Diabetes
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Publicado: 3 de mayo de 2012
GUIDELINES & PROTOCOLS
ADVISORY COMMITTEE
Diabetes Care
Effective Date: September 1, 2010
Scope
This guideline describes the care objectives for the prevention, diagnosis and management ofdiabetes mellitus (DM) in non-pregnant adults. It focuses on the approaches and systems that are ideally in place to improve care for the majority of patients the majority of the time. Diagnostic Code:250 – Diabetes mellitus
Prevention and Risk Factors
Safe and effective therapies for the prevention of type 1 DM have not yet been identified.1 The risk for developing type 1 DM is influencedby family history of type 1 DM and other autoimmune diseases. A large proportion of type 2 DM can be prevented using lifestyle modification and/or pharmacologic intervention.1 Lifestyle modification isparticularly important for persons considered at high-risk, and pharmacologic therapy with metformin or acarbose can also be considered for patients with impaired glucose tolerance (IGT).2,3 Riskfactors for type 2 DM include but are not limited to: obesity; age ≥40 years; close relative with type 2 DM; member of a high risk population (Aboriginal, Hispanic, South Asian, Asian, or Africandescent); history of IGT or impaired fasting glucose (IFG) and other conditions associated with insulin resistance (e.g. dyslipidemia, hypertension, abdominal obesity, vascular disease, schizophrenia and useof antipsychotic medications).4
Diagnosis
The classic diagnostic symptoms for DM are polyuria, polydipsia, and unexplained weight loss with a “casual”* plasma glucose (PG) ≥11.1 mmol/L. In theabsence of classic symptoms, a fasting† plasma glucose (FPG) is the recommended initial test in the diagnosis of diabetes. Glycosylated hemoglobin (A1C) has been proposed as a diagnostic test for type2 diabetes; however, has not universally been adopted.5 See Appendix A Screening Algorithm