Diabetes: Clearer Names and a Lower Number for Diagnosis


	A Lower Number To Diagnose Diabetes Testing for Diabetes During Pregnancy An international expert committee recently recommended a change in the names of the two main types of diabetes because the former names caused confusion. The type of diabetes that was known as Type I, juvenile-onset diabetes, or insulin-dependent diabetes (IDDM) is now type 1 diabetes. The type of diabetes that was known as Type II, noninsulin-dependent diabetes (NIDDM), or adult-onset diabetes is now type 2 diabetes. The new names reflect an effort to move away from basing the names on the treatment or age at onset.
A Lower Number To Diagnose Diabetes	The expert committee recommended a lower fasting plasma glucose (FPG) number to diagnose diabetes. The new FPG number is greater than or equal to 126 milligrams per deciliter (mg/dL), rather than greater than or equal to 140 mg/dL. This recommendation was based on a 2-year review of more than 15 years of research. This research showed that when blood glucose was consistently over 126 mg/dL the prevalence of diabetes complications, such as heart disease and loss of sight, increased dramatically and developed before the diagnosis of diabetes. The experts believe the earlier diagnosis and treatment can prevent or delay the costly and burdensome complications of diabetes. For the first time, these experts suggest that adults age 45 and older be tested for diabetes. If their blood glucose is normal at the first test, they should be tested at 3-year intervals. People under 45 should be tested if they are at high risk for diabetes. Risk factors include Being more than 20 percent above ideal body weight or having a body mass index (BMI) of greater than or equal to 27 kg/m². Having a first-degree relative with diabetes (mother, father, or sibling). Being a member of a high-risk ethnic group (African American, American Indian, Alaska Native, Asian and Pacific Islander American, or Hispanic American). Delivering a baby weighing more than 9 pounds or having diabetes during a pregnancy. Having blood pressure at or above 140/90 mm/Hg. Having abnormal blood fat levels, such as high density lipoproteins (HDL) less than or equal to 35 mg/dL or triglycerides greater than or equal to 250 mg/dL. Having impaired glucose tolerance when previously tested for diabetes. The committee states a diagnosis of diabetes is warranted for any of three positive tests, with a second positive test on a different day: A fasting plasma glucose of greater than or equal to 126 mg/dL. A casual plasma glucose (taken any time of day) of greater than or equal to 200 mg/dL with the symptoms of diabetes. An oral glucose tolerance test (OGTT) value of greater than or equal to 200 mg/dL in the blood measured at the 2-hour interval. (The OGTT is given over a 3-hour timespan and administered by a physician or medical laboratory. The person comes in fasting and a blood sample is taken. He or she drinks a glucose syrup. Then a blood sample is taken from the person to measure glucose once an hour for 3 hours.) The committee recommended that the fasting plasma glucose is preferable to OGTT because it is less expensive, easier to administer, and more acceptable to the person being tested. A new category for glucose intolerance--impaired fasting glucose (IFG)--was defined as having a fasting plasma glucose value of greater than or equal to 110 mg/dL but less than 126 mg/dL. The existing category, impaired glucose tolerance (IGT), is now defined as results of an OGTT greater than or equal to 140 mg/dL but less than 200 mg/dL in the 2-hour sample.
Testing for Diabetes During Pregnancy	The expert panel also suggested a change in the testing for diabetes during pregnancy, stating that women at low risk for gestational diabetes do not need to be tested. This group includes women who are Younger than 25 years of age. At normal body weight. Without family history of diabetes. Not members of a high-risk ethnic group. All women who do not fall into the low-risk category should continue to be tested for gestational diabetes during the 24th to 28th weeks of pregnancy. The National Diabetes Information Clearinghouse (NDIC) has more free information on diabetes. Contact NDIC at 1 Information Way, Bethesda, MD 20892-3560; fax: (301) 907-8906; and e-mail: ndic@niddk.nih.gov. To learn whether you have diabetes and what type of diabetes you have, ask your health care provider.
	National Diabetes Information Clearinghouse 1 Information Way Bethesda, MD 20892-3560 E-mail: ndic@info.niddk.nih.gov The National Diabetes Information Clearinghouse (NDIC) is a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). NIDDK is part of the National Institutes of Health under the U.S. Public Health Service. Established in 1978, the clearinghouse provides information about diabetes to people with diabetes and their families, health care professionals, and the public. NDIC answers inquiries; develops, reviews, and distributes publications; and works closely with professional and patient organizations and government agencies to coordinate resources about diabetes. Publications produced by the clearinghouse are reviewed carefully for scientific accuracy, content, and readability. This e-text is not copyrighted. The clearinghouse encourages users of this e-pub to duplicate and distribute as many copies as desired.
	NIH Publication No. 99-4642 e-text last updated: 18 August 1999

A Lower Number To Diagnose Diabetes

Testing for Diabetes During Pregnancy

National Diabetes Information Clearinghouse