Diabetes mellitus type 1 Diagnostic study of choice: Difference between revisions
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==Overview== | ==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). | The [[Diagnostic study of choice|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 [[diabetes mellitus type 1|type 1 DM]] include 2-h [[blood sugar|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 [[symptom|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== | ||
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><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 study of choice]] for [[diabetes mellitus]] is [[Fasting plasma glucose|fasting plasma glucose (FPG)]]. According to the ADA criteria, [[diabetes mellitus]] is [[Diagnosis|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><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 recommendation== | |||
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!style="background:#4479BA; color: #FFFFFF;" align="center" + |'''American Diabetes Association (ADA) Recommendation for [[diagnosis]] of [[diabetes mellitus type 1|DM type 1]]''' | |||
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* [[blood sugar|Plasma blood glucose]] rather than [[Glycosylated hemoglobin|A1C]] should be used to [[diagnosis|diagnose]] the acute onset of [[diabetes mellitus type 1|type 1 diabetes]] in individuals with [[symptoms|symptoms]] of [[hyperglycemia]]. | |||
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* [[Screening]] for [[diabetes mellitus type 1|type 1 diabetes]] with a panel of [[Autoantibody|autoantibodies]] is currently recommended only in the setting of a [[research]] trial or in first-degree family members of a proband with [[diabetes mellitus type 1|type 1 diabetes]]. | |||
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* Persistence of two or more [[Autoantibody|autoantibodies]] predicts clinical [[diabetes]] and may serve as an indication for intervention in the setting of a [[clinical trial]]. | |||
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|style="background:#DCDCDC;" align="left" + |<small>'''Adapted from [https://doi.org/10.2337/dc18-S002 American Diabetes Association (ADA)]'''</small> | |||
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==Diagnostic criteria== | ==Diagnostic criteria== | ||
ADA criteria for the diagnosis of type 1 | |||
ADA criteria for the [[diagnosis]] of [[diabetes mellitus type 1|type 1 diabetes]] 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> | |||
{| class="wikitable" | {| class="wikitable" | ||
!ADA Criteria for the diagnosis of | ! style="background:#4479BA; color: #FFFFFF;" align="center" + |'''American Diabetes Association (ADA) Criteria for the [[diagnosis]] of [[Diabetes]]''' | ||
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|[[Fasting plasma glucose|FPG]] ≥126 mg/dL (7.0 mmol/L). [[Blood sugar|Fasting]] is defined as no caloric intake for at least 8 h.* | | style="background:#F5F5F5;" align="center" + |[[Fasting plasma glucose|FPG]] ≥126 mg/dL (7.0 mmol/L). [[Blood sugar|Fasting]] is defined as no [[calorie|caloric]] intake for at least 8 h.* | ||
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|OR | |style="background:#F5F5F5;" align="center" + |OR | ||
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|2-h PG ≥200 mg/dL (11.1 mmol/L) during an [[Glucose tolerance test|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.* | |style="background:#F5F5F5;" align="center" + |2-h [[blood sugar|PG]] ≥200 mg/dL (11.1 mmol/L) during an [[Glucose tolerance test|OGTT]]. The test should be performed as described by the [[World Health Organization|WHO]], using a [[glucose]] load containing the equivalent of 75 g anhydrous [[glucose]] dissolved in water.* | ||
|- | |- | ||
|OR | |style="background:#F5F5F5;" align="center" + |OR | ||
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|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.* | |style="background:#F5F5F5;" align="center" + |[[Glycosylated hemoglobin|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 [[Complication (medicine)|Complications]] Trial|DCCT]] assay.* | ||
|- | |- | ||
|OR | |style="background:#F5F5F5;" align="center" + |OR | ||
|- | |- | ||
|In a patient with classic symptoms of [[hyperglycemia]] or [[hyperglycemic crisis]], a random plasma glucose ≥200 mg/dL (11.1 mmol/L). | |style="background:#F5F5F5;" align="center" + |In a [[patient]] with classic [[symptom|symptoms]] of [[hyperglycemia]] or [[hyperglycemic crisis]], a random [[blood sugar|plasma glucose]] ≥200 mg/dL (11.1 mmol/L). | ||
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|style="background:#DCDCDC;" align="left" + |<small>'''Adapted from [https://doi.org/10.2337/dc18-S002 American Diabetes Association (ADA)]'''</small> | |||
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* In the absence of unequivocal [[hyperglycemia]], results should be confirmed by repeat testing. | * In the absence of unequivocal [[hyperglycemia]], results should be confirmed by repeat testing. | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} |
Latest revision as of 10:57, 20 September 2020
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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 |
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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 |
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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
- ↑ 1.0 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.
- ↑ 2.0 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.
- ↑ "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.
- ↑ 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.