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Classification

• Type 1 Diabetes (Due to Beta cell destruction, usually leading to absolute insulin deficiency)

• Type II Diabetes (Due to progressive insulin secretory defect on the background of insulin resistance)

• Gestational diabetes mellitus (GDM) (diabetes diagnosed during second or third trimester)

• Other cause

  • MODY (Maturity Onset Diabetes of Young)

  • Disease pf exocrine pancreas such as cystic fibrosis

  • Drug or chemical induced diabtetes (such as in treatment of HIV/AIDS or after organ transplantation)

  • Monogenic diabetes syndromes

Diagnostic Criteria

• HbA1C ≥6.5%.

               OR

• FPG ≥ 126 mg/dl

               OR

• 2h PG ≥ 200 mg/dl during an OGTT . The Test should be performed as described by the WHO, using a glucose load containing the equivalent of 75gm anhydrous glucose dissolved in water.

               OR

• Ina patient with classic symptoms of hyperglycemia or hyperglycemic crisis, a random plasma glucose >200 mg/dl.

Prediabetes

• It is diagnosed with either HbA1C, FPG or 2h PG after 75 gm OGTT.

• They should target a weight loss of 7% of body weight.

• Moderate intensity physical activity (such as brisk walking) to atleast 150 min/week.

• Metformin therapy for prevention of type 2 diabetes may be considered in those with prediabetes., especially with BMI>35 kg/m^2, aged <60 years and women with prior GDM.

• Screening and treatment of modifiable risk factors for cardiovascular disease is recommended.

• Annual monitoring for development of diabetes in those with prediabetes is suggested.

Updated on 8/7/15

Reference

• ADA Guidelines 2013