Diabetes Diagnostic Categories
By Frederick R. Jelovsek, M.D.,
There are now new recommendations about the diagnosis and classification
of Diabetes. These have been well summarized by William F. Rayburn MD,
Diagnosis and Classification of Diabetes Mellitus: Highlights from
the American Diabetes Association, J Repro Med 1997;(42):585-6,
-
The term "insulin dependent diabetes" should be eliminated
- The term "non-insulin dependent diabetes" should be eliminated
Diabetes Mellitus is now classified:
-
Diabetes Type 1 - beta cells of pancreas are destroyed usually leading to absolute
insulin deficiency and it is either immune-mediated or unknown (idiopathic)
-
Diabetes Type 2 - individuals with insulin resistance who usually have a relative
insulin deficiency
-
Impaired fasting glucose - individuals at risk for future diabetes and cardiovascular
disease with a fasting plasma glucose greater than 110mg/dl and less than
126 mg/dl
-
Gestational diabetes - abnormal glucose tolerance during pregnancy
-
Normal - fasting plasma glucose of 110/mg/dl or less
The following table illustrates different ways to make these diagnoses:
Tests for Diagnosing Diabetes
| Stage |
Fasting Plasma Glucose |
Casual Plasma Glucose |
Oral Glucose Tolerance Test |
Diabetes
(Type 1 or 2) |
fasting plasma glucose >= 126 mg/dl |
casual plasma glucose >= 200 mg/dl |
2-hour (75g load) plasma glucose >=200mg/dl |
| Impaired Glucose Homeostasis |
fasting plasma glucose >= 110 mg/dl and < 126 mg/dl |
. |
2-hour (75g load) plasma glucose >= 140 mg/dl and < 200 mg/dl |
| Normal |
fasting plasma glucose < 110 mg/dl |
causal plasma glucose < 110 mg/dl |
2-hour (75g load) plasma glucose < 140 mg/dl |
It is important to keep in mind that these are criteria for diagnosis
but not for monitoring treatment or goals of therapy.
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