Diagnosis and Classification of Diabetes Flashcards
How is screening conducted for type 1 diabetes?
Screening for presymptomatic type 1 diabetes, by testing autoantibodies to insulin, GAD, islet antigen 2, or ZnT8
is recommended in research study setting or for those with first-degree family members with type 1 diabetes.
Who should be screened for type 2 diabetes?
Test all adults starting at age 35 for prediabetes and diabetes using Fasting Plasma Glucose, A1c or OGTT
Who is risk based screening conducted on to assess for type 2 diabetes?
Perform risk-based screening if BMI is 25 or BMI is 23 in Asian Americans with 1 or more risk factors:
History of cardiovascular disease
Physical inactivity
First degree relative with diabetes
History of GDM (repeat test at least every 3 years)
People with HIV*
Hypertension 130/80 or on therapy for HTN
HDL of 35 mg/dl or triglyceride of 250 mg/dl
A1c of 5.7% or Impaired Fasting Glucose (test yearly)
Other clinical conditions associated with insulin
resistance (PCOS, Acanthosis Nigricans)
High risk ethnicity (African American, Latino, Native
American, Asian American, Pacific Islanders)
How often should rescreening for type 2 diabetes be repeated?
If results normal, repeat test at a minimum of 3-year intervals or more frequently based on risk status.
What screening should be conducted for people with HIV before starting antiretroviral therapy and how often should it be repeated?
Screen those w/ HIV with FPG before starting & during antiretroviral therapy. If FPG normal, check yearly.
What tests can be used to make a diagnosis of diabetes?
A1C 6.5 or greater, fasting plasma glucose 126 or greater, random plasma glucose of 200 + symptoms (usual polyuria, polydipsia, and unexplained wt. loss), or a 2 hour OGTT with 2 hour plasma glucose greater than or equal to 200.
What tests can be used to make a diagnosis of prediabetes?
A1C of 5.7 to 6.4, fasting plasma glucose 100-125, or a 2 hour OGTT with 2 hour plasma glucose 140-199.
What results indicate no prediabetes or diabetes?
A1C less than 5.7, fasting plasma glucose less than 100, or a 2 hour OGTT with 2 hour plasma glucose less than 140.
How is gestational diabetes diagnosed?
Can use either IADPSG consensus:
“One Step” 75-g OGTT fasting and at 1 and 2 h (perform after overnight fast of at least 8 h)
One Step: GDM diagnosis when ANY of
following BG values are exceeded:
Fasting ≥92 mg/dl,
1 h ≥180 mg/dl
2 h ≥153 mg/dl
“Two step” NIH Consensus – Step 1:
50gm glucose load (non fasting) w/ plasma BG test at 1 hr. If BG ≥ 130-140*, go to Step 2
Two Step -Step 2 - 100g OGTT (fasting) GDM diagnosis if at least 2 of 4 plasma BG measured fasting, 1h, 2h, 3h after OGTT are met or exceeded.
