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Diagnosis of diabetes

Diagnosis of diabetes. Diabetic symptoms. Diabetic symptoms + venous sample for : Random venous ≥ 11.1 mmol/l (4.4-7.8) Fasting glucose > 7 (<6.1) OGTT ≥ 11.1 (<7.8) HbA1c ≥ 6.5 (<6). Asymptomatic.

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Diagnosis of diabetes

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  1. Diagnosisof diabetes

  2. Diabetic symptoms Diabetic symptoms + venous sample for : • Random venous ≥ 11.1 mmol/l (4.4-7.8) • Fasting glucose > 7 (<6.1) • OGTT ≥ 11.1 (<7.8) • HbA1c ≥ 6.5 (<6)

  3. Asymptomatic Plasma venous confirmation + 2nd blood test (3/12) (random/fasting/OGTT)

  4. Oral Glucose Tolerance Test (OGTT) • Fast 15h • 75g glucose in 300ml water in 5min • After 2h: normal < 7.8 IGT 7.8-11 DM ≥ 11.1

  5. HbA1c Glycosylation of Hg at rate proportional to : red cell life span blood glucose concentration Measure of blood glucose over 60 days If HbA1c > 6.5% = type 2 diabetes (mean 8.5)

  6. HbA1c • Not appropriate in: • Type 1, young • Symptoms < 2/12 • Medications causing glucose (steroids, antipsychotics) • Pregnancy

  7. HbA1c • Not appropriate in: • Anaemias/haemoglobinopathies • CKD 4/5 • Liver disease

  8. Pre-diabetes Pre-diabetes (impaired gluose tolerance, impaired fasting glucose): HbA1c: 6-6.4% Fasting glucose 6.1-6.9mmol/l (normal < 6.1) IGT OGTT 7.8-11.1, Fasting < 7 IFG OGTT < 7.8, Fasting < 7

  9. Pre-diabetes • Cardiovascular risks • Progression to diabetes ~ 50% over 10y • Annual review: glucose regulation CV risk factors

  10. Thank You

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