|
CRITERIA
FOR
DIAGNOSIS OF DIABETES
Guidelines.
 |
Urine
Sugar testing must not be used to diagnose diabetes. | |
True
blood glucose should be estimated using enzymatic methods like the 'Glucose
Oxidase Method'. |
Criteria
for diagnosis.
Fasting
blood glucose.
|
Fasting
venous whole blood glucose of more than 110 mg %. | |
Fasting
venous plasma blood glucose of more than 126 mg %. |
OR
Random
blood glucose.
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Random venous whole
blood glucose of more than 180 mg %.(Plasma
blood glucose of more than 200 mg %),confirmed
on repeated testing, in a patient with characteristic sign and symptoms of
diabetes. |
Glucose
Tolerance Test.
 |
Abnormal
'Glucose Tolerance Test'. |
Glucose
Tolerance Test. (G.T.T)
Preparation
of patient.
|
The
person to be tested must be on a normal diet for at least 48 to 72 hours
prior to the test; this should contain at least 300 grams of carbohydrates per
day, which is not a problem in those eating a traditional Indian diet. | |
The
test should be carried out after fasting for 8-10 hours. | |
The
person must rest throughout the test. | |
No
smoking during test. |
Procedure.
 |
Blood
is collected in fasting state, and then 75 grams of glucose is given orally,
this may be diluted to avoid nausea and flavored with a little lime to make
it more palatable, the glucose solution should be drunk with in 2-3 minutes. | |
Blood
is collected 2 hours after glucose ingestion. | |
The
results are interpreted according to the WHO. criteria. |
GLUCOSE CONCENTRATION (mg / 100ml)
|
|
WHOLE BLOOD
|
PLASMA
VENOUS
|
|
VENOUS
|
CAPILLARY
|
|
DIABETES
MELLITUS
|
|
FASTING
OR
2
HRS POST GLUCOSE LOAD
(OR
BOTH) |
>/=110
>/=180 |
>/=110
>/=200
|
>/=126
>/=200 |
|
IMPAIRED
GLUCOSE TOLERANCE- I.G.T
|
|
FASTING
(IF MEASURED)
AND
2 HRS POST GLUCOSE LOAD |
<110
>/=120 &<180
|
<110
>/=140 &<200
|
<126
>/=140 &<200
|
|
IMPAIRED
FASTING GLYCEMIA- I.F.G
|
|
FASTING
2
HRS POST
GLUCOSE
LOAD
(IF
MEASURED) |
>/=100
& <110
<120 |
>/=100
& <110
<140 |
>/=100
& <126
<140 |
Impaired Glucose Tolerance (I.G.T)
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Many
patients in this category will go on to have diabetes; | |
Many I.G.T. patients show
associated problems like hypertension, lipid disorders, high uric acid, obesity
etc. which merit treatment; | |
I.G.T. is a risk factor for development of macro vascular
disease. (angina, stroke, retinal damage, kidney failure) |
Impaired Fasting Glycemia.- I.F.G
|
Impaired
fasting glycemia is an entity which has been recently introduced to
delineate persons in whom only the fasting blood glucose has been done, but
who do not come in the normal or diabetic category.
| |
It
has been proposed that the diagnosis of diabetes can be made from a fasting
blood glucose level only and that it may not be necessary to do a
complete Glucose
Tolerance Test. (G.T.T)
| |
The
general consensus is that whilst doing only the fasting blood glucose may be
sufficient to pin point those with diabetes, it may be better to confirm
this with a complete Glucose
Tolerance Test. (G.T.T), if feasible.
|
A
negative Glucose
Tolerance Test. (G.T.T) result shows that the patient is not a Diabetic at the
time of testing; it does not mean that he will never develop Diabetes; such
persons must have an annual check up.
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