An expert committee of the American Diabetes Association recently recommended a change in the names of the two main types of diabetes since the previous names generated confusion.
The type of diabetes known as type I, juvenile-onset diabetes or insulin dependent diabetes mellitus (IDDM) is now known as type 1 diabetes. The type of diabetes known as Type II, noninsulin dependent diabetes mellitus (NIDDM) or adult-onset diabetes is now type 2 diabetes. The new names reflect the effort to stop basing the names on treatment or age of onset.
A lower figure for the Diagnosis of Diabetes.
The expert committee also recommended a lower fasting plasma glucose (FPG) for diagnosis of diabetes. The new FPG value is 126 milligrams per deciliter (mg/dL) or higher, a difference of 140 mg/dL or higher. This recommendation was based on a review of the results of more than 15 years of research.
This investigation showed that a level of fasting blood glucose of 126 mg/dL or more is associated with an increased risk of diabetes complications affecting the eyes, nerves and kidneys. When the diagnosis was based on a blood glucose level of 140 mg/dL or higher, these complications often developed before the diagnosis of diabetes.
Experts believe that the diagnosis and treatment can prevent or delay the costly and burdensome that develops diabetes complications.
The previous criteria for the diagnosis of diabetes were based largely on the implementation of a proof of an oral glucose tolerance (OGTT). In this test, the person must go without food, drink a glucose syrup and 2 hours later she took another blood sample. This complicated procedure made detection and diagnosis of diabetes was a difficult and complicated process, and the committee of experts recommended its removal from clinical use.
The change to using the FPG to determine the presence of diabetes will make detection and diagnosis of diabetes easier. The fasting value readily available for medical consultation, clinics set up in the workplace and in other situations. Currently, about 5 to 6 million adults in the United States have diabetes but do not know. This simple method to assess fasting glucose should help identify these people so they can reap the benefits of early treatment.
Persons at High Risk for Diabetes.
Experts suggest that adults 45 and older be screened for diabetes. If your blood glucose is normal after the first test, should be reassessed every 3 years. Those under 45 years should be evaluated if they are at high risk for diabetes. These risk factors are:
- Be 20% above ideal body weight or having a body mass index (BMI) of 27 or more. BMI is the ratio of weight in kilograms divided by height in meters squared (kg/m2). (Your doctor or dietitian can give you information about your BMI).
- Having a mother, father, brother or sister with diabetes.
- African American, Native Alaskan, American Indian, Asian American, Hispanic American, American or Pacific Islander.
- Giving birth to a baby weighing over 4.5 kg. or diabetes during pregnancy.
- Have blood pressure equal to or greater than 140/90 millimeters of mercury (mm Hg).
- Having abnormal levels of blood lipids such as HDL cholesterol below 35 mg/dL or triglyceride over 250 mg/dL.
- Have impaired glucose tolerance, if it has been previously evaluated for diabetes.
The committee reports that diabetes can be detected by any of these 3 positive tests. To confirm the diagnosis should be a second positive test on another day.
* A casual plasma glucose level (taken at any time of day) of 200 mg/dL or greater when symptoms of diabetes.
* A level of fasting plasma glucose 126 mg/dL or higher.
* A blood glucose tolerance test value of 200 mg/dL or greater measured at 2 hours interval.
As mentioned above, the committee recommended not to use the OGTT.
Test Diabetes During Pregnancy. The panel also suggested a change in the assessment of diabetes during pregnancy, reporting that women at low risk for gestational diabetes do not need to be evaluated. This low-risk group includes women:
- Under 25 years of age.
- With normal body weight.
- No family history of diabetes.
- Not belonging to any ethnic group at high risk.
All women who are not in the low risk category should be evaluated for the diagnosis of gestational diabetes between weeks 24 and 28 of pregnancy. The assessment procedure requires the ingestion of a glucose drink and measurement of blood glucose 1 hour later. If the blood glucose level is 140 mg/dL or greater, the woman should be re-evaluated.
Popularity: unranked [?]
