Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (957 page)

   Use

   Diagnosis of DM

   Control of DM

   Diagnosis of hypoglycemia

   Other carbohydrate metabolism disorders including gestational diabetes, neonatal hypoglycemia, idiopathic hypoglycemia, and pancreatic islet cell carcinoma

   Criteria for the diagnosis of DM (American Diabetes Association Expert Committee)

   Four ways to diagnose diabetes are possible. Each must be confirmed on a subsequent day by any one of the four methods given above.

   Symptoms of diabetes plus casual (random) plasma/serum glucose concentration ≥200 mg/dL (11.1 mmol/L). Casual is defined as any time of day without regard to time since the last meal.

   FPG (fasting plasma glucose) ≥126 mg/dL (7.0 mmol/L). Fasting is defined as no caloric intake for at least 8 hours.

   Two-hour PG (postload glucose) ≥200 mg/dL (11.1 mmol/L) during an OGTT. The test should be performed using a 75-g glucose load.

   HbA
_1C
of >6.5%.

   In the absence of unequivocal hyperglycemia with acute metabolic decompensation, these criteria should be confirmed by repeat testing on a separate day. The third measure (OGTT) is not recommended for routine clinical use.