Diagnostic criteria- there are 4 lab-based criteria to confirm DM: A1C, random plasma glucose, fasting plasma glucose, and 2-hr post load plasma glucose
AIC of 6.5 or higher=diabetes
Random plasma glucose level of 200 WITH classic symptoms of hyperglycemia or a hyperglycemic crisis
Fasting plasma glucose level of 126 or higher on TWO occasions(fasting is defined as no caloric intake for at least 8 hrs
2-hour post load plasma glucose level of 200 or higher during an OGTT, following consumption of a glucose load containing the equivalent of 75g of anhydrous glucose dissolved in water (OGTT is also used to screen for diabetes during pregnancy)
*** In the absence of unequivocal hyperglycemia results should be confirmed by repeat testing on a new blood sample without delay, preferably using the same type of test.***
*All above-but confirmation of type 2 diabetes mellitus requires: two fasting blood glucoses
≥126 mg/dL or two random blood glucoses ≥200 mg/dL.
You do not screen for type 1 diabetes but you do screen for type 2 if an individual is overweight or obese, regardless of age, and for all adults aged 45 years and older. Tests should be repeated at a minimum of 3 year intervals
Initial Treatment-
Type 1- FIRST LINE: INSULIN. The initial goal of treatment for type 1 DM is to normalize the elevated blood glucose level. This is best accomplished by intensive insulin regimens to achieve the following goals: plasma glucose levels of 80 to 130 mg/dL before meals, peak postprandial 1 (1–2 hours after the beginning of a meal) glucose levels of less than 180 mg/dL, and an A1C below 7% for adults with type 1 DM. A comprehensive treatment plan requires exogenous insulin, frequent self-monitoring of blood glucose (SMBG), medical nutrition therapy, regular exercise, continuing education in prevention and treatment of diabetic complications, and the periodic reassessment of treatment goals. (Type 1A: insulin dependent, Type 1B: variably insulin dependent). The ADA Standards of medical care in diabetes states that the majority of patients with type 1 DM, should be treated with multiple daily injections of prandial insulin and daily basal insulin or with a continuous subcutaneous insulin infusion pump. INITIATION OF INSULIN
Please Sign In to contact this author.