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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.


  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 (
  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 (


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