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Definitions
Terms
have changed over the years to describe diabetes disease and management.
The table below includes current definitions
for commonly used terms.
Type 1
diabetes, as mentioned earlier, is a fairly recent term that
characterizes diabetes by acute onset early in life, and an absolute
insulin deficiency.
An oral
glucose tolerance test involves consuming glucose and testing blood
sugar over time. You can add insulin levels to this test to find insulin
resistance.
Impaired
fasting glucose is a range of glucose that is above what is considered
normal, but below the levels that would diagnose diabetes.
Impaired
glucose tolerance characterizes prediabetes, but it uses a glucose
tolerance test with middle ground results at the 2-hour mark.
Term |
Definition and Comments |
Type 1 diabetes |
Type 1
diabetes, as mentioned earlier, is a fairly recent term that
characterizes diabetes by acute onset early in life, and an absolute
insulin deficiency. We discussed Type 2 diabetes on the previous slide.
Diabetes characterized by absolute insulin
deficiency and acute onset usually before 25 years of age,
formerly called type I diabetes, insulin-dependent diabetes
mellitus (IDDM), and juvenile diabetes. |
Type 2 diabetes |
Diabetes characterized by a combination of
insulin resistance and a beta cell secretory defect, formerly
called type II diabetes, non-insulin-dependent diabetes
mellitus, and adult onset diabetes. |
Prediabetes |
An intermediate state between normal and diabetes
levels of glucose homeostasis; a condition of high risk for
developing diabetes, with IFG and/or IGT present and recognized
risk factors |
Oral glucose tolerance test (OGTT) |
An oral
glucose tolerance test involves consuming glucose and testing blood
sugar over time. You can add insulin levels to this test to find insulin
resistance.
A screening test for diabetes and prediabetes.
The standard includes ingestion of 75 grams of glucose in a
fasted state. Blood is taken at intervals and tested for glucose
levels and, in some instances, insulin levels to look for
insulin insensitivity. |
Impaired fasting glucose (IFG) |
Impaired
fasting glucose is a range of glucose that is above what is considered
normal, but below the levels that would diagnose diabetes.
Seen in prediabetes, defined as a fasting glucose
that is between 100-125 mg/dL (5.6-6.9 mmol/L), which is above
normal range, but below the level to diagnose diabetes |
Impaired glucose tolerance (IGT) |
Impaired
glucose tolerance characterizes prediabetes, but it uses a glucose
tolerance test with middle ground results at the 2-hour mark.
Seen in prediabetes, defined as a level between
normal and diabetic levels of glucose tolerance during an oral
glucose tolerance test (OGTT); associated with higher levels of
fat tissue and obesity. |
Hemoglobin A1c (HbA1c) |
Hemoglobin A1c is a standard test to monitor blood glucose control over
a period of up to four months.
Tested to monitor glucose control in diabetes. HbA1c is
increased in red blood cells when blood glucose is high and
remains attached for the life of the red blood cell
(approximately 120 days). The level of HbA1c can reflect the
blood glucose control over a period of about 4 months. Normal
levels are below 6.5%, which is the target for consistent blood
glucose control in diabetes. Testing frequency is recommended at
every 3-6 months. |
Polyuria |
Polyuria
and glycosuria are both symptoms of diabetes.
Increased urinary frequency, it is a symptom of elevated blood
glucose in diabetes as well as other conditions. |
Glycosuria or glucosuria |
Excess of sugar in urine, associated with elevated plasma
glucose and poor glucose control in diabetes. |
Carbohydrate counting |
Carbohydrate counting is a method of dietary regulation of blood sugar
and insulin control.
The use of “carbohydrate servings” to determine the level of
carbohydrates in foods and meals. Generally a carbohydrate
serving contains 15 grams of carbohydrate. By knowing how much
carbohydrate is in a meal (carbohydrate counting), a person with
diabetes can better control blood sugar and titrate insulin
doses if treated with insulin. |
Casual plasma glucose |
A casual
plasma glucose is defined as a blood glucose level in a non-fasted
state.
A blood glucose during a non-fasted state, which doesn’t require
any special preparation (fasting or particular meals or diets). |
Etiology
Metabolic disorders
Altered sensitivity to
insulin
Reduced insulin levels
Excessive glucose
production
Other altered hormones
The
causes of type 2 diabetes can vary between patients and have a strong
association with genetic predisposition. Type 2 diabetes is caused by
defects of multiple organ tissues resulting from a complex set of
metabolic disorders. These defects can include changes in insulin
sensitivity for muscle and fat tissues, reduction in insulin levels,
excessive hepatic glucose production, and alterations in hormonal
status.
Obesity
Obesity
is a common finding in type 2 diabetes patients, which can increase
insulin resistance. Even in non-obese patients, increased levels of
visceral fat tissues can lead to insulin resistance.
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