Classification and Diagnosis of Diabetes: Difference between revisions
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{{CMG}} {{AE}} {{SCh}}; {{MehdiP}}; {{TarekNafee}} | {{CMG}} {{AE}} {{SCh}}; {{MehdiP}}; {{TarekNafee}} | ||
==2016 ADA Standards of Medical Care in Diabetes Guidelines== | ==2016 ADA Standards of Medical Care in Diabetes Guidelines== | ||
===Categories of Increased risk for diabetes (PREDIABETES)=== | |||
{|class="wikitable" | {|class="wikitable" | ||
| bgcolor="Seashell"|<nowiki>"</nowiki>'''1.''' | | bgcolor="Seashell"|<nowiki>"</nowiki>'''1.''' Testing to assess risk for future di- abetes in asymptomatic people should be considered in adults of any age who are overweight or obese (BMI $25 kg/m2 or $23 kg/m2 in Asian Americans) and who have one or more additional risk factors for diabetes. ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: B]])''<nowiki>"</nowiki> | ||
|- | |- | ||
| bgcolor="Seashell"|<nowiki>"</nowiki>'''2.''' | | bgcolor="Seashell"|<nowiki>"</nowiki>'''2.''' For all patients, testing should begin at age 45 years ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: B]])''<nowiki>"</nowiki> | ||
|- | |- | ||
| bgcolor="Seashell"|<nowiki>"</nowiki>'''3.''' | | bgcolor="Seashell"|<nowiki>"</nowiki>'''3.''' If tests are normal, repeat testing carried out at a minimum of 3-year intervals is reasonable. ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: C]])''<nowiki>"</nowiki> | ||
|- | |- | ||
| bgcolor="Seashell"|<nowiki>"</nowiki>'''4.''' | | bgcolor="Seashell"|<nowiki>"</nowiki>'''4.''' To test for prediabetes, fasting plasma glucose, 2-h plasma glucose after 75-g oral glucose tolerance test, and A1C are equally appropriate. ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: B]])''<nowiki>"</nowiki> | ||
|- | |- | ||
| bgcolor="Seashell"|<nowiki>"</nowiki>'''5.''' | | bgcolor="Seashell"|<nowiki>"</nowiki>'''5.''' In patients with prediabetes, iden- tify and, if appropriate, treat other cardiovascular disease risk factors. ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: A]])''<nowiki>"</nowiki> | ||
|- | |||
| bgcolor="Seashell"|<nowiki>"</nowiki>'''6.''' Testing to detect prediabetes should be considered in children and ado- lescents who are overweight or obese and who have two or more additional risk factors for diabetes ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: E]])''<nowiki>"</nowiki> | |||
|- | |||
|} | |||
===TYPE 1 DIABETES=== | |||
{|class="wikitable" | |||
| bgcolor="Seashell"|<nowiki>"</nowiki>'''1.''' Blood glucose rather than A1C should be used to diagnose acute onset of type 1 diabetes in individuals with symptoms of hyperglycemia. ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: E]])''<nowiki>"</nowiki> | |||
|- | |||
| bgcolor="Seashell"|<nowiki>"</nowiki>'''2.''' Inform the relatives of patients with type 1 diabetes of the opportunity to be tested for type 1 diabetes risk, but only in the setting of a clinical research study. ''([[American Diabetes Association#Evidence Grading System|Level of Evidence:E]])''<nowiki>"</nowiki> | |||
|- | |||
|} | |||
===TYPE 2 DIABETES=== | |||
{|class="wikitable" | |||
| bgcolor="Seashell"|<nowiki>"</nowiki>'''1.''' Testing to detect type 2 diabetes in asymptomatic people should be con- sidered in adults of any age who are overweight or obese (BMI $25 kg/m2 or $23 kg/m2 in Asian Amer- icans) and who have one or more additional risk factors for diabetes. ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: B]])''<nowiki>"</nowiki> | |||
|- | |||
| bgcolor="Seashell"|<nowiki>"</nowiki>'''2.''' For all patients, testing should be- gin at age 45 years. ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: B]])''<nowiki>"</nowiki> | |||
|- | |||
| bgcolor="Seashell"|<nowiki>"</nowiki>'''3.''' If tests are normal, repeat testing carried out at a minimum of 3-year intervals is reasonable. ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: C]])''<nowiki>"</nowiki> | |||
|- | |||
| bgcolor="Seashell"|<nowiki>"</nowiki>'''4.''' To test for type 2 diabetes, fasting plasma glucose, 2-h plasma glucose after 75-g oral glucose tolerance test, and A1C are equally appropriate. ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: B]])''<nowiki>"</nowiki> | |||
|- | |||
| bgcolor="Seashell"|<nowiki>"</nowiki>'''5.''' In patients with diabetes, identify and, if appropriate, treat other cardiovascular disease risk factors. ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: B]])''<nowiki>"</nowiki> | |||
|- | |||
| bgcolor="Seashell"|<nowiki>"</nowiki>'''6.''' Testing to detect prediabetes should be considered in children and ado- lescents who are overweight or obese and who have two or more additional risk factors for diabetes ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: E]])''<nowiki>"</nowiki> | |||
|- | |- | ||
|} | |} | ||
== | ===GESTATIONAL DIABETES MELLITUS=== | ||
{|class="wikitable" | |||
| bgcolor="Seashell"|<nowiki>"</nowiki>'''1.''' Test for undiagnosed type 2 diabe- tes at the first prenatal visit in those with risk factors, using stan- dard diagnostic criteria. ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: B]])''<nowiki>"</nowiki> | |||
|- | |||
