Diabetes mellitus type 1 Diagnostic study of choice

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Trusha Tank, M.D.[2]

Overview

The diagnostic test of choice for diabetes mellitus is fasting plasma glucose (FPG). According to the ADA criteria, diabetes mellitus is diagnosed with FPG ≥126 mg/dL (7.0 mmol/L). Other diagnostic findings consistent with the diagnosis of type 1 DM include 2-h PG ≥200 mg/dL (11.1 mmol/L) during an OGTT, or A1C ≥6.5% (48 mmol/mol), or classic symptoms of hyperglycemia or hyperglycemic crisis, a random plasma glucose ≥200 mg/dL (11.1 mmol/L).

Diagnostic study of choice

Diagnostic study of choice for diabetes mellitus is fasting plasma glucose (FPG). According to the ADA criteria, diabetes mellitus is diagnosed with FPG ≥126 mg/dL (7.0 mmol/L). [1][2][3]

Diagnostic recommendation

American Diabetes Association (ADA) Recommendation for diagnosis of DM type 1
Adapted from American Diabetes Association (ADA)

Diagnostic criteria

ADA criteria for the diagnosis of type 1 diabetes follows:[1][2][4]

American Diabetes Association (ADA) Criteria for the diagnosis of Diabetes
FPG ≥126 mg/dL (7.0 mmol/L). Fasting is defined as no caloric intake for at least 8 h.*
OR
2-h PG ≥200 mg/dL (11.1 mmol/L) during an OGTT. The test should be performed as described by the WHO, using a glucose load containing the equivalent of 75 g anhydrous glucose dissolved in water.*
OR
A1C ≥6.5% (48 mmol/mol). The test should be performed in a laboratory using a method that is NGSP certified and standardized to the [[Diabetes Control And Complications Trial|DCCT]] assay.*
OR
In a patient with classic symptoms of hyperglycemia or hyperglycemic crisis, a random plasma glucose ≥200 mg/dL (11.1 mmol/L).
Adapted from American Diabetes Association (ADA)
  •  In the absence of unequivocal hyperglycemia, results should be confirmed by repeat testing.

References

  1. 1.0 1.1 Nguyen Q, Nguyen L, Felicetta J (October 2008). "Evaluation and management of diabetes mellitus". Am Health Drug Benefits. 1 (8): 39–48. PMC 4106505. PMID 25126259.
  2. 2.0 2.1 "Standards of medical care in diabetes--2008". Diabetes Care. 31 Suppl 1: S12–54. January 2008. doi:10.2337/dc08-S012. PMID 18165335.
  3. "2. Classification and Diagnosis of Diabetes:Standards of Medical Care in Diabetes—2018". Diabetes Care. 41 (Supplement 1): S13–S27. 2017. doi:10.2337/dc18-S002. ISSN 0149-5992.
  4. Sacks DB, Arnold M, Bakris GL, Bruns DE, Horvath AR, Kirkman MS, Lernmark A, Metzger BE, Nathan DM (June 2011). "Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus". Diabetes Care. 34 (6): e61–99. doi:10.2337/dc11-9998. PMC 3114322. PMID 21617108.