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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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