TPN

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Indications for screening

Diagnosis

Screening often, starting early if at risk

Based on risk factors

Family history

Lack of physical activity

Overweight

Cardiovascular disease

Ethnic group

Screening for diabetes is recommended according to the risk factors a person may have. If there are a number of risk factors, then screening may be recommended more often and at a younger age. Screening includes the evaluation of risk factors and the testing of blood glucose. A number of risk factors have been identified which can be used to direct prevention, screening, and treatment strategies. Specific risk factors include:

A family history of diabetes, a previous record of high fasting blood glucose or glucose intolerance, previous gestational diabetes or delivery of an infant >9 pounds,

A lack of physical activity,

Being overweight (with a body mass index between 25-30), or obese (with a body mass index >30),

Existing cardiovascular disease or increased hypertension, polycystic ovary syndrome, or psychiatric illness,

Being a member of an at-risk ethnic group: Hispanic, non-Hispanic black, Asian descent, Native American, or Pacific Islander

Older age,

Smoking, or

Women with a history of gestational diabetes

Screening identifies prediabetes

Prediabetes

Impaired fasting glucose

Impaired glucose tolerance

Often no symptoms with onset of type 2 diabetes

Symptoms may include:

Thirst

Polyuria

Others

Screening and diagnosis for diabetes includes one or more of the following tests:

Casual (or non-fasting) plasma glucose ≥200 mg/dL (or 11.1 mmol/L) plus symptoms, or

A 75 gram oral glucose tolerance test with 2 hour values ≥200 mg/dL, or

Fasting plasma glucose ≥126 mg/dL, or

The presence of urinary ketones (which is usually negative).

Readings should be confirmed with an additional casual or fasting plasma glucose level on another day within one week of the initial test.

Casual plasma glucose

≥ 200 mg/dL plus symptoms

OGTT

2 hour values ≥ 200 mg/dL

Others

Urinary ketones