Diabetes Diagnosis Flashcards
Asymptomatic patient at high risk
Fasting blood glucose <5.5
Diabetes unlikely
Repeat test in 3 years if indicated
Asymptomatic patient at high risk
Fasting blood glucose 5.5 - 6.9
Diabetes possible
Perform OGTT
Asymptomatic patient at high risk
Fasting blood glucose >=7
Confirm with repeat FBG
Normal glucose tolerance
Fasting < 6.1
2 hour post < 7.8
Diabetes unlikely - repeat in 3 years
Impaired fasting glucose
Fasting 6.1 - 6.9
2 hour post < 7.8
Repeat in one year
Impaired glucose tolerance
Fasting < 7.0
2 hour post 7.8 - 11.1
Repeat in one year
OGTT Diabetes
Fasting >= 7
2 hour post >= 11.1
Asymptomatic patient at high risk
HbA1c < 6% or 42mmol/mol
Diabetes unlikely
Re-test in 3 years if indicated
Asymptomatic patient at high risk
HbA1c 6-6.4% or 42-46mmol/mol
High risk/Diabetes possible
Re-test in one year
Asymptomatic patient at high risk
HbA1c >=6.5% or 48mmol/mol
Diabetes likely
Confirm with repeat HbA1c
Diagnosing diabetes in symptomatic patients
Symptoms suggestive of hyperglycaemia
- lethargy, polyuria, polydipsia
- frequent fungal/bacterial infx
- blurred vision
- loss of sensation (touch, vibration, cold)
- poor wound healing
- weight loss
+ one of the following:
- hyperglycaemic crisis
- single elevated FBG >6mmol/L
- single HbA1c >6.5%
- random blood glucose > 11.1
A secondary lab test is not required to confirm dx unless uncertainty remains
Clinical signs of insulin resistance
Acanthosis nigricans
Skin tags
Central obesity
Hirsutism
Define: Type 1 Diabetes
B-cell destruction due to an autoimmune process leading to insulin deficiency
Define: Type 2 Diabetes
Progressive insulin secretory defect on the background of insulin resistance
Define: Gestational Diabetes Mellitus
Glucose tolerance with onset or first recognition during pregnancy
