Diagnosis of Hyperglycemia

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Created by:

fraittrain  on January 22, 2011

Subjects:

merp medical biochemistry

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Diagnosis of Hyperglycemia

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.
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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) AssayIrrespective 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) AssayFast 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 tolerance2hrs 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 TestPerformed 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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