Diabetes :Why gynecologists are unable to treat ?

Why cant we the gynecologist treat  GDM or DM by ourselves.

Q. 1:  How to diagnose  frank DM by people like us?? What are the criteria for diagnosis of frank diabetes??

For  men & non pregnant woman what is frank Diabetes?? When GTT becomes an  unnecessary investigation ?? Ans:-All values mentioned under are the diagnostic criteria of frank DM e.g.  are venous plasma true glucose values random venous plasma   glucose > 200 mg % is  sufficient to make diagnosis  of diabetes. However the diagnostic criteria for  glucose  metabolic abnormalities taken together are as follows egg,  three kinds of abnormalities  for diabetes , IFG and IGT .

A) In a person with classical symptoms of diabetes one reading  of unequivocal  hyperglycemia i.e.  random venous plasma   glucose > 200 mg % is  sufficient to make diagnosis  of diabetes. For  example   if a person has polyuria  , polydipsia,  weight loss and random blood  glucose is   of 278 mg%  he/ she is diabetic  and no other   test is required to confirm  the diagnosis . In such a situation he/ she should be treated with a consulation f diabetologists or else treated by local doctor with 1) diet control b)  Exercise and in  phases 3) Oral antidiabetic agents like metformins, gliptins .

B)  Fasting only > 126 on two occasions?  Ans; This is also to be treated as frank DM. For instance imagine a condition where fasting venous plasma glucose of 126 mg % on more  than one occasion then also he /she  should  also be  considered as  frank DM ,This is  sufficient for diagnosis  of diabetes  even in the absence   of symptoms and no PP sugar estimation is essential for confirmation of frank DM,..

C) A two hour venous plasma glucose  of 200 mg %   or more after oral  glucose   load of 75 g  on more  than one occasion is frank  DM

 Q. 2:- What is isolated IFG/IGT  ?? Ans: If fasting  venous plasma glucose level is between 100 to 126 mg%  and if two hours  post 75 g glucose  venous plasma glucose  level  is below  140 mg %  then the  condition is called  impaired fasting glucose tolerance(IFT).  . What is “impaired fasting glucose tolerance?? ::- In  non diabetic persons fasting and 2 hours  post oral  75 g glucose  values  of venous plasma glucose  are in the range of  100 mg% to-125 mg%  but PPBS is <  140  mg%   respectively then it is called  IFG.

 IFT /IGT  are the   two conditions that represent an intermediary state between   normal on one side and diabetes on the other side  .

Q.3:- Why such clasifiaction ? What is the relevance ?  Ans: Some   people have isolated IFG/IGT   while others have combined IFG  and IGT.  As regards micro vascular   complications   of diabetes people in IFG   and IGT  are not at significant   risk  and in this respect both the conditions are equivalent. However as regards macrovascular   diseases associated with diabetes people in IGT are at a higher risk  as compared  to those in IFG