Diagnosing Diabetes
An international expert committee recently recommended a change in the names of the two main types of diabetes because the former names caused confusion. The type of diabetes that was known as Type I, juvenile-onset diabetes, or insulin-dependent diabetes (IDDM) is now type 1 diabetes. The type of diabetes that was known as Type II, noninsulin-dependent diabetes (NIDDM), or adult-onset diabetes is now type 2 diabetes. The new names reflect an effort to move away from basing the names on the treatment or age of onset.
A Lower Number To Diagnose Diabetes The expert committee recommended a lower fasting plasma glucose (FPG) number to diagnose diabetes. The new FPG number is greater than or equal to 126 milligrams per deciliter (mg/dl), rather than greater than or equal to 140 mg/dl. This recommendation was based on a 2-year review of more than 15 years of research. This research showed that when blood glucose was consistently over 126 mg/dl the prevalence of diabetes complications, such as heart disease and loss of sight, increased dramatically and developed before the diagnosis of diabetes. The experts believe the earlier diagnosis and treatment can prevent or delay the costly and burdensome complications of diabetes.
For the first time, these experts suggest that adults age 45 and older be tested for diabetes. If their blood glucose is normal at the first test, they should be tested at three-year intervals. People under 45 should be tested if they are at high risk for diabetes. Risk factors include:
- Being more than 20 percent above ideal body weight or having a body mass index (BMI) of greater than or equal to 27 kgm/m2.
- Having a first-degree relative with diabetes (mother, father, or sibling).
- Being a member of a high-risk ethnic group (African American, Hispanic, Asian, or Native American).
- Delivering a baby weighing more than nine pounds or having diabetes during a pregnancy.
- Having blood pressure at or above 140/90 mm/Hg.
- Having abnormal blood fat levels, such as high-density lipoproteins (HDL) less than or equal to 35 mg/dl or triglycerides greater than or equal to 250 mg/dl.
- Having impaired glucose tolerance when previously tested for diabetes.
- The committee states a diagnosis of diabetes is warranted for any of three positive tests, with a second positive test on a different day:
- A fasting plasma glucose of greater than or equal to 126 mg/dl. ? A casual plasma glucose (taken any time of day) of greater than or equal to 200 mg/dl with the symptoms of diabetes.
- An oral glucose tolerance test (OGTT) value of greater than or equal to 200 mg/dl in the blood measured at the two-hour interval. (The OGTT is given over a three-hour time-span and administered by a physician or medical laboratory. The person comes in fasting and a blood sample is taken. He or she drinks glucose syrup. Then a blood sample is taken from the person to measure glucose once an hour for three hours.)
