Classificaton & Diagnosis of Diabetes

Question 1

Diabetes Diagnosis

Answer 1

FPG ≥ 126 fasting at least 8 hrs
2 hr PG ≥ 200 during an OGTT, glucose load 75g
A1c ≥ 6.5%
Random plasma ≥ 200 + hyperglycemia sx

Question 2

Prediabetes testing

Answer 2

Consider screening in adults of any age with:
BMI ≥25, ≥23 in Asians
Have one or more additional risk factor
For asymptomatic adults testing should begin at 45 years
Repeat testing at least every 3 years

Question 3

Prediabetes diagnosis

Answer 3

FPG 100 to 125
2 hr PG in the 75g OGTT 140 - 199
A1c 5/7% - 6.4%

Question 4

Gestational diabetes diagnosis

Answer 4

Test at 1st trimester in those with risk factors
Test at 24-28 weeks gestation
Test women with gestational diabetes at 4 -12 weeks post-partum with OGTT
Women with hx of GDM should be screen for DM or Pre-DM every 3 years

Question 5

GDM testing

Answer 5

1 and 2 step strategy
1- (most common)
75g OGTT fasting, PG at 1 and 2 hr done at 24-28 weeks gestation
Positive test if: Fasting 92, 1 hr 180, 2 hr 153

Question 6

Monogenic diabetes syndromes

Answer 6

1- Neonatal diabetes

2-MODY

Question 7

Neonatal diabetes

Answer 7

diabetes diagnosed in the first 6 months of life

Question 8

Maturity-Onset Diabetes of the Young

Answer 8

usually diagnosed before 25, but can occur at older ages.
Impaired insulin secretion with minimal or no defects in insulin action exhibiting mild, stable, fasting hyperglycemia.
Does not require tx except sometimes during pregnancy
SU are first line of therapy

Question 9

CF-related diabetes testing

Answer 9

Begin at 10 years
OGTT
A1c as screening tool is not recommended

Question 10

CF- related diabetes

Answer 10

Insulin insufficiency is primary defect
Treat with insulin
begin testing for complications 5 yrs after diagnosis

Question 11

Posttransplantation diabetes

Answer 11

OGTT is preferred after immunosuppressive regimen is stable

Fasting glucose and A1c are also diagnostic