Please register or login to view the chart

Type 2 diabetes – diagnosis

Tests – criteria to establish Type 2 diabetes Fasting plasma glucose of
 > 7.0 mmol / L or more Fasting is defined as no caloric intake for atleast 8 hrs

 

Random Blood
 glucose > 11.1 mmol /L , And presence of symptoms of diabetes including polyuria , polydipsia and unexplained weight loss

 

If the person is symptomatic – a single HbA1c or fasting plasma glucose level 
can be used , although repeat testing is 
sensible to confirm diagnosis

 

If the person is asymptomatic – do not diagnose diabetes on the basis of a 
single abnormal HbA1c or plasma glucose result
Repeat the test preferably the same one to confirm diagnosis ( if repeat test normal -monitor )

 

HbA1c of 48 mmol /mol
 ie 6.5 % or more HbA1c may lack accuracy ( specificity / and or sensitivity )
 in the following group
 age < 18 yrs acute – onset glycemic states such as post-traumatic type 2 diabetes 
( e,g pancreatitis ) rapid onset of glycemia with sepsis and steroid use
ie severe glycemia when a person is acutely unwell is not diagnostic of diabetes on long term medications which can cause hyperglycemia as steroids pregnant women or 2 months post partum people with underlying haemoglobinopathy or hemolysis or advanced CKD , sickle cell disease , recent blood transfusion , iron deficiency anaemia pancreatic damage including pancreatic surgery End stage renal disease ( ESRD ) HIV infection

 

Take into account any existing disease suggesting insulin resistance as
 CVD Obesity PCOS NAFLD Metabolic syndrome

 

OGTT 11.1 mmol / L or more – as per WHO instructions 8 hr fasting 75 g glucose oral venous blood fasting and 2 hr post glucose challenge.

REFERENCES

  1. Type 2 diabetes what is it ? CKS NHS Definition | Background information | Diabetes – type 2 | CKS | NICE
  2. Freeman AM, Pennings N. Insulin Resistance. 2021 Jul 10. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. PMID: 29939616. ( Excerpt ) Insulin Resistance – PubMed (nih.gov)
  3. Irish College of General Practitioners A practical guide to Integrated Type 2 Diabetes Care Dr Velma Harkins icgp-guide-to-integrated-type-2.pdf (hse.ie)

Share

Related Charts:

Add Your Comments

Your email address will not be published.

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

A4 Medicine  - Search Less and Learn More

Welcome to the A4 medicine community where we are constantly working to provide exceptional educational material to primary health care professionals. Subscribe to our website for complete access to our A4 Charts. They are aesthetically designed charts that contain 300 (plus and adding) common and complex medical conditions with the all information required for primary care in one single page that can help you in consultation/practice and exam.

Additionally, you will get complete access for our Learn From Experts : A4 Webinar Series in which domain experts share the video explainer presentation on one medical condition in one hour for the primary care. And you will also get a hefty discount on our publications and upcoming digital products.

We are giving a lifetime flat 30% discount to our first thousand users, discount code already applied to checkout.