DEFINITION, CLASSIFICATION AND DIAGNOSIS OF DIABETES AND OTHER by SNz207M

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									     2003 Clinical Practice Guidelines
   for the Prevention and Management
           of Diabetes in Canada

DEFINITION, CLASSIFICATION AND DIAGNOSIS
             OF DIABETES AND
     OTHER DYSGLYCEMIC CATEGORIES
DEFINITION

  Diabetes mellitus is a metabolic disorder characterized by the
    presence of hyperglycemia due to defective insulin secretion, insulin
    action, or both.

  The chronic hyperglycemia of diabetes mellitus is associated with
    significant long-term sequelae, particularly damage, dysfunction and
    failure of various organs - especially the kidneys, eyes, nerves, heart
    and blood vessels.

  Dysglycemia is a qualitative term used to describe glucose that is
    abnormal, without defining a threshold.
CLASSIFICATION
 TYPE 1 DIABETES is primarily a result of pancreatic beta cell
   destruction and is prone to ketoacidosis.

 TYPE 2 DIABETES may range from predominant insulin resistance
   with relative insulin deficiency to a predominant secretory defect with
   insulin resistance.

 GESTATIONAL DIABETES MELLITUS (GDM) refers to
   glucose intolerance with onset or first recognition during pregnancy.

 OTHER forms consist mainly of specific genetically defined forms of
   diabetes or diabetes associated with other diseases or drug use.
DIAGNOSTIC CRITERIA
DIABETES
  - fasting plasma glucose  7.0 mmol/L, or
  - any plasma glucose  11.1 mmol/L with symptoms, or
  - 2-hour plasma glucose  11.1 mmol/L during a 75-g oral glucose
   tolerance test **confirmatory test usually required
PREDIABETES
  a practical and convenient term for impaired fasting glucose (IFG) and
  impaired glucose tolerance (IGT).
METABOLIC SYNDROME
  a distinctive constellation of abnormalities that include central obesity,
  hypertension, dyslipidemia, insulin resistance and dysglycemia.
DIAGNOSTIC CRITERIA
                     Fasting plasma             75-g OGTT
                    glucose (mmol/L)            2-hr plasma
                                             glucose (mmol/L)
        IFG             6.1 - 6.9             Not applicable

   IFG (isolated)       6.1 - 6.9      and        < 7.8

   IGT (isolated)        < 6.1         and      7.8 – 11.0

   IFG and IGT          6.1 – 6.9      and      7.8 – 11.0

     Diabetes             7.0         or          11.1
METABOLIC SYNDROME

 National Cholesterol Education Program ATP III definition

 Three or more of:

       fasting plasma glucose  6.1 mmol/L
       blood pressure  130/85 mm Hg
       fasting triglycerides  1.7 mmol/L
       HDL-cholesterol < 1.0 mmol/L (men) or < 1.3 mmol/L (women)
       waist circumference > 102 cm (men) or > 88 cm (women)

								
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