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.

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