Building Competency in Diabetes Education THE ESSENTIALS

3-26 | CHAPTER 3

SCREENING AND DIAGNOSIS

Table 5 summarizes the diagnostic criteria that can be used with a venous blood sample for a diagnosis of diabetes (1). There are also recommendations listed in the 2018 Guidelines about the advantages and disadvantages of using the different diagnostic tests for diabetes (see Table 6) (1).

Table 5. Diagnosis of diabetes

FPG >7.0 mmol/L Fasting = no caloric intake for at least 8 hours prior to test Or A1C ≥ 6.5% (in adults) Using a standardized, validated assay in the absence of factors that affect the accuracy of the A1C and not for suspected type 1 diabetes (see Chapter 7: Monitoring Glycemic control for details on A1C) Or 2hPG in a 75 g OGTT >11.1 mmol/L Or Random PG >11.1 mmol/L Random = any time of the day, without regard to the interval since the last meal 2hPG = 2-hour plasma glucose; A1C = glycated hemoglobin; FPG = fasting plasma glucose; OGTT = oral glucose tolerance test; PG = plasma glucose Reprinted from Diabetes Canada 2018 Clinical Practice Guidelines (1) Current guidelines support using hbA1C as a diagnostic test for type 2 diabetes in the elderly, but with consideration of utilizing other tests (FBG, OGTT) due to age, race and gender impact on hbA1C. This is especially important when A1C is 6.5-7.0%. In the pediatric population, A1C is not recommended as a solid diagnostic parameter, but any of the three tests (A1C, FBG, OGTT) used in combination can be utilized to diagnose diabetes in children and adolescents.