Laboratory Testing in Diabetes
|Key points and Introduction|
|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|
Full colour PDF of the The Laboratory Testing in Diabetes POEM.
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|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.
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 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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