TYPE 2 DIABETES MELLITUS:
Diabetes Mellitus is metabolic disorder that causes blood sugar (glucose) levels to rise higher than normal (hyperglycemia). Type 2 Diabetes Mellitus is one of the major causes of early illness and death worldwide. It is the most common form of diabetes and it accounts for over 90% of patients with diabetes. Type 2 Diabetes Mellitus is characterized by insulin resistance leading to increase insulin production by the Beta-cells of the pancreas.Over time, the insulin secretory capacity of the pancreas becomes unable to overcome insulin resistance, resulting in progressive deterioration of Beta-cell function and steady decrease in plasma insulin and subsequently an increase in plasma glucose. Although obesity is the most important risk factor for Type 2 Diabetes Mellitus, other important risks factors such as; positive family history, ethnicity (e.g. Native Americans, African Americans, Hispanics, Asian Americans and Pacific Islanders), age and gender have also been associated with increased risk for developing Type 2 Diabetes Mellitus.
DIAGNOSTIC CRITERIA BASED ON ADA GUIDELINES:
Symptoms of hyperglycemia — The diagnosis of diabetes mellitus is easily established when a patient presents with classic symptoms of hyperglycemia (thirst, polyuria, weight loss, blurry vision) and has a random blood glucose value of 200 mg/dL (11.1 mmol/L) or higher.
Asymptomatic — The diagnosis of diabetes in an asymptomatic individual can be established with any of the following criteria:
– Fasting plasma glucose (FPG) values ≥126 mg/dL (7.0 mmol/L). Fasting is defined as no caloric intake for at least eight hours.*
– Two-hour plasma glucose values of ≥200 mg/dL (11.1 mmol/L) during an oral glucose tolerance test (OGTT)
– A1C values ≥6.5 percent (48 mmol/mol)
– Fasting plasma glucose (FPG) values ≥126 mg/dL (7.0 mmol/L). Fasting is defined as no caloric intake for at least eight hours.*
– Two-hour plasma glucose values of ≥200 mg/dL (11.1 mmol/L) during an oral glucose tolerance test (OGTT)
– A1C values ≥6.5 percent (48 mmol/mol)
Categories of increased risk for diabetes:
– FPG between 100 and 125 mg/dL (5.6 to 6.9 mmol/L).
– Two-hour plasma glucose value during a 75 g OGTT between 140 and 199 mg/dL (7.8 to 11.0 mmol/L).
– Persons with 5.7 to 6.4 percent (39 to 46 mmol/mol), (6.0 to 6.4 percent [42 to 46 mmol/mol] in the International Expert Committee report) are at highest risk, although there is a continuum of increasing risk across the entire spectrum of A1C levels less than 6.5 percent (48 mmol/mol).
– FPG between 100 and 125 mg/dL (5.6 to 6.9 mmol/L).
– Two-hour plasma glucose value during a 75 g OGTT between 140 and 199 mg/dL (7.8 to 11.0 mmol/L).
– Persons with 5.7 to 6.4 percent (39 to 46 mmol/mol), (6.0 to 6.4 percent [42 to 46 mmol/mol] in the International Expert Committee report) are at highest risk, although there is a continuum of increasing risk across the entire spectrum of A1C levels less than 6.5 percent (48 mmol/mol).
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