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alaskarealestate com Normal blood sugar levels for a non-diabetic range from 70 to 130 mg/dL based on the time of day and last time you ate a meal. Learn more in ...

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alaskarealestate com

Overview Of Diabetes


alaskarealestate comDiagnosis

alaskarealestate comThe biochemical hallmark of diabetes is elevated blood glucose. Therefore, diagnosis of diabetes is made by estimation of glucose concentrations in the blood.

alaskarealestate comWhen the fasting plasma glucose is ≥ 126 mg/dl or random blood glucose ≥ 200 mg/dl on more than one occasion.1

alaskarealestate comFasting Plasma Glucose:

alaskarealestate comElevated fasting plasma glucose is always regarded to have a high degree of specificity for the diagnosis of diabetes. It is more consistent and reproducible than postprandial plasma glucose because there are more variable in the latter, such as timing and carbohydrate load. FPG may be easier to control with medications than PPG. An overnight fasting for 8 – 12 hours is considered desirable.

alaskarealestate comThe ADA and WHO have recommended FPG value of ≥ 126 mg/dl as the diagnostic value for diabetes and the value of 110 – 125 mg/dl have been termed as impaired fasting glucose which is a prediabetic stage.1

alaskarealestate comPostprandial Blood Glucose:

alaskarealestate comThe word postprandial means after a meal and hence it refers to plasma glucose concentration after food intake. The optimal time to measure postprandial glucose concentrations is 2 hr after the start of a meal. An elevated PPG concentration is one of the earliest abnormalities of type 2 diabetes, and represents an independent risk for cardiovascular disease. Postprandial changes precipitate atherosclerosis before FPG concentrations are affected. The recommended PPG goal of treatment is a value of <160mg/dl.

alaskarealestate comOral Glucose Tolerance Test

alaskarealestate comIt is recommended for diagnosis/exclusion for diabetes.

alaskarealestate comThe Oral Glucose Tolerance Test (OGTT) is done in the morning after 8-10hrs of overnight fast (water may be taken). A fasting blood sample should be taken before giving glucose load. The person then drinks 75gm of glucose in 250-300 ml of water (the glucose load should be consumed over a period of five minutes). A further blood sample must be collected 2 hours after the load.

Diabetes is diagnosed if the fasting value is ≥ 126 mg/dl or 2 hour plasma glucose is ≥ 200mg/dl.1

Impaired Glucose Tolerance is present when the 2 hour value is in the range of ≥140 mg/dl - < 200 mg/dl.

alaskarealestate comalaskarealestate comImpaired Fasting Glucose is present when the fasting level is ≥ 110mg/dl and ≤ 125mg/dl and the 2 hour value is < 140mg/dl.

alaskarealestate comGlucose tolerance is normal when the fasting and the 2 hour values are < 110mg/dl and < 140mg/dl respectively.

alaskarealestate comHemoglobin A1c (HBA1c)

alaskarealestate comThe red blood cells that circulate in the body live for about three months before they die off. When sugar sticks to these hemoglobin proteins in these cells, it is known as glycosylated hemoglobin or hemoglobin A1c (HbA1c). Measurement of HbA1c gives us an idea of how much sugar is present in the bloodstream for the preceding three months. In most labs, the normal range is 4%-5.6 %. In poorly controlled diabetes, its 8.0% or above, and in well controlled patients it's less than 7.0% (optimal is <6.5%). The benefits of measuring A1c is that gives a more reasonable and stable view of what's happening over the course of time (three months), and the value does not vary as much as finger stick blood sugar measurements.

alaskarealestate comWhile there are no guidelines to use HbA1c as a screening tool, it gives a physician a good idea that someone is diabetic if the value is elevated. Right now, it is used as a standard tool to determine blood sugar control in patients known to have diabetes.  The recommended cut-off points are 2

