8.4 Type 2 Diabetes
Aboriginal and Torres Strait Islander peoples Age 0-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-79 > 80 Abnormal blood glucose is a modifiable risk factor for CVD and a diagnosis of diabetes substantially increases a person’s absolute CVD risk score. The Australian type 2 diabetes risk assesment tool (AUSDRISK) is useful in assessing risk of diabetes. Preventive interventions (refer to Table 8.4.3) have been shown to reduce progression to diabetes in patients with impaired fasting glucose. Patients at high risk should be screened for diabetes every three years from 40 years of age. Aboriginal and Torres Strait Islander peoples should have their risk of diabetes assessed every three years from 18 years of age. Screening should be part of a comprehensive CVD assessment including BP, lipids, smoking, physical activity, diet, overweight and obesity. Table 8.4.1. Type 2 diabetes: Identifying risk Who is at risk? What should be done? How often? Increased risk ≥40 years of age Aboriginal and Torres Strait Islander peoples aged ≥18 years AUSDRISK* (III, B)56 Every three years (III, C) High risk ≥40 years of age and being overweight or obese (refer to Section 7.2. Overweight) AUSDRISK score of 12 or more Consider screening the following groups because they may be at increased risk for diabetes at an earlier age or lower body mass index (BMI): first-degree relative with diabetes high-risk race/ethnicity (Indian subcontinent or Pacific Islanders) all people with a history of a previous cardiovascular event (eg acute myocardial infarction or stroke) women with a history of gestational diabetes mellitus women with polycystic ovary syndrome patients on antipsychotic drugs Fasting blood glucose (III, B) 57–59 OR glycated haemoglobin (HbA1c) E Continue reading >>
Diabetes Mellitus: Screening And Diagnosis
Diabetes mellitus is one of the most common diagnoses made by family physicians. Uncontrolled diabetes can lead to blindness, limb amputation, kidney failure, and vascular and heart disease. Screening patients before signs and symptoms develop leads to earlier diagnosis and treatment, but may not reduce rates of end-organ damage. Randomized trials show that screening for type 2 diabetes does not reduce mortality after 10 years, although some data suggest mortality benefits after 23 to 30 years. Lifestyle and pharmacologic interventions decrease progression to diabetes in patients with impaired fasting glucose or impaired glucose tolerance. Screening for type 1 diabetes is not recommended. The U.S. Preventive Services Task Force recommends screening for abnormal blood glucose and type 2 diabetes in adults 40 to 70 years of age who are overweight or obese, and repeating testing every three years if results are normal. Individuals at higher risk should be considered for earlier and more frequent screening. The American Diabetes Association recommends screening for type 2 diabetes annually in patients 45 years and older, or in patients younger than 45 years with major risk factors. The diagnosis can be made with a fasting plasma glucose level of 126 mg per dL or greater; an A1C level of 6.5% or greater; a random plasma glucose level of 200 mg per dL or greater; or a 75-g two-hour oral glucose tolerance test with a plasma glucose level of 200 mg per dL or greater. Results should be confirmed with repeat testing on a subsequent day; however, a single random plasma glucose level of 200 mg per dL or greater with typical signs and symptoms of hyperglycemia likely indicates diabetes. Additional testing to determine the etiology of diabetes is not routinely recommended. Clinical r Continue reading >>
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New-onset Type 2 Diabetes Mellitus
Pediatrics Overview: What every practitioner needs to know Are you sure your patient has new-onset type 2 diabetes mellitus? What are the typical findings for this disease? Type 2 Diabetes mellitus (T2DM) in youth has been increasing over the last few decades paralleling the increased prevalence of obesity. Youth with T2DM tend to be obese with evidence of insulin resistance in the setting of insufficient insulin secretion. They may also present with other cardiovascular risk factors including hypertension or dyslipidemia. Commonly children who present with T2DM have a strong family history of T2DM. Certain ethnic groups are more at risk for T2DM, most notably children of native Americans and Pacific Islanders. Presentations can be acute, like in patients with Type 1 diabetes mellitus (T1DM) who often present with diabetic ketoacidosis, symptomatic with polyuria and polydipsia. Children with T2DM may also present like many adults with T2DM who