oral glucose tolerance test,
3) An HbA1c    6.5% or
4) A Random Plasma Glucose concentration   11.1 mmol/L (200 mg/dL) accompanied by classic symptoms of DM (polyuria, polydipsia, polyphagia, weight loss). 


Note:
1) Fasting means no calorie intake for the past 8 hours.
2) For the glucose tolerance test, we must use 75 g of anhydrous glucose dissolved in water.
3) The diagnostic HbA1c test should be performed using a method certified by the National Glycohemoglobin Standardization Program (NGSP) and standardized or traceable to the Diabetes Control and Complications Trial (DCCT) reference assay. The currently available assays are not accurate enough.
4) Random Plasma Glucose means without regard to time since last meal. 

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