Diagnosis of Diabetes mellitus
Diabetes mellitus is characterized
by recurrent or persistent high blood sugar, and is diagnosed by demonstrating
any one of the following:
by recurrent or persistent high blood sugar, and is diagnosed by demonstrating
any one of the following:
- Fasting plasma glucose level ≥ 7.0
mmol/l (126 mg/dl)
mmol/l (126 mg/dl)
- Plasma glucose ≥ 11.1 mmol/l (200
mg/dl) two hours after a 75 g oral glucose load as in a glucose tolerance test
mg/dl) two hours after a 75 g oral glucose load as in a glucose tolerance test
- Symptoms of high blood sugar and
casual plasma glucose ≥ 11.1 mmol/l (200 mg/dl)
casual plasma glucose ≥ 11.1 mmol/l (200 mg/dl)
- Glycated hemoglobin (HbA1C) ≥ 48
mmol/mol (≥ 6.5 DCCT %).
mmol/mol (≥ 6.5 DCCT %).
A positive result, in the absence of unequivocal high blood
sugar, should be confirmed by a repeat of any of the above methods on a
different day. It is preferable to measure a fasting glucose level because of
the ease of measurement and the considerable time commitment of formal glucose
tolerance testing, which takes two hours to complete and offers no prognostic
advantage over the fasting test. According to the current definition, two
fasting glucose measurements above 126 mg/dl (7.0 mmol/l) is considered
diagnostic for diabetes mellitus.
sugar, should be confirmed by a repeat of any of the above methods on a
different day. It is preferable to measure a fasting glucose level because of
the ease of measurement and the considerable time commitment of formal glucose
tolerance testing, which takes two hours to complete and offers no prognostic
advantage over the fasting test. According to the current definition, two
fasting glucose measurements above 126 mg/dl (7.0 mmol/l) is considered
diagnostic for diabetes mellitus.
Per the World Health Organization people with fasting
glucose levels from 6.1 to 6.9 mmol/l (110 to 125 mg/dl) are considered to have
impaired fasting glucose. People with plasma glucose at or above 7.8 mmol/l
(140 mg/dl), but not over 11.1 mmol/l (200 mg/dl), two hours after a 75 g oral
glucose load are considered to have impaired glucose tolerance. Of these two
prediabetic states, the latter in particular is a major risk factor for
progression to full-blown diabetes mellitus, as well as cardiovascular disease.
The American Diabetes Association since 2003 uses a slightly different range
for impaired fasting glucose of 5.6 to 6.9 mmol/l (100 to 125 mg/dl).
glucose levels from 6.1 to 6.9 mmol/l (110 to 125 mg/dl) are considered to have
impaired fasting glucose. People with plasma glucose at or above 7.8 mmol/l
(140 mg/dl), but not over 11.1 mmol/l (200 mg/dl), two hours after a 75 g oral
glucose load are considered to have impaired glucose tolerance. Of these two
prediabetic states, the latter in particular is a major risk factor for
progression to full-blown diabetes mellitus, as well as cardiovascular disease.
The American Diabetes Association since 2003 uses a slightly different range
for impaired fasting glucose of 5.6 to 6.9 mmol/l (100 to 125 mg/dl).
Glycated hemoglobin is better than fasting glucose for
determining risks of cardiovascular disease and death from any cause.
determining risks of cardiovascular disease and death from any cause.
Prevention of Diabetes mellitus
There is no known preventive measure for type 1 diabetes.
Type 2 diabetes — which accounts for 85-90% of all cases — can often be
prevented or delayed by maintaining a normal body weight, engaging in physical
exercise, and consuming a healthful diet. Higher levels of physical activity
(more than 90 minutes per day) reduce the risk of diabetes by 28%. Dietary
changes known to be effective in helping to prevent diabetes include
maintaining a diet rich in whole grains and fiber, and choosing good fats, such
as the polyunsaturated fats found in nuts, vegetable oils, and fish. Limiting
sugary beverages and eating less red meat and other sources of saturated fat
can also help prevent diabetes. Tobacco smoking is also associated with an
increased risk of diabetes and its complications, so smoking cessation can be
an important preventive measure as well.
Type 2 diabetes — which accounts for 85-90% of all cases — can often be
prevented or delayed by maintaining a normal body weight, engaging in physical
exercise, and consuming a healthful diet. Higher levels of physical activity
(more than 90 minutes per day) reduce the risk of diabetes by 28%. Dietary
changes known to be effective in helping to prevent diabetes include
maintaining a diet rich in whole grains and fiber, and choosing good fats, such
as the polyunsaturated fats found in nuts, vegetable oils, and fish. Limiting
sugary beverages and eating less red meat and other sources of saturated fat
can also help prevent diabetes. Tobacco smoking is also associated with an
increased risk of diabetes and its complications, so smoking cessation can be
an important preventive measure as well.
The relationship between type 2 diabetes and the main
modifiable risk factors (excess weight, unhealthy diet, physical inactivity and
tobacco use) is similar in all regions of the world. There is growing evidence
that the underlying determinants of diabetes are a reflection of the major
forces driving social, economic and cultural change: globalization,
urbanization, population aging, and the general health policy environment.
modifiable risk factors (excess weight, unhealthy diet, physical inactivity and
tobacco use) is similar in all regions of the world. There is growing evidence
that the underlying determinants of diabetes are a reflection of the major
forces driving social, economic and cultural change: globalization,
urbanization, population aging, and the general health policy environment.
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