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Laboratory Testing in Diabetes

Key points and Introduction Labs diabetes PDF
People at high risk of diabetes
Prevention and identification
How to test
Laboratory tests and monitoring
Laboratory tests to prevent and delay complications of diabetes
Diabetic renal disease
Other tests
References

Full colour PDF of the The Laboratory Testing in Diabetes POEM.
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Download a powerpoint presentation of the key points.

Key Points

  “...the human and economic costs of diabetes can be reduced by prevention, particularly early detection...” International Diabetes Federation
  • Fasting morning venous glucose is the best initial test for diagnosing diabetes.
  • An oral glucose tolerance test is reserved for people with equivocal fasting glucose results.
  • Patients with impaired glucose tolerance or impaired fasting glucose benefit from lifestyle intervention and annual review.
  • HbA1C is the best test of glycaemic control in diabetes.
  • Patients with diabetes benefit from aggressive monitoring and management of all cardiovascular risk factors.

Introduction

The prevalence of diagnosed diabetes in New Zealand is estimated to be 3 - 4% and is higher among Māori (5 - 10%), Pacific Island peoples (4 - 8%) and people of Asian origin (4%). In New Zealand, 115,000 people were estimated to have diabetes in the year 2000, but this is predicted to increase to over 160,000 by 2021 (NZGG, Diabetes, 2003).

Type 1 diabetes

  Type 1 diabetes
  • Most frequently affects children and adolescents.
  • Symptoms include excessive thirst, excessive urination, weight loss and lack of energy.
  • Daily insulin injections required for survival.
Type 2 diabetes
  • Occurs mainly in adults.
  • Usually people have no early symptoms.
  • People may require oral hypoglycaemic drugs and may also need insulin injections.

Type 1 diabetes mellitus develops most frequently in children and adolescents. About 5% to 10% of people with diabetes have type 1 diabetes, and it accounts for 3% of all new cases of diabetes each year. The exact cause of type 1 diabetes is not known, but is thought to be autoimmune. Patients require daily insulin injections for survival.

Type 2 diabetes

Type 2 diabetes is more common than type 1 diabetes. Type 2 diabetes results from the combination of insulin resistance (resistance by body tissues to the action of insulin), and an insulin secretory defect.

Type 2 diabetes occurs mainly in adults although it is now also increasingly found in children and adolescents. Most people with type 2 diabetes, however, have no early symptoms and are only diagnosed several years after the onset of the condition, when various diabetic complications are often already present.

People with type 2 diabetes may require oral hypoglycaemic drugs and may also need insulin injections.


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