DIABETES MELLITUS   Current diagnostic criteria <ul><li>Diabetes symptoms (polyuria, polydipsia, unexplained weight loss) ...
Classic symptoms of Diabetes <ul><li>Excess urine (Polyuria), </li></ul><ul><li>Excess drinking water (Polydipsia), </li><...
Fasting and Random <ul><li>FASTING </li></ul><ul><ul><li>Overnight fast, </li></ul></ul><ul><ul><li>Sample in the morning,...
GTT -  Diagnostic Criteria <ul><li>Normal </li></ul><ul><ul><li>2h value <140 mg </li></ul></ul><ul><li>Borderline </li></...
Glucose Tolerance Test - Procedure <ul><li>Normal diet for at least 3 days, </li></ul><ul><li>Overnight fasting, </li></ul...
Why the diagnose delayed? <ul><li>Awareness is sub-optimum, </li></ul><ul><li>Negligence, </li></ul><ul><li>Economic restr...
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Diagnozing Diabetes

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Diagnozing Diabetes

  1. 1. DIABETES MELLITUS Current diagnostic criteria <ul><li>Diabetes symptoms (polyuria, polydipsia, unexplained weight loss) plus: </li></ul><ul><ul><li>Random venous plasma glucose 200 mg/dl or </li></ul></ul><ul><ul><li>Fasting venous plasma glucose 126 mg/dl or </li></ul></ul><ul><ul><li>2 hour venous plasma glucose 200 mg/dl (after 75 g glucose in OGTT) </li></ul></ul><ul><li>No symptoms: at least two glucose tests on different days within diabetic range </li></ul>WHO definition, diagnosis and classification of diabetes mellitus and its complications. http://www.diabetes.org.uk/healthcare/5/sum.htm
  2. 2. Classic symptoms of Diabetes <ul><li>Excess urine (Polyuria), </li></ul><ul><li>Excess drinking water (Polydipsia), </li></ul><ul><li>Recent weight loss, </li></ul><ul><li>Blurring of vision, </li></ul><ul><li>Genital infection </li></ul><ul><ul><li>Balanoposthitis in man, </li></ul></ul><ul><ul><li>Vulvovaginitis in women. </li></ul></ul>
  3. 3. Fasting and Random <ul><li>FASTING </li></ul><ul><ul><li>Overnight fast, </li></ul></ul><ul><ul><li>Sample in the morning, </li></ul></ul><ul><ul><li>No diet restriction, </li></ul></ul><ul><ul><li>Venous blood. </li></ul></ul><ul><li>RANDOM </li></ul><ul><ul><li>Anytime of the day, </li></ul></ul><ul><ul><li>Helpful for epidemiological purpose, </li></ul></ul><ul><ul><li>No diet restriction, </li></ul></ul><ul><ul><li>Venous blood. </li></ul></ul>
  4. 4. GTT - Diagnostic Criteria <ul><li>Normal </li></ul><ul><ul><li>2h value <140 mg </li></ul></ul><ul><li>Borderline </li></ul><ul><ul><li>2h value 140 – 199 mg </li></ul></ul><ul><li>Diabetes </li></ul><ul><ul><li>2h 200 mg or more. </li></ul></ul>
  5. 5. Glucose Tolerance Test - Procedure <ul><li>Normal diet for at least 3 days, </li></ul><ul><li>Overnight fasting, </li></ul><ul><li>Blood sample for fasting glucose, </li></ul><ul><li>75 Gm glucose in 300 ml water to drink over 5 min, </li></ul><ul><li>Blood sample after 2hr for glucose, </li></ul><ul><li>Delayed breakfast. </li></ul><ul><ul><ul><li>Should not be admitted, </li></ul></ul></ul><ul><ul><ul><li>No smoking </li></ul></ul></ul><ul><ul><ul><li>Free from stress </li></ul></ul></ul><ul><ul><ul><li>Six wks from significant medical illness. </li></ul></ul></ul>
  6. 6. Why the diagnose delayed? <ul><li>Awareness is sub-optimum, </li></ul><ul><li>Negligence, </li></ul><ul><li>Economic restraint, </li></ul><ul><li>Access to medical service, </li></ul><ul><li>Non-specific presentation. </li></ul>

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