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Diagnozing Diabetes
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Diagnozing Diabetes

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Transcript

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