DIABETES MELLITUSDIABETES MELLITUS Current diagnostic criteriaCurrent diagnostic criteria

Diabetes symptoms (polyuria, polydipsia, unexplained weight loss) plus: – Random venous plasma glucose 200 mg/dl or– Fasting venous plasma glucose 126 mg/dl or – 2 hour venous plasma glucose 200 mg/dl (after 75 g glucose in

OGTT)

No symptoms: at least two glucose tests on different days within diabetic range

WHO definition, diagnosis and classification of diabetes mellitus and its complications. http://www.diabetes.org.uk/healthcare/5/sum.htm

Classic symptoms of DiabetesClassic symptoms of Diabetes

Excess urine (Polyuria), Excess drinking water

(Polydipsia), Recent weight loss, Blurring of vision, Genital infection

– Balanoposthitis in man,– Vulvovaginitis in women.

Fasting and RandomFasting and Random

FASTING– Overnight fast,– Sample in the morning,– No diet restriction,– Venous blood.

RANDOM– Anytime of the day,– Helpful for

epidemiological purpose,

– No diet restriction,– Venous blood.

GTT - GTT - Diagnostic CriteriaDiagnostic Criteria

Normal– 2h value <140 mg

Borderline– 2h value 140 – 199 mg

Diabetes– 2h 200 mg or more.

Glucose Tolerance Test -Glucose Tolerance Test -ProcedureProcedure

Normal diet for at least 3 days, Overnight fasting, Blood sample for fasting glucose, 75 Gm glucose in 300 ml water to drink over 5 min, Blood sample after 2hr for glucose, Delayed breakfast.

Should not be admitted, No smoking Free from stress Six wks from significant medical illness.

Why the diagnose delayed?Why the diagnose delayed?

Awareness is sub-optimum,

Negligence, Economic restraint, Access to medical

service, Non-specific

presentation.