Presented by:AMNA

AZEEMA

NOUREEN

SIDRA

Enumerate different tests used for the diagnosis of Diabetes mellitus

Discuss criteria diagnosis of Diabetes mellitus

Discuss oral glucose tolerence test Discuss gesational Diabetes

mellitus(GTD) and its diagnosis

Learning Objectives

A group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action or both.

The chronic hyperglycemia of diabetes is associated with the long term damage, dysfunction and failure of different organs, especially the eyes, kidneys, nerves, heart and blood vessels.

Diabetes mellitus

NORMAL VALUES:Impaired Fasting Glucose(IFG)•FPG: 100 to 125mg/dl (5.6 to 6.9 mmol/l)

Impaired Glucose Tolerance (IGT): •FPG =less than 7.0mmol/l (<126mg/dl)•2-hrs PG in 75-g OGTT =140 to 199 mg/dl (7.8 to 11.0mmol/l)

Glycosylated Hemoglobin(HBA1c): 5.7 – 6.4%

Fasting Plasma glucose Random Plasma Glucose 75g Oral Glucose Tolerance Test (OGTT)

Blood Glucose Tests

Fasting Plasma Glucose:

is a test that can be used to help diagnose diabetes or pre-diabetes.

FPG= 3.3-5.6mmol/l (60 - 100mg/dl): NFG

FPG= 5.6-6.9mmol/l (100 -125mg/dl): IFG

FPG= ≥7.0mmol/l (≥126): Diabetes

Random Plasma Glucose :

Only helpful in emergencies, Not useful in screening / diagnosis

RPG 3.3- 11.1 mmol/l (60-200mg/dl)

Fasting Glucose Test

A fasting plasma glucose test, also known as a fasting glucose test (FGT), is a test that can be used to help diagnose diabetes or pre-diabetes.

75g Oral glucose Tolerance Test

Test is performed in the morning after 6 – 14 hrs fast

Individual should remain seated during test without

smoking cigarette.

Test should begin between 0700 to 0900 hrs.

75g Glucose or 7.5g/Kg body weight is dissolved in 300

ml of water

Glucose in ingested over 5 minutes

Plasma glucose is measured during fasting followed by

Every one hour for 2hrs after an oral glucose load.

PROCEDURE

Test is not performed on hospitalized, acutely ill or

inactive subject

Test is performed only in ambulatory subjects

After 3 days of unrestricted diet ( at least 150 g

of CHO / day ) and activity

PRECAUTIONS

2hPG <7.8 mmol/L(< 140mg/dl):

Normal

2hPG 7.8-11.0 mmol/L(140 – 199mg/dl):

Impaired Glucose Tolerance

2hPG >11.1 mmol/L(> 200mg/dl):

Diabetes Mellitus

75g OGTT: Interpretation

Non enzymatic binding of glucose to Haemoglobin alpha chains•Hb A1a/b/c (97%)•HbA 2 (2.5%)•HbF (0.5%)Expressed as the percent of total hemoglobin •<5.7%: normal•5.7 – 6.4%: Prediabetes•≥ 6.5%: DiabetesIt reflects mean blood glucose over the past 2-3 monthsHelpful in management in known diabetics

Glycosylated Haemoglobin(HBA1c)

GDM is defined as any degree of glucose intolerance with onset or first recognition during pregnancy

In the majority of cases of GDM, glucose regulation will return to normal after delivery.

5) Gestational Diabetes mellitus(GTD)