DEFINITIONS OF DIABETES Type 1 Diabetes (previously IDDM) Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance of …
DEFINITIONS OF DIABETES
The terms IDDM and NIDDM should be avoided as they classify patients on the
basis of diabetes treatment rather than the pathogenesis of the disease
Type 1 Diabetes previously IDDM
Results from an absolute deficiency of insulin due to pancreatic beta-cell
destruction It more commonly presents acutely before the age of 35, but
can occur at any age Patients are dependent on insulin to maintain health
and are prone to ketoacidosis
Type 2 Diabetes previously NIDDM
Results from a relative deficiency of, or insensitivity to, insulin and is
more commonly diagnosed over the age of 35, although it can occur in
younger especially obese individuals
Although the onset of Type 2 diabetes is less dramatic than that of Type 1
diabetes, the long-term sequelae are similar and equally devastating Both
Type 1 and Type 2 patients are at risk of developing the microvascular and
macrovascular complications of the disease For this reason, Type 2
diabetes should never be referred to as mild diabetes
Impaired Glucose Tolerance IGT OGTT 2-hour value 78 but 111
mmol/L
IGT is a state of impaired
glucose regulation, diagnosed on glucose
tolerance testing, which confers an increased risk of future diabetes of 2-
5 per year and an increased cardio-vascular risk The attrition rate to
T2DM can be modified by weight reduction and exercise Patients with IGT
tend to have higher blood pressure and plasma triglycerides when compared
to non-diabetic individuals
Impaired Fasting Glycaemia IFG FPG 60 mmol/L but 70mmol/L
The term IFG has been introduced to classify individuals with fasting
glucose values above the normal range, but below those diagnostic of
diabetes Diabetes UK recommends that all such individuals should have an
oral glucose tolerance test to exclude a diagnosis of diabetes
IGT and IFG are risk categories for future diabetes and / or cardiovascular
disease Patients with either condition should have their fasting plasma
glucose checked annually or sooner if symptoms occur and should receive
advice on the avoidance of obesity and the benefits of regular exercise
Co-existing cardiovascular risk factors should be treated aggressively
Gestational Diabetes Mellitus
Gestational diabetes mellitus GDM is defined as carbohydrate intolerance
of variable severity with
onset, or first recognition, during pregnancy
It is defined by a blood glucose value of 78 mmol/l measured two hours
after a standard 75g OGTT It does not exclude that the glucose
intolerance may have antedated pregnancy; therefore a post-natal OGTT
should be performed six weeks after delivery Women with a history of GDM
have a 60 chance of developing diabetes usually Type 2 within the
subsequent 20 years and this risk is increased by obesity For this reason
they should be advised to control their weight and have an annual fasting
glucose measurement performed
Diagnosis is made by laboratory measurement of glucose on a venous or
capillary whole blood sample
Capillary blood glucose measurements made on a blood glucose-testing meter
eg in General Practice cannot be relied upon for diagnosis
Author: -Diabetes Multidisciplinary Team Version No 1Issue Date; - June
2004Review Date June 2006
Author: -Diabetes Multidisciplinary Team Version No 2Issue Date; - Oct
2008Review Date Oct 2010
Source:spiritlakeconsulting.com
