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

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==Overview==
==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.
[[Blood sugar|Fasting plasma glucose]], 2-h [[Blood sugar|plasma glucose]] during 75-g [[Glucose tolerance test|oral glucose tolerance test]], and [[Glycosylated hemoglobin|A1C]] are equally appropriate in diagnosing [[diabetes mellitus type 2]].


==Diagnostic recommendation==
==Diagnostic recommendation==
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>
According to the ADA criteria, fasting [[Blood sugar|plasma glucose]], 2-h [[Blood sugar|plasma glucose]] during 75-g oral [[glucose tolerance test]], and [[Glycosylated hemoglobin|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>
 


{| class="wikitable"
{| class="wikitable"
|+
|+
!style="background:#4479BA; color: #FFFFFF;" align="center" + |'''Diabetes mellitus type 2 diagnostic recommendations'''
! style="background:#4479BA; color: #FFFFFF;" align="center" + |'''ADA Recommendation For Diagnosis of Diabetes Mellitus Type 2'''
|-
|-
|Testing for type 2 diabetes in asymptomatic people should be considered in adults of any age who are overweight or obese (BMI ≥25 kg/m2 or ≥23 kg/m2 in Asian Americans) and who have one or more additional risk factors for diabetes
|
* Testing for [[Diabetes mellitus type 2|type 2 diabetes]] in asymptomatic people should be considered in adults of any age who are [[overweight]] or [[Obesity|obese]] ([[Body mass index|BMI]] ≥25 kg/m2 or ≥23 kg/m2 in Asian Americans) and who have one or more additional [[Risk factor|risk factors]] for [[Diabetes mellitus|diabetes]]
|-
|-
|For all people, testing should begin at age 45 years.
|
* For all people, testing should begin at age 45 years.
|-
|-
|If tests are normal, repeat testing carried out at a minimum of 3-year intervals is reasonable.
|
* If tests are normal, repeat testing carried out at a minimum of 3-year intervals is reasonable.
|-
|-
|To test for type 2 diabetes, fasting plasma glucose, 2-h plasma glucose during 75-g oral glucose tolerance test, and A1C are equally appropriate.  
|
* To test for [[Diabetes mellitus type 2|type 2 diabetes]], fasting [[Blood sugar|plasma glucose]], 2-h [[Blood sugar|plasma glucose]] during 75-g oral [[glucose tolerance test]], and [[Glycosylated hemoglobin|A1C]] are equally appropriate.
|-
|-
|In patients with diabetes, identify and treat other cardiovascular disease risk factors.
|
* In patients with [[diabetes]], identify and treat other [[cardiovascular disease]] [[Risk factor|risk factors]].
|-
|-
|Testing for type 2 diabetes should be considered in children and adolescents who are overweight or obese (BMI >85th percentile for age and sex, weight for height >85th percentile, or weight >120% of ideal for height) and who have additional risk factors for diabetes
|
* Testing for [[Diabetes mellitus type 2|type 2 diabetes]] should be considered in children and adolescents who are [[overweight]] or [[Obesity|obese]] ([[Body mass index|BMI]] >85th percentile for age and sex, weight for height >85th percentile, or weight >120% of ideal for height) and who have additional [[Risk factor|risk factors]] for [[diabetes]]
|-
|-
!style="background:#DCDCDC; + " |<small>'''Adapted from [http://care.diabetesjournals.org/content/41/Supplement_1/S13.html#bx2| ADA]'''
| style="background:#DCDCDC;" align="left" + |<small>'''Adapted from [https://doi.org/10.2337/dc18-S002 American Diabetes Association (ADA)]'''</small>
|}
|}


==Diagnostic criteria==
==Diagnostic criteria==
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>
American Diabetes Association (ADA) [[Criterion|criteria]] for the [[diagnosis]] of [[Diabetes mellitus type 2|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>


{| class="wikitable"
{| class="wikitable"
!ADA Criteria for the diagnosis of diabetes
! style="background:#4479BA; color: #FFFFFF;" align="center" + |'''American Diabetes Association (ADA) Criteria for the Diagnosis of Diabetes'''
|-
|-
|[[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 caloric intake for at least 8 hours.*
|-
|-
|OR
| style="background:#F5F5F5;" align="center" + |OR
|-
|-
|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-hours 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
|-
|-
|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 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 symptoms of [[hyperglycemia]] or [[hyperglycemic crisis]], a random [[Blood sugar|plasma glucose]] ≥200 mg/dL (11.1 mmol/L).
|-
|-
!style="background:#DCDCDC; + " |<small>'''Adapted from [http://care.diabetesjournals.org/content/41/Supplement_1/S13.html#bx2| ADA]'''
| style="background:#DCDCDC;" align="left" + |<small>'''Adapted from [https://doi.org/10.2337/dc18-S002 American Diabetes Association (ADA)]'''</small>
|}
|}
 
* 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 14:33, 6 August 2020

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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 recommendation

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]

ADA Recommendation For Diagnosis of Diabetes Mellitus Type 2
  • For all people, testing should begin at age 45 years.
  • If tests are normal, repeat testing carried out at a minimum of 3-year intervals is reasonable.
  • Testing for type 2 diabetes should be considered in children and adolescents who are overweight or obese (BMI >85th percentile for age and sex, weight for height >85th percentile, or weight >120% of ideal for height) and who have additional risk factors for diabetes
Adapted from American Diabetes Association (ADA)

Diagnostic criteria

American Diabetes Association (ADA) criteria for the diagnosis of type 2 DM follows:[2][3][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 hours.*
OR
2-hours 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).
Adapted from American Diabetes Association (ADA)
  •  In the absence of unequivocal hyperglycemia, results should be confirmed by repeat testing.

References

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