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.
|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).
|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].|