TESTS AND DIAGNOSTIC CRITERIAFOR DM & GDM

Every 3 years

All adults ≥ 45 years old _________

Every year

Individuals with ≥ 1 risk factor __________

RPG

“Non Fasting”

Important considerations

• In conjunctions with Sx of DM (3Ps)

Normal

• < 200 mg/dL

Pre-diabetes

• ———

DM

• ≥ 200 mg/dL

FPG

"Screening & Confirmation”

Important considerations

• Fasting for at least 8 hrs (no food or drink except water)

• Most preferred test

Normal

• < 100 mg/dL

Pre-diabetes

• 100-125 (IFG - Impaired Fasting Glucose)

DM

• ≥ 126 mg/dL

2-hr PG (OGTT)

“ Post load glucose”

Important considerations

• CHO intake > 150g/day for 3 days prior to OGTT

• Fasting 8-14 hr

• Standard load 75g (adult), 1.75 g/kg (child)

Normal

• < 140 mg/dL

Pre-diabetes

• 140-199 mg/dL (IGL)

DM

• ≥ 200 mg/dL

HB A_1c

Important considerations

• Specimen: EDTA (whole blood)

Normal

• ———-

Pre-diabetes

• 5.7% - 6.4 %

DM

• ≥ 6.5%

24-28 weeks of gestation

All nondiabetic pregnant women should be screened for GDM at ____________

One Step Method

“for risk women”

Glucose Load

• 75 g (2hr OGTT)

Diagnostic criteria

• FPG: ≥ 92 mg/dL

• 1-h PG: ≥ 180 mg/dL

• 2-h PG: ≥ 153 mg/dL

Two Step Method (Step 1)

Glucose Load

• 50g (non fasting 1-h OGTT)

Diagnostic criteria

• If the 1-h PG is ≥ 140 mg/dL, proceed to Step 2

• Some use the ≥ 130 or 135 mg/dL cutoff which has greater sensitivity

Two Step Method (Step 2)

Glucose Load

• 100g (fasting 3-h OGTT)

Diagnostic criteria

• FPG: ≥ 95 mg/dL

• 1-h PG: ≥ 180 mg/dL

• 2-h PG: ≥ 155 mg/dL

• 3-h PG: ≥ 140 mg/dL