are diagnosed based on screening studies and are asymptomatic at the time of diagnosis. Obese youth with phenotypic T2DM should have pancreatic antibodies measured to rule out T1DM. Other monogenic causes of diabetes may also be considered in patients with a strong family history who present atypically. Approved first line therapies includes lifestyle modification, Metformin and insulin. Other antihyperglycemic medications are being used in older adolescents for T2DM, but are not yet approved in children < 18 years. The diagnosis of diabetes mellitus is made by demonstrating a random blood glucose level at or above 200 mg/dL plus the classic symptoms of polyuria and polydipsia, a fasting blood glucose level of greater than or equal to 126 mg/dL, an elevation of greater than or equal to 200 mg/dL of glucose 2 hours after a standard Continue reading >>
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Diagnosis And Classification Of Diabetes Mellitus
Go to: DEFINITION AND DESCRIPTION OF DIABETES MELLITUS Diabetes is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. The chronic hyperglycemia of diabetes is associated with long-term damage, dysfunction, and failure of differentorgans, especially the eyes, kidneys, nerves, heart, and blood vessels. Several pathogenic processes are involved in the development of diabetes. These range from autoimmune destruction of the β-cells of the pancreas with consequent insulin deficiency to abnormalities that result in resistance to insulin action. The basis of the abnormalities in carbohydrate, fat, and protein metabolism in diabetes is deficient action of insulin on target tissues. Deficient insulin action results from inadequate insulin secretion and/or diminished tissue responses to insulin at one or more points in the complex pathways of hormone action. Impairment of insulin secretion and defects in insulin action frequently coexist in the same patient, and it is often unclear which abnormality, if either alone, is the primary cause of the hyperglycemia. Symptoms of marked hyperglycemia include polyuria, polydipsia, weight loss, sometimes with polyphagia, and blurred vision. Impairment of growth and susceptibility to certain infections may also accompany chronic hyperglycemia. Acute, life-threatening consequences of uncontrolled diabetes are hyperglycemia with ketoacidosis or the nonketotic hyperosmolar syndrome. Long-term complications of diabetes include retinopathy with potential loss of vision; nephropathy leading to renal failure; peripheral neuropathy with risk of foot ulcers, amputations, and Charcot joints; and autonomic neuropathy causing gastrointestinal, genitourinary, and cardiovascul Continue reading >>
- Diagnosis and treatment of diabetes mellitus in chronic pancreatitis
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Diagnosis
It's important for diabetes to be diagnosed early so treatment can be started as soon as possible. If you experience the symptoms of diabetes, visit your GP as soon as possible. They'll ask about your symptoms and may request blood and urine tests. Your urine sample will be tested for glucose. Urine doesn't normally contain glucose, but glucose can overflow through the kidneys and into your urine if you have diabetes. If your urine contains glucose, a specialised blood test known as glycated haemoglobin (HbA1c) can be used to determine whether you have diabetes. Glycated haemoglobin (HbA1c) In people who have been diagnosed with diabetes, the glycated haemoglobin (HbA1c) test is often used to show how well their diabetes is being controlled. The HbA1c test gives your average blood glucose levels over the previous two to three months. The results can indicate whether the measures you're taking to control your diabetes are working. If you've been diagnosed with diabetes, it's recommended you have your HbA1c measured at least twice a year. However, you may need to have your HbA1c measured more frequently if: you've recently been diagnosed with diabetes your blood glucose remains too high your treatment plan has been changed Unlike other tests, such as the glucose tolerance test (GTT), the HbA1c test can be carried out at any time of day and doesn't require any special preparation, such as fasting. However, the test can't be used in certain situations, such as during pregnancy. The advantages associated with the HbA1c test make it the preferred method of assessing how well blood glucose levels are being controlled in a person with diabetes. HbA1c can also be used as a diagnostic test for diabetes and as a screening test for people at high risk of diabetes. HbA1c as a diagno Continue reading >>
Will There Ever Be A Cure For Diabetes? Why Or Why Not?
