Issue 15, January 2010
1. Diagnosis of Prediabetes and Diabetes- now made easy
HbA1c Diagnosis
Upto 5 % Absence of Diabetes
5.7% to 6.4% Prediabetes
6.5% or higher . Presence of Diabetes
     Diabetes is an extremely common illness affecting both developing and developed world.

     Yet for all of the patients known to have diabetes, many individuals with high serum glucose levels remain undiagnosed. With this in mind, the ADA has updated its recommendations for the diagnosis of type 2 diabetes, which include A1c level as a means to diagnose diabetes for the first time. Thus, the new diagnostic criteria for type 2 diabetes as follows: >
  • An A1c level of 6.5% or more.
  • Fasting plasma glucose level of 126 mg/dL or more.
  • A 2-hour plasma glucose level of 200 mg/dL or more after a 75-g oral glucose tolerance test.
  • A random plasma glucose level of 200 mg/dL or more in a patient with symptoms of hyperglycaemia.
     In the absence of symptoms of hyperglycaemia, the first 3 options listed should be confirmed with repeated testing. The potential benefits of using A1c level in the initial diagnosis of type 2 diabetes include the ability to perform the test in a non fasting state and less perturbation of the test result because of stress and illness.

     Patients with an A1c level between 5.7% and 6.4% should be considered to have prediabetes and should receive appropriate counselling on therapeutic lifestyle change.

Source: Diabetes Care. December 29, 2009; January 2010 Supplement.
 
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