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Medicine

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Endocrine

Question
5 out of 8
 

Which one is best for diagnosis of diabetes mellitus? (PNQ)

 

 
A Fasting BG> 100 mg and post prandial >200 mg

 

B Fasting BG>125 mg and post prandial >140mg

 

C HbA1C >6.5%

 

D Insulin level <6 iu/ml

 

 

Ans. C

HbA1C >6.5%

Diabetes mellitus (Ref. Hari - 18th ed., Pg-2970)

Diabetes mellitus screening is done by: Fasting glucose, Random glucose, Oral GTT (Ref. Hari-18th ed., Pg.-2970)

Definition: DM includes a group of metabolic disorder that share the phenotype of Hyperglycemia.

Diagnosis: Diabetes is diagnosed by any of the following criteria.

1). Classical triad of Symptoms of DM (polyuria, polydipsia, weight loss) plus random blood glucose ≥ 200mg/dl.Q

2). Fasting plasma glucose ≥ 126mg/dl Q. (Fasting is defined as no calorie intake for at least 8hr) Q.

3). Plasma glucose ≥ 200mg/dl 2hrs after an oral glucose tolerance test with 75gm of glucose

4). HBA1C > 6.5% (Ref. Hari-18th ed., Pg-2970, table 344.2)

Recent Advances: HbA1C > 6.5% is a new diagnostic criteria for DM

 

Table 344-2 Criteria for the Diagnosis of Diabetes Mellitus
 

Symptoms of diabetes plus RBS ≥200 mg/dL or

FBS 126 mg/dL or

HBA1C > 6.5% or

Two-hour plasma glucose 200 g/dL during an oral GTT

 

Criteria of impaired GTT
 

 

Normal Glucose tolerance

Impaired Glucose tolerance (pre diabetic)

Diabetes mellitus

Fasting plasma glucose (mg%)

<100

100-125

≥ 126

Two hours after glucose(mg%)

<140

140 -199

≥200

 

Extra Edge:

1). Impaired glucose tolerance on an oral GTT is indicated by 2 hrs after glucose load 140-199 mg/dl; fasting blood sugar < 126 mg/dl or HbA1C between 5.7 to 6.4 %.

2). Fasting is defined as no caloric intake for at least 8 h. Normal FBS < 100 mg%

3). 1 mmol/lit of blood sugar = 18 mg% of blood sugar