CLASSIFICATION of DIABETES MELLITUS Dr Agamohammadzadeh

Dr Nasser Aghamohammadzadeh

Associate Professor of Endocrinology

Tabriz University of Medical Sciences

CLASSIFICATION and diagnosis of DIABETES MELLITUS

CLASSIFICATION of DIABETES MELLITUS :

Diabetes can be classified into the following general categories:

Type 1 diabetes (due to autoimmune B-cell destruction, usually leading to absolute insulin deficiency)

2. Type 2 diabetes (due to a progressive loss of B-cell insulin secretion frequently on the background of insulin resistance)

3. Gestational diabetes mellitus (GDM) (diabetes diagnosed in the second or third trimester of pregnancy that was not clearly overt diabetes prior to gestation)

4. Specific types of diabetes due to other causes, e.g., monogenic diabetes syndromes (such as neonatal diabetes and maturity-onset diabetes of the young [MODY]), diseases of the exocrine pancreas (such as cystic fibrosis and pancreatitis), and drug- or chemical-induced diabetes (such as with glucocorticoid use, in the treatment of HIV/AIDS, or after organ transplantation)

Criteria for the diagnosis of diabetes :

FPG ≥126 mg/dL Fasting is defined as no caloric intake for at least 8 h.*

2-h PG ≥ 200 mg/dL during OGTT. The test should be performed as described by the WHO, using a glucose load containing the equivalent of 75-g anhydrous glucose dissolved in water.*

A1C ≥ 6.5%. The test should be performed in a laboratory using a method that is NGSP certified and standardized to the DCCT assay.*

In a patient with classic symptoms of hyperglycemia or hyperglycemic crisis, a random plasma glucose ≥ 200 mg/dL.

*In the absence of unequivocal hyperglycemia, diagnosis requires two abnormal test results from the same sample or in two separate test samples.

Criteria for testing for diabetes or prediabetes in asymptomatic adults