Skip to main content

Diabetes Mellitus: Clinical Presentation and Diagnosis!

 CLINICAL PRESENTATION AND DIAGNOSIS OF DM


2. SCREENING

  • American Diabetes Association (ADA) recommends routine screening for T2 DM every 3 years in all adults starting at 45 years of age.
  • Testing of T2 DM should be considered in any adult, regardless of their age, who have a BMI greater than or equal to 25kg/m2.
  • The ADA does not currently recommend widespread screening for T1 DM because of the relatively low incidence in the general population, although measurement of Islet antibodies may be appropriate for high-risk individuals.


3.GESTATIONAL DIABETES:

"Gestational diabetes is the glucose intolerance in women during pregnancy".

  • All pregnant women who have risk factors for T2 DM should be screened for undiagnosed T2 DM at their first prenatal visit using standard diagnostic criteria. 
  • Any women found to have diabetes in the early point at pregnancy is considered to have T2 DM or GDM.
  • All other pregnant women, not currently known to have DM should be screened for GDM with a 75g oral-glucose tolerance test (OGTT) between weeks 24 and 28 of gestation. 


4.ADA CRITERIA FOR THE DIAGNOSIS OF DM:

1. Symptoms of diabetes plus a casual plasma glucose conc. greater than or equal to 200mg/dL.
    "Casual is defined as any time of day without regard to time since last meal, the classic symptoms of        Diabetes include polyuria, polydipsia, and unexplained weight loss.

2. FPG greater or equal to 126mg/dL. "Fasting is defined as no caloric intake for at least 8 hours".

3. 2 hr. post load glucose greater or equal to 200mg/dL during OGTT. The test should be performed as     described by WHO using a glucose load containing the equivalent of 75g of anhydrous glucose               dissolved in water.

4. A1c greater or equal to 6.5%. The test should be performed in a laboratory using a method that is            NGSP Certified to DCCT Assay.


Labels:

Comments

Post a Comment

Popular posts from this blog

General Mechanism of Actions of INSULIN.

GENERAL MECHANISM OF ACTION OF INSULIN AND RELATE HORMONES The body's main fuel is Glucose. Glucose is stored in the liver and muscles as Glycogen.  Excess glucose is stored in the adipose tissues which yield fatty acids via lipolysis. In the fasting state, free fatty acids supply much of the energy needs of the body except for the CNS which requires Glucose to function normally. Proteins can also be converted to glucose via gluconeogenesis. RELEASE OF INSULIN AND GLUCAGON Insulin and Glucagon are produced in the pancreas by the Islets of Langerhans . Beta cells   make up 70%-90% of the Islets and produce Insulin and Amylin while the a-cells   produce glucagon. The main function of insulin is to decrease blood glucose levels. Glucagon, along with other counter-regulatory hormones such as growth factor, cortisol, and Epinephrine, increases Blood glucose levels.  The opposing actions of Glucagon and Insulin along with other counter-regulatory hormones maintain a norma...
Post a Comment
Read more

Diabetes Mellitus: Its Goals Of Therapy!

  GOAL OF THERPY The goals of treatment of DM includes; Reducing, controlling and managing long-term microvascular, macrovascular and neuropaathic complications. Preserving beta cell function. Preventing acute complications from increased Blood glucosel level. Minimizing hypoglycemic episodes. Maintaining patient quality of life. --Two landmark trials, THE DIABETES CONTROL AND COMPLICATION TRIAL (DCCT) and THE UNITED KINGDOM PROSPECTIVE DIABETES STUDY(UKPDS), showed that lowering blood glucose levels decreased the risk of developing chronic complications. --A near normal blood glucose level can be achieved with appropriate patient education , lifestyle modification and medications . --Proper care of DM requires goal setting and assessment for glycemic control , self-monitoring of blood glucose (SMBG) monitoring of blood glucose pressure , and lipid levels , regular monitoring for the development of complications , dietary and exercise lifestyle modifications and proper medicatio...
Post a Comment
Read more