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DEFINITION, CLASSIFICATION AND DIAGNOSIS OF DIABETES AND OTHER DYSGLYCEMIC CATEGORIES

DEFINITION. Diabetes mellitus is a metabolic disorder characterized by the presence of hyperglycemia due to defective insulin secretion, insulin action, or both.The chronic hyperglycemia of diabetes mellitus is associated with significant long-term sequelae, particularly damage, dysfunction and fai

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DEFINITION, CLASSIFICATION AND DIAGNOSIS OF DIABETES AND OTHER DYSGLYCEMIC CATEGORIES

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    1. DEFINITION, CLASSIFICATION AND DIAGNOSIS OF DIABETES AND OTHER DYSGLYCEMIC CATEGORIES 2003 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada

    2. DEFINITION Diabetes mellitus is a metabolic disorder characterized by the presence of hyperglycemia due to defective insulin secretion, insulin action, or both. The chronic hyperglycemia of diabetes mellitus is associated with significant long-term sequelae, particularly damage, dysfunction and failure of various organs - especially the kidneys, eyes, nerves, heart and blood vessels. Dysglycemia is a qualitative term used to describe glucose that is abnormal, without defining a threshold.

    3. CLASSIFICATION TYPE 1 DIABETES is primarily a result of pancreatic beta cell destruction and is prone to ketoacidosis. TYPE 2 DIABETES may range from predominant insulin resistance with relative insulin deficiency to a predominant secretory defect with insulin resistance. GESTATIONAL DIABETES MELLITUS (GDM) refers to glucose intolerance with onset or first recognition during pregnancy. OTHER forms consist mainly of specific genetically defined forms of diabetes or diabetes associated with other diseases or drug use.

    4. DIAGNOSTIC CRITERIA DIABETES - fasting plasma glucose ? 7.0 mmol/L, or - any plasma glucose ? 11.1 mmol/L with symptoms, or - 2-hour plasma glucose ? 11.1 mmol/L during a 75-g oral glucose tolerance test **confirmatory test usually required PREDIABETES a practical and convenient term for impaired fasting glucose (IFG) and impaired glucose tolerance (IGT). METABOLIC SYNDROME a distinctive constellation of abnormalities that include central obesity, hypertension, dyslipidemia, insulin resistance and dysglycemia.

    5. DIAGNOSTIC CRITERIA

    6. METABOLIC SYNDROME National Cholesterol Education Program ATP III definition Three or more of: fasting plasma glucose ? 6.1 mmol/L blood pressure ? 130/85 mm Hg fasting triglycerides ? 1.7 mmol/L HDL-cholesterol < 1.0 mmol/L (men) or < 1.3 mmol/L (women) waist circumference > 102 cm (men) or > 88 cm (women)

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