Diabetes mellitus type 2 diagnostic study of choice: Difference between revisions

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Revision as of 20:06, 17 January 2019

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

Overview

Fasting plasma glucose, 2-h plasma glucose during 75-g oral glucose tolerance test, and A1C are equally appropriate in diagnosing diabetes mellitus type 2.

Diagnostic study of choice

According to the ADA criteria, fasting plasma glucose, 2-h plasma glucose during 75-g oral glucose tolerance test, and A1C are equally appropriate in diagnosing diabetes mellitus type 2.^[1]

Diagnostic criteria

ADA criteria for the diagnosis of type 2 DM follows:^[2]^[3]^[4]

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 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).

In the absence of unequivocal hyperglycemia, results should be confirmed by repeat testing.

References

↑ "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.
↑ 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.
↑ "Standards of medical care in diabetes--2008". Diabetes Care. 31 Suppl 1: S12–54. January 2008. doi:10.2337/dc08-S012. PMID 18165335.
↑ 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.

[1] "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.

[pmid25126259-2] 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.

[pmid18165335-3] "Standards of medical care in diabetes--2008". Diabetes Care. 31 Suppl 1: S12–54. January 2008. doi:10.2337/dc08-S012. PMID 18165335.

[pmid21617108-4] 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.

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 ==Overview==
-The diagnostic test of choice for diabetes mellitus is [[Fasting plasma glucose|fasting plasma glucose (FPG)]]. According to the ADA criteria, diabetes mellitus is diagnosed with [[Fasting plasma glucose|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 [[Glucose tolerance test|OGTT]], or [[Glycosylated hemoglobin|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).
+Fasting plasma glucose, 2-h plasma glucose during 75-g oral glucose tolerance test, and A1C are equally appropriate in diagnosing diabetes mellitus type 2.
 ==Diagnostic study of choice==
-Diagnostic study of choice for diabetes mellitus is [[Fasting plasma glucose|fasting plasma glucose (FPG)]]. According to the ADA criteria, diabetes mellitus is diagnosed with [[Fasting plasma glucose|FPG]] ≥126 mg/dL (7.0 mmol/L). <ref name="pmid25126259">{{cite journal |vauthors=Nguyen Q, Nguyen L, Felicetta J |title=Evaluation and management of diabetes mellitus |journal=Am Health Drug Benefits |volume=1 |issue=8 |pages=39–48 |date=October 2008 |pmid=25126259 |pmc=4106505 |doi= |url=}}</ref><ref name="pmid18165335">{{cite journal |vauthors= |title=Standards of medical care in diabetes--2008 |journal=Diabetes Care |volume=31 Suppl 1 |issue= |pages=S12–54 |date=January 2008 |pmid=18165335 |doi=10.2337/dc08-S012 |url=}}</ref>
+According to the ADA criteria, fasting plasma glucose, 2-h plasma glucose during 75-g oral glucose tolerance test, and A1C are equally appropriate in diagnosing diabetes mellitus type 2.<ref>{{cite journal|title=2. Classification and Diagnosis of Diabetes:Standards of Medical Care in Diabetes—2018|journal=Diabetes Care|volume=41|issue=Supplement 1|year=2017|pages=S13–S27|issn=0149-5992|doi=10.2337/dc18-S002}}</ref>
 ==Diagnostic criteria==
-ADA criteria for the diagnosis of type 1 DM follows:<ref name="pmid25126259">{{cite journal |vauthors=Nguyen Q, Nguyen L, Felicetta J |title=Evaluation and management of diabetes mellitus |journal=Am Health Drug Benefits |volume=1 |issue=8 |pages=39–48 |date=October 2008 |pmid=25126259 |pmc=4106505 |doi= |url=}}</ref><ref name="pmid18165335">{{cite journal |vauthors= |title=Standards of medical care in diabetes--2008 |journal=Diabetes Care |volume=31 Suppl 1 |issue= |pages=S12–54 |date=January 2008 |pmid=18165335 |doi=10.2337/dc08-S012 |url=}}</ref><ref name="pmid21617108">{{cite journal |vauthors=Sacks DB, Arnold M, Bakris GL, Bruns DE, Horvath AR, Kirkman MS, Lernmark A, Metzger BE, Nathan DM |title=Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus |journal=Diabetes Care |volume=34 |issue=6 |pages=e61–99 |date=June 2011 |pmid=21617108 |pmc=3114322 |doi=10.2337/dc11-9998 |url=}}</ref>
+ADA criteria for the diagnosis of type 2 DM follows:<ref name="pmid25126259">{{cite journal |vauthors=Nguyen Q, Nguyen L, Felicetta J |title=Evaluation and management of diabetes mellitus |journal=Am Health Drug Benefits |volume=1 |issue=8 |pages=39–48 |date=October 2008 |pmid=25126259 |pmc=4106505 |doi= |url=}}</ref><ref name="pmid18165335">{{cite journal |vauthors= |title=Standards of medical care in diabetes--2008 |journal=Diabetes Care |volume=31 Suppl 1 |issue= |pages=S12–54 |date=January 2008 |pmid=18165335 |doi=10.2337/dc08-S012 |url=}}</ref><ref name="pmid21617108">{{cite journal |vauthors=Sacks DB, Arnold M, Bakris GL, Bruns DE, Horvath AR, Kirkman MS, Lernmark A, Metzger BE, Nathan DM |title=Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus |journal=Diabetes Care |volume=34 |issue=6 |pages=e61–99 |date=June 2011 |pmid=21617108 |pmc=3114322 |doi=10.2337/dc11-9998 |url=}}</ref>
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