Normal range: 4.5 – 5.6%

Prediabetes range: 5.7 – 6.4%

alaskarealestate comalaskarealestate comDiabetic range: ≥ 6.5%

 

alaskarealestate comGestational Diabetes Diagnosis:3

alaskarealestate com“One-Step” Strategy 

75-g OGTT with Plasma Glucose measurement fasting and at 1 h and 2 h, at 24-28 wks in women not previously diagnosed with overt diabetes 

alaskarealestate comPerform OGTT in the morning after overnight fast ( ≥8 h) 

alaskarealestate comGDM diagnosis made if PG values meet or exceed: 

alaskarealestate comFasting : 92 mg/dL (5.1 mmol/L)

alaskarealestate com1 hour   : 180 mg/dL (10.0 mmol/L)

alaskarealestate com2 hour   : 153 mg/dL (8.5 mmol/L)

 

alaskarealestate com“Two-Step” Strategy

alaskarealestate com50-g GLT (nonfasting) with Plasma Gluocse measurement at 1 h (Step 1), at 24-28 wks in women not previously diagnosed with overt diabetes

alaskarealestate comIf Plasma Glucose at 1 h after load is ≥140 mg/dL (7.8 mmol/L), proceed to 100-g OGTT

alaskarealestate com(Step 2), performed while patient is fasting

alaskarealestate comGDM diagnosis made when two or more Plasma Glucose levels meet or exceed:

Fasting : 95 mg/dL or 105 mg/dL (5.3/5.8 mmol/L)

alaskarealestate com1 hour  : 180 mg/dL or 190 mg/dL (10.0/10.6 mmol/L)

alaskarealestate com2 hour  : 155 mg/dL or 165 mg/dL (8.6/9.2 mmol/L)

alaskarealestate com3 hour  : 140 mg/dL or 145 mg/dL (7.8/8.0 mmol/L)

alaskarealestate comReferences:

  1. Definition and Diagnosis of Diabetes and Intermediate Hyperglycemia – Report of a WHO/IDF consultation. Geneva: Whorl Health Organization; 2006.
  2. alaskarealestate comWorld Health Organization. Use of Glycated Haemoglobin in the Diagnosis of Diabetes Mellitus. Abbreviated Report of a WHO Consultation. Geneva: WHO; 2011.
  3. alaskarealestate comStandards of Medical Care in Diabetes—2015, Diabetes Care Volume 38, Supplement 1, January 2015

Overview Of Diabetes


alaskarealestate comDiagnosis

alaskarealestate com

The biochemical hallmark of diabetes is elevated blood glucose. Therefore, diagnosis of diabetes is made by estimation of glucose concentrations in the blood.

alaskarealestate comalaskarealestate comWhen the fasting plasma glucose is ≥ 126 mg/dl or random blood glucose ≥ 200 mg/dl on more than one occasion.1

alaskarealestate comFasting Plasma Glucose:

alaskarealestate comElevated fasting plasma glucose is always regarded to have a high degree of specificity for the diagnosis of diabetes. It is more consistent and reproducible than postprandial plasma glucose because there are more variable in the latter, such as timing and carbohydrate load. FPG may be easier to control with medications than PPG. An overnight fasting for 8 – 12 hours is considered desirable.

alaskarealestate comThe ADA and WHO have recommended FPG value of ≥ 126 mg/dl as the diagnostic value for diabetes and the value of 110 – 125 mg/dl have been termed as impaired fasting glucose which is a prediabetic stage.1

Postprandial Blood Glucose:

alaskarealestate comThe word postprandial means after a meal and hence it refers to plasma glucose concentration after food intake. The optimal time to measure postprandial glucose concentrations is 2 hr after the start of a meal. An elevated PPG concentration is one of the earliest abnormalities of type 2 diabetes, and represents an independent risk for cardiovascular disease. Postprandial changes precipitate atherosclerosis before FPG concentrations are affected. The recommended PPG goal of treatment is a value of <160mg/dl.

