Page 263 - fourth year book

DIABETES MELLITUS

Additionally type 2 diabetics commonly suffer from:

 Blurred vision
 Dry mouth

 Dry or itchy skin
 Impotence in males

 Recurrent infections
 Sores that do not heal.

Diagnosis of Diabetes Mellitus:

Diagnosis of diabetes is mainly based on the distribution of the glucose

levels.

 Hemoglobin A1C ≥ 6.5%.
 Fasting Plasma Glucose (FPG) ≥126 mg/dl (7.0mmol/l). Fasting is
defined as no caloric intake for at least 8 hours.

 2 Hours Plasma Glucose ≥200 mg/dl. (11.1mmol/l) during an
oral glucose tolerance test (OGTT). The test should be performed
using a glucose load containing the equivalent of 75g anhydrous
glucose dissolved in water.
 In a patient with classic symptoms of hyperglycemia or
hyperglycemic crisis, a random plasma glucose ≥ 200 mg/dl

(11.1mmol/l) is recommended.

Note:

The diagnosis of diabetes in an asymptomatic person should not
be made on the basis of a single abnormal plasma glucose or HbA1c
value. Those tests should be repeated.

Management of Diabetes:

A complete medical evaluation should be performed at the initial visit to :

 Classify diabetes.
 Detect diabetes complications.
 Review previous treatment and risk factor control in patients with
established diabetes
 Assist in formulating a management plan.

 Provide a basis for continuing care.

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