Diagnosis of Hyperglycemia
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Created by:
fraittrain on January 22, 2011
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What are the 3 criteria that lead to a diagnosis of diabetes? | - Fasting plasma glucose (FPG): 126 mg/dL or higher - Plasma glucose 2 hr after 75 g glucose load (2hr PG): 200 mg/dL or higher - A casual/random plasma glucose (PG) of 200 mg/dL or higher - Confirmation is not required if the patient presents with either a hyperosmolar or ketotic crisis. The criteria apply to both adult and pediatric patients. |
What are normal FPG and 2hr Postprandial after 75g glucose challenge? | - FPG below 110 mg/dL - 2h PG below 140 mg/dL Borderline type includes those who are neither diabetic nor normal types, e.g. IFG or IGT. |
Casual (Random) Plasma Glucose (RPG) Assay | Irrespective of last meal or time of day. Glucose result of 200mg/dL or greater in presence of symptoms is presumptive of DM. |
Fasting Plasma Glucose (FPG) Assay | Fast for at least 8hrs. FPG result less than 110 mg/dL is normal, between 110 and 125 mg/dL imply impaired fasting glucose (IFG), values greater than or equal to 126 mg/dL indicate DM. |
Two Hour Posprandial Plasma Glucose (2-H PP) | Plasma glucose measured 2hrs after 75g glucose load. Value greater than or equal to 200mg/dL indicative of DM if confirmed on another day by either an elevated FPG (above 126) or RPG value (200) or elevated glycosylated hemoglobin A1c. |
Impaired glucose tolerance | 2hrs after 75g glucose load. Correlates to values between 140 and 199mg/dL. Value of less than 140mg/dL are considered normal. |
Oral Glucose Tolerance Test (OGTT) | Plasma glucose levels measured every 30mins for up to 3hrs. In diabetic, glucose levels start high and rise higher than in a normal patient. Levels also remain higher for a longer period of time. |
-Line 1 is a normal response. What is Line 2 showing? -Line 1 is normal response. What is line 3 showing? -Line 1 is normal. What is line 4 showing? | ![]() -Impaired Glucose Tolerance (IGT). Glucose level rises higher than 140 but is less than 200. -Impaired Fasting Glucose (IFG). -DM |
Screening for Gestational Diabetes Mellitus (GDM) | No fasting required. 50g glucose load. Between 24-28 weeks gestation. If FPG >125mg/dL then GDM confirmed. If Peak plasma or 2hr glucose value >200mg/dL then GDM confirmed. |
Intravenous Glucose Tolerance Test | Performed in place of OGTT (Oral Glucose Tolerance Test). For patients w/ poor absorption of orally administered glucose. [May have a glucose transporter problem in GI tract]. |
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