Oral Glucose Tolerance Test

alaskarealestate comIt is recommended for diagnosis/exclusion for diabetes.

alaskarealestate comThe Oral Glucose Tolerance Test (OGTT) is done in the morning after 8-10hrs of overnight fast (water may be taken). A fasting blood sample should be taken before giving glucose load. The person then drinks 75gm of glucose in 250-300 ml of water (the glucose load should be consumed over a period of five minutes). A further blood sample must be collected 2 hours after the load.

alaskarealestate comDiabetes is diagnosed if the fasting value is ≥ 126 mg/dl or 2 hour plasma glucose is ≥ 200mg/dl.1

Impaired Glucose Tolerance is present when the 2 hour value is in the range of ≥140 mg/dl - < 200 mg/dl.

alaskarealestate comImpaired Fasting Glucose is present when the fasting level is ≥ 110mg/dl and ≤ 125mg/dl and the 2 hour value is < 140mg/dl.

alaskarealestate comGlucose tolerance is normal when the fasting and the 2 hour values are < 110mg/dl and < 140mg/dl respectively.

alaskarealestate comalaskarealestate com

alaskarealestate comHemoglobin A1c (HBA1c)

alaskarealestate comThe red blood cells that circulate in the body live for about three months before they die off. When sugar sticks to these hemoglobin proteins in these cells, it is known as glycosylated hemoglobin or hemoglobin A1c (HbA1c). Measurement of HbA1c gives us an idea of how much sugar is present in the bloodstream for the preceding three months. In most labs, the normal range is 4%-5.6 %. In poorly controlled diabetes, its 8.0% or above, and in well controlled patients it's less than 7.0% (optimal is <6.5%). The benefits of measuring A1c is that gives a more reasonable and stable view of what's happening over the course of time (three months), and the value does not vary as much as finger stick blood sugar measurements.

alaskarealestate comWhile there are no guidelines to use HbA1c as a screening tool, it gives a physician a good idea that someone is diabetic if the value is elevated. Right now, it is used as a standard tool to determine blood sugar control in patients known to have diabetes.  The recommended cut-off points are 2

alaskarealestate comalaskarealestate comNormal range: 4.5 – 5.6%

alaskarealestate comPrediabetes range: 5.7 – 6.4%

alaskarealestate comDiabetic range: ≥ 6.5%

 

Gestational Diabetes Diagnosis:3

alaskarealestate com“One-Step” Strategy 

alaskarealestate com75-g OGTT with Plasma Glucose measurement fasting and at 1 h and 2 h, at 24-28 wks in women not previously diagnosed with overt diabetes 

alaskarealestate comPerform OGTT in the morning after overnight fast ( ≥8 h) 

GDM diagnosis made if PG values meet or exceed: 

alaskarealestate comFasting : 92 mg/dL (5.1 mmol/L)

alaskarealestate com1 hour   : 180 mg/dL (10.0 mmol/L)

alaskarealestate com2 hour   : 153 mg/dL (8.5 mmol/L)

alaskarealestate com 

alaskarealestate com“Two-Step” Strategy

alaskarealestate com50-g GLT (nonfasting) with Plasma Gluocse measurement at 1 h (Step 1), at 24-28 wks in women not previously diagnosed with overt diabetes

If Plasma Glucose at 1 h after load is ≥140 mg/dL (7.8 mmol/L), proceed to 100-g OGTT

alaskarealestate com(Step 2), performed while patient is fasting

GDM diagnosis made when two or more Plasma Glucose levels meet or exceed:

alaskarealestate comFasting : 95 mg/dL or 105 mg/dL (5.3/5.8 mmol/L)

alaskarealestate com1 hour  : 180 mg/dL or 190 mg/dL (10.0/10.6 mmol/L)

2 hour  : 155 mg/dL or 165 mg/dL (8.6/9.2 mmol/L)

alaskarealestate com3 hour  : 140 mg/dL or 145 mg/dL (7.8/8.0 mmol/L)

alaskarealestate comReferences:

  1. alaskarealestate comDefinition and Diagnosis of Diabetes and Intermediate Hyperglycemia – Report of a WHO/IDF consultation. Geneva: Whorl Health Organization; 2006.
  2. World Health Organization. Use of Glycated Haemoglobin in the Diagnosis of Diabetes Mellitus. Abbreviated Report of a WHO Consultation. Geneva: WHO; 2011.
  3. alaskarealestate comStandards of Medical Care in Diabetes—2015, Diabetes Care Volume 38, Supplement 1, January 2015

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