Diabetes from suspicion to diagnosis

Diabetes from suspicion to diagnosis

However, an inconspicuous fasting glucose value does not automatically mean that you can not be a diabetic. If you belong to the circle of persons at risk, you should make every three years with your doctor an Oral Glucose Tolerance Test (OGTT). Risk individuals are:

• People over 45 years
• BMI (Body Mass Index)> 25 kg / m2
• People with high blood pressure ≥140 / 90 mmHg
• People with coronary heart disease or circulatory disorders of the brain
• People with diabetes in the family already exists
• People who ever had Increased blood glucose levels (see table at right)
• Women who had a pregnancy diabetes
• Who have children born with more than 4,000 g Women
• Women with polycystic ovary syndrome

Diagnostic criteria for diabetes mellitus according to the guidelines of the DDG:

	Fasting Glucose		OGTT 2-h-Value
	mg/dl	mmol/l	mg/dl	mmol/l
Plasma - Vein related	>=126	7,0	>=200	>=11,1
Thoroughbred Capillary	>=110	>=6,1	>=200	>=11,1

Unless marked hyperglycemia with metabolic imbalance is present (= positive "Azetontest" in the urine), the diagnosis by measuring on another day to be confirmed.

Impaired fasting glucose - IFG / impaired glucose tolerance - IGT

Diagnostic criteria

	Fasting Glucose		OGTT 2-h-Value
	mg/dl	mmol/l	mg/dl	mmol/l
Plasma - Vein related	>=100 / <126	>=5,0 / 7,0	>=140 / <200	>=7,8 / <11,1
Thoroughbred Capillary	>=90 / <110	>=5,0 / <6,1	>=140 / <200	>=7,8 / <11,1

Table explanation:

• Blood glucose is measured in mg / dl (= mg per 100 ml) or in mmol / l (= millimoles per liter).
• The Conversion Factor is 18 (mg / dl): 1 (mmol / l). Example: 90 mg / dl (18) = 5 mmol / l.
• Sober = 8-12 hours, no calories, no nicotine, no tea or coffee or drinks other than water.
• Impaired fasting glucose = fasting blood glucose is elevated, but not so strong that one of a "diabetes mellitus" speaks.
• Impaired glucose tolerance = blood glucose level after glucose administration is increased, but not so strong that one of a "diabetes mellitus" speaks. The classification is correct only if the fasting glucose value is below the limit for the diabetes mellitus.

Hemoglobin A1c (HbA1c)

Blood glucose accumulates on hemoglobin - the red blood pigment - on, which HbA1c is produced.
The higher the blood glucose and the longer high blood glucose levels persist, the higher the HbA1c. The determination of HbA1c in the blood is used for long-term control of diabetes because it correlates very well with the mean blood glucose values of the last 8-12 weeks ("blood sugar memory"). It is also used for assessing the risk of long-term damage in diabetics. For diagnosis of diabetes HbA1c determination is for various reasons (still) not recommended.