What are the diagnostic criteria  for diagnosis of diabetes ??

A)                   For non pregnant person:

In a person with classical symptoms of diabetes ( e.g. polyuria,  polydipsia, weight loss ) has  any 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 nd random blood glucose  of 305 mg%  he is diabetic  and no other   test is required to confirm  the diagnosis . In such a situation full GTT  is a define  waste of time and money  and hence  need not be done.

B)                       Fasting venous plasma glucose of 126 mg % on more than one occasion is sufficient for diagnosis  of diabetes  even in the absence   of symptoms.

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

In  non diabetic persons fasting and 2 hours  post oral  75 g glucose  values  of venous plasma glucose  are lower  than 100 mg%  and 140  mg%   respectively .

 What is IGTT?? What is possible risk  for microvascular diseases in IGTT ??  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 %  the condition is called  impaired fasting glucose tolerance . These   two conditions represent an intermediary state between   normal on one side and diabetes on the other side  . 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.

What is possible risk  for macrovascular diseases??  However as regards  macro  vascular   diseases associated with diabetes people in IGT are  at a higher risk  as compared  to those in IFG . With control  of weight  with  prudent  diet  and physical   exercise   approximately k 50%  people with IGT   revert back to normal. Some remain   in IGT  range while others slip into clear diabetic range over a course of time . On an  average every year 5%  of people with IGT  group there is no  urgency  to put them  on OAD  . However    they need proper  diet control exercise and six monthly follow up with blood  glucose estimation. Those who are unlikely  to follow  diet and exercise regimen can be   put on metformin  or acarbose. It is not uncommon to see an IGT  patient recently  and wrongly  diagnosed  as a diabetic and put on a stiff dose of sulphonylura to preset with OAD  induced repeated hypoglycemia as the present ing symptoms