| bgcolor="Seashell"|<nowiki>"</nowiki>'''2.''' Test for gestational diabetes mel- litus at 24–28 weeks of gestation in pregnant women not previously known to have diabetes. ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: B]])''<nowiki>"</nowiki> | |||
|- | |||
| bgcolor="Seashell"|<nowiki>"</nowiki>'''3.''' Screen women with gestational di- abetes mellitus for persistent diabe- tes at 6–12 weeks postpartum,using the oral glucose tolerance test and clinically appropriate non- pregnancy diagnostic criteria. ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: E]])''<nowiki>"</nowiki> | |||
|- | |||
| bgcolor="Seashell"|<nowiki>"</nowiki>'''4.''' Women with a history of gesta- tional diabetes mellitus should have lifelong screening for the de- velopment of diabetes or predia- betes at least every 3 years. ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: B]])''<nowiki>"</nowiki> | |||
|- | |||
| bgcolor="Seashell"|<nowiki>"</nowiki>'''5.''' Women with a history of gesta- tional diabetes mellitus found to have prediabetes should receive lifestyle interventions or metfor- min to prevent diabetes. ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: A]])''<nowiki>"</nowiki> | |||
|- | |||
|} | |||
==References== | |||
{{Reflist|2}} | {{Reflist|2}} | ||
{{WH}}{{WS}} | {{WH}}{{WS}} | ||
Revision as of 19:23, 6 December 2016
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2016 ADA Guideline Recommendations |
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Types of Diabetes Mellitus |
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2016 ADA Standard of Medical Care Guideline Recommendations |
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Cardiovascular Disease and Risk Management |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shivani Chaparala M.B.B.S [2]; Seyedmahdi Pahlavani, M.D. [3]; Tarek Nafee, M.D. [4]
2016 ADA Standards of Medical Care in Diabetes Guidelines
Categories of Increased risk for diabetes (PREDIABETES)
| "1. Testing to assess risk for future di- abetes in asymptomatic people should be considered in adults of any age who are overweight or obese (BMI $25 kg/m2 or $23 kg/m2 in Asian Americans) and who have one or more additional risk factors for diabetes. (Level of Evidence: B)" |
| "2. For all patients, testing should begin at age 45 years (Level of Evidence: B)" |
| "3. If tests are normal, repeat testing carried out at a minimum of 3-year intervals is reasonable. (Level of Evidence: C)" |
| "4. To test for prediabetes, fasting plasma glucose, 2-h plasma glucose after 75-g oral glucose tolerance test, and A1C are equally appropriate. (Level of Evidence: B)" |
| "5. In patients with prediabetes, iden- tify and, if appropriate, treat other cardiovascular disease risk factors. (Level of Evidence: A)" |
| "6. Testing to detect prediabetes should be considered in children and ado- lescents who are overweight or obese and who have two or more additional risk factors for diabetes (Level of Evidence: E)" |
TYPE 1 DIABETES
| "1. Blood glucose rather than A1C should be used to diagnose acute onset of type 1 diabetes in individuals with symptoms of hyperglycemia. (Level of Evidence: E)" |
| "2. Inform the relatives of patients with type 1 diabetes of the opportunity to be tested for type 1 diabetes risk, but only in the setting of a clinical research study. (Level of Evidence:E)" |
TYPE 2 DIABETES
| "1. Testing to detect type 2 diabetes in asymptomatic people should be con- sidered in adults of any age who are overweight or obese (BMI $25 kg/m2 or $23 kg/m2 in Asian Amer- icans) and who have one or more additional risk factors for diabetes. (Level of Evidence: B)" |
| "2. For all patients, testing should be- gin at age 45 years. (Level of Evidence: B)" |
| "3. If tests are normal, repeat testing carried out at a minimum of 3-year intervals is reasonable. (Level of Evidence: C)" |
| "4. To test for type 2 diabetes, fasting plasma glucose, 2-h plasma glucose after 75-g oral glucose tolerance test, and A1C are equally appropriate. (Level of Evidence: B)" |
| "5. In patients with diabetes, identify and, if appropriate, treat other cardiovascular disease risk factors. (Level of Evidence: B)" |
| "6. Testing to detect prediabetes should be considered in children and ado- lescents who are overweight or obese and who have two or more additional risk factors for diabetes (Level of Evidence: E)" |
GESTATIONAL DIABETES MELLITUS
| "1. Test for undiagnosed type 2 diabe- tes at the first prenatal visit in those with risk factors, using stan- dard diagnostic criteria. (Level of Evidence: B)" |
| "2. Test for gestational diabetes mel- litus at 24–28 weeks of gestation in pregnant women not previously known to have diabetes. (Level of Evidence: B)" |
| "3. Screen women with gestational di- abetes mellitus for persistent diabe- tes at 6–12 weeks postpartum,using the oral glucose tolerance test and clinically appropriate non- pregnancy diagnostic criteria. (Level of Evidence: E)" |
| "4. Women with a history of gesta- tional diabetes mellitus should have lifelong screening for the de- velopment of diabetes or predia- betes at least every 3 years. (Level of Evidence: B)" |
| "5. Women with a history of gesta- tional diabetes mellitus found to have prediabetes should receive lifestyle interventions or metfor- min to prevent diabetes. (Level of Evidence: A)" |