For More tips,read more about diabetes Diabetes Full Control- Live a Better Life What is type 1 diabetes? Around 400,000 people in Germany are producing cells of the pancreas and destroys them. As a result, it comes within a few days to weeks for lack of insulin production. Type 1 diabetes often occurs as early as childhood and adolescence. The hormone insulin is responsible for the locks of dietary sugar from the blood into the cells that need it for energy. In insulin deficiency, the glucose in the blood accumulates - the blood sugar level rises. This can damage permanently the blood vessels, nerves and numerous organs. Patients with type 1 diabetes need throughout their lives several times daily insulin injections to prevent acute metabolic disorders and related diseases due to high blood sugar levels. What is the difference between Type 1 diabetes and Type 2? In contrast to type 1 diabetes is the type 2 diabetes, below the estimated about seven million people in Germany suffer, not the consequence of a lack of insulin, but an insulin resistance. This means that the cells no longer speak adequately to insulin, so that the hormone can not smuggle the sugar into the cells. The blood sugar level rises. To compensate, the pancreas initially produces larger amounts of insulin. Also no longer sufficient to overcome the insulin resistance, a type 2 diabetes develops. The main causes of type 2 diabetes are genetic predisposition, obesity and lack of exercise. While the type 1 diabetes is more likely in recent years, a type 2 diabetes often develops at an advanced age in patients. Training: What to know patients Typically, a person with Type 1 diabetes leads his therapy in everyday life through their own, as long as no problems or complaints arise. In children take parents th Continue reading >>
Diagnosis Of Diabetes Mellitus
Diabetes is diagnosed on the basis of history (ie polyuria, polydipsia and unexplained weight loss) PLUS a random venous plasma glucose concentration >= 11.1 mmol/l OR a fasting plasma glucose concentration >= 7.0 mmol/l (whole blood >= 6.1 mmol/l) OR 2 hour plasma glucose concentration >= 11.1 mmol/l 2 hours after 75g anhydrous glucose in an oral glucose tolerance test (OGTT) With no symptoms diagnosis should not be based on a single glucose determination but requires confirmatory plasma venous determination. At least one additional glucose test result on another day with a value in the diabetic range is essential, either fasting, from a random sample or from the two hour post glucose load (1,2). If the fasting or random values are not diagnostic the 2-hour value should be used. These diagnostic criteria for diagnosing and classifying diabetes were applied to the management of diabetes in the UK from June 1st 2000 (1). The new criteria included lowering the threshold for diagnosing diabetes from a fasting glucose level of 7.8 mmol/l to 7.0 mmol/l. It should be noted that children usually present with severe symptoms and diagnosis should then be based on a single raised blood glucose result, as above. Immediate referral to a Paediatric Diabetes Team should not be delayed. A diagnosis should never be made on the basis of glycosuria or a stick reading of a finger prick blood glucose alone, although such tests may be useful for screening purposes. HbA1c in the diagnosis of diabetes mellitus (3) HbA1c can be used as a diagnostic test for diabetes providing that stringent quality assurance tests are in place and assays are standardised to criteria aligned to the international reference values, and there are no conditions present which preclude its accurate measurement an HbA Continue reading >>
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- Women in India with Gestational Diabetes Mellitus Strategy (WINGS): Methodology and development of model of care for gestational diabetes mellitus (WINGS 4)
How Can Overweight People Who Are Diagnosed With Type 2 Diabetes Continue To Eat High Sugar Foods?
TLDR: Get diabetes, eat what you want. Go blind, lose limbs, as well as independence. Totally killing yourself slowly. Think of it like smoking, you aren't directly killing yourself, but you are setting in motion the circumstances of your own demise. As Karen Tiede said, it takes a long time to kill you. You can eat what you want, but be prepared for the horrific health consequences. What CAN kill you quickly, is diabetic shock, or having too low of blood sugar, but that generally happens from injecting too much insulin, or you know... not eating. Fun fact: My dad was diagnosed with diabetes when he was 40. This was before I was even born. He was morbidly obese, I would say, I mean the man is huge in pictures but he was able to get around well enough. No need for a rascal or any other mobility help. Anyway, he ignored his diabetes for over a decade, 13 years in fact. He simply didn't have time to worry about his health when he was working so much and providing for his wife and 8, yes I said 8, children. Well, because he didn't take care of himself for so long, he developed what I would say is an unforeseen side effect doctors don't really tell you about. At least I don't hear much about it in regards to diabetes. He went blind. He drove A LOT for work. He was a regional manager for a major bakery in the northwest. He knew his vision was going bad, but he couldn't afford to not do his job. So he kept quiet about it, until one day when he got into a horrible car accident. What's funny is this accident wasn't on the highway, or some extreme circumstance, he was about a mile from home. His depth perception was shot and he failed to brake at a red light. He isn't dead if that is what you think I am leading up to. No he is very much alive. However, I'm pretty certain he wishe Continue reading >>
Criteria For Diagnosing Diabetes - Topic Overview
To be diagnosed with diabetes, you must meet one of the following criteria:1 Have symptoms of diabetes (increased thirst, increased urination, and unexplained weight loss) and a blood sugar level equal to or greater than 200 milligrams per deciliter (mg/dL). The blood sugar test is done at any time, without regard for when you last ate (random plasma glucose test or random blood sugar test). Have a fasting blood sugar level that is equal to or greater than 126 mg/dL. A fasting blood sugar test (fasting plasma glucose) is done after not eating or drinking anything but water for 8 hours. Have a 2-hour oral glucose tolerance test (OGTT) result that is equal to or greater than 200 mg/dL. An OGTT is most commonly done to check for diabetes that occurs with pregnancy (gestational diabetes). Have a hemoglobin A1c that is 6.5% or higher. Your doctor may repeat the test to confirm the diagnosis of diabetes. If the results of your fasting blood sugar test are between 100 mg/dL and 125 mg/dL, your OGTT result is between 140 to 199 mg/dL (2 hours after the beginning of the test), or your hemoglobin A1c is 5.7% to 6.4%, you have prediabetes. This means that your blood sugar is above normal but not high enough to be diabetes. Discuss with your doctor how often you need to be tested.1 Continue reading >>
What Is A Healthy Blood Sugar Range For A 47-year-old Woman?
Blood sugar, or glucose, serves as the fuel your body uses to generate energy. The level of glucose in your blood remains fairly stable, slightly rising after eating and declining a small amount between meals or after exercising. Blood glucose can be measured in many ways. Some tests measure glucose directly, while others measure the amount of glucose attached to a specific protein. The amount of glucose in the blood varies, depending on when you last ate. A fasting blood glucose level after at least 8 hours without caloric intake in a healthy, nondiabetic adult typically ranges from 70 to 99 mg/dL, according to the American Diabetes Association (ADA). People with a fasting blood glucose of 100 to 125 mg/dL are considered prediabetic, meaning the body’s handling of glucose is impaired but not yet to the point of warranting a diagnosis of diabetes. A fasting blood glucose of 126 mg/dL or greater typically indicates diabetes, according to ADA criteria. Among people diagnosed with diabetes who are not pregnant, the ADA recommends a target fasting or premeal blood sugar level of 80 to 130 mg/dL. The A1C blood test — more specifically called glycated hemoglobin A1C — assesses the blood sugar level over time. Instead of determining the amount of blood sugar present at the time of the test, the A1C test determines the average blood sugar level over an extended period, typically the past 3 months. This is done by measuring glycated hemoglobin, which is formed when glucose attaches to the hemoglobin protein found in red blood cells. The percent of hemoglobin with sugar bound to it correlates to the amount of sugar in the bloodstream over time. The more sugar in the blood, on average, the higher the percentage of glycated hemoglobin in the red blood cells. The normal range Continue reading >>
Diabetes Diagnosis
Tweet Diagnosis for both type 1 and type 2 diabetes can occur in a number of different ways. Usually type 2 is diagnosed by diabetes symptoms, such as polyuria (excessive urination) and polydipsia (excessive thirst). Otherwise, diabetes is picked up through screening, hyperglycaemia when doctor investigates a complication, or signs and symptoms prompted by diabetes. What is a diabetes screening test? A screening test determines whether a person has diabetes, and how serious it is. Depending on where you are and what your circumstances are, the screening test will vary. Tests include: Random blood glucose tests - commonly used to test for type 1 diabetes Urine glucose test Fasting plasma glucose tests (FPG tests) Oral glucose tolerance tests Additional diagnostic tests, such as urine ketone tests, GAD autoantibodies tests or C-peptide tests may also be used, as part of the diagnosis, to distinguish between type 1 and type 2 diabetes. For adults aged between 40 and 50, screening should be considered. For people who have higher risk factors (ethnicity, family history, obesity) screening should be conducted beforehand. More on tests for diabetes If you have recently been diagnosed with diabetes by your healthcare team, please see our guide for newly diagnosed. Measuring hemoglobin A1c (HbA1c) can help diagnose cases of prediabetes and type 2 diabetes. According to diagnostic guidelines set out by the World Health Organisation (WHO), a HbA1c value of: 6% (below 42 mmol/mol) is considered non-diabetic 6-6.4% (42 to 47 mmol/mol) indicates impaired fasting glucose regulation and is considered prediabetes 6.5% or more (48 mmol/mol and above) indicates the presence of type 2 diabetes Diabetes screening is strongly recommended for adults aged between 40 and 50 years, or earlier fo Continue reading >>
Type 2 Diabetes Ada Diagnosis Criteria
Type 2 Diabetes ADA Diagnosis Criteria The American Diabetes Association (ADA) criteria for the diagnosis of diabetes are any of the following: [1] A hemoglobin A1c (HbA1c) level of 6.5% or higher; the test should be performed in a laboratory using a method that is certified by the National Glycohemoglobin Standardization Program (NGSP) and standardized or traceable to the Diabetes Control and Complications Trial (DCCT) reference assay, or A fasting plasma glucose (FPG) level of 126 mg/dL (7 mmol/L) or higher; fasting is defined as no caloric intake for at least 8 hours, or A 2-hour plasma glucose level of 200 mg/dL (11.1 mmol/L) or higher during a 75-g oral glucose tolerance test (OGTT), or A random plasma glucose of 200 mg/dL (11.1 mmol/L) or higher in a patient with classic symptoms of hyperglycemia (ie, polyuria, polydipsia, polyphagia, weight loss) or hyperglycemic crisis Continue reading >>
How Do You Prevent Getting Type 2 Diabetes?
People will often look first at diet in this scenario. This makes sense, type 2 diabetes is strongly influenced by lifestyle. Changing your diet though can be hard. You should make the effort to change your diet, but I personally think there is an easier way to have a big impact quickly. High Intensity Interval Training (HIIT) is a very good way of dropping insulin sensitivity, often quite dramatically. You needn't set huge chunks of time aside for this, barely an hour per week can dramatically reduce your health risks (not just diabetes). Without getting into the specifics of how HIIT works, the main thing you need to know is how easy and effective it is to implement. The session can involve your favorite exercise (or least hated), running, cycling, swimming, rowing, even weights can be effective. As a simple rule of thumb, you want to be doing maximal effort for a short duration, followed by a quick recovery period and then repeat. Example: (20 second max effort cycle, 40 seconds slow pace cycle) x 10 Total Time/Week: 10 minutes session x 3 sessions per week = 30 minutes As meager as this sounds, it could have a surprising health impact. HIIT can even be used as training for long endurance events, such is its impact on fitness. I currently use HIIT extensively for my Ironman Triathlon training. WARNING: Consult your doctor about the safety of HIIT for you before attempting it. Due to the nature of maximal effort, you will be training close to your maximum heart-rate, in your anaerobic zone. This is not something you want to just try if your haven't exercised in years, nor if you have a heart condition. Continue reading >>
[diagnostic Criteria For Type 2 Diabetes].
Abstract A new definition of diabetes is just about to be adopted by WHO. The main change concerns the glycemic threshold for diagnosis of diabetes. Its value will decrease from 7.7 mmol/L to 7 mmol/L. This drop is neither the consequence of a methodological change (diabetes remains defined by glycemic values at risk of retinopathy) nor a revision of the gold standard (glycemic value > or = 11 mmol/L at 2 h. post glucose load remains the most accurate criterion for diagnosis). The only purpose of the new definition is to better correlate fasting glycemia with the 2 h. post load value during OGTT. So, the new definition of diabetes with a glycemic value > or = 7 mmol/L will allow to do diagnosis without OGTT. The WHO experts hope that this simplification will improve the earliness of diagnosis and treatment. WHO will propose to categorize 3 groups according to glycemic values: normal values < 6.05 mmol/L, diabetic values > 7 mmol/L, and impaired fasting glucose encompassing values above normal but below the diagnosis cut-off for diabetes (plasma glucose > or = 6.05 mmol/L to < 7.0 mmol/L). This impaired fasting glucose should be considered as a risk factor for diabetes and cardiovascular disease. Continue reading >>
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Type 2 Diabetes
Print Diagnosis To diagnose type 2 diabetes, you'll be given a: Glycated hemoglobin (A1C) test. This blood test indicates your average blood sugar level for the past two to three months. It measures the percentage of blood sugar attached to hemoglobin, the oxygen-carrying protein in red blood cells. The higher your blood sugar levels, the more hemoglobin you'll have with sugar attached. An A1C level of 6.5 percent or higher on two separate tests indicates you have diabetes. A result between 5.7 and 6.4 percent is considered prediabetes, which indicates a high risk of developing diabetes. Normal levels are below 5.7 percent. If the A1C test isn't available, or if you have certain conditions — such as if you're pregnant or have an uncommon form of hemoglobin (known as a hemoglobin variant) — that can make the A1C test inaccurate, your doctor may use the following tests to diagnose diabetes: Random blood sugar test. A blood sample will be taken at a random time. Blood sugar values are expressed in milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L). Regardless of when you last ate, a random blood sugar level of 200 mg/dL (11.1 mmol/L) or higher suggests diabetes, especially when coupled with any of the signs and symptoms of diabetes, such as frequent urination and extreme thirst. Fasting blood sugar test. A blood sample will be taken after an overnight fast. A fasting blood sugar level less than 100 mg/dL (5.6 mmol/L) is normal. A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes. If it's 126 mg/dL (7 mmol/L) or higher on two separate tests, you have diabetes. Oral glucose tolerance test. For this test, you fast overnight, and the fasting blood sugar level is measured. Then you drink a sugary liquid, and blood s Continue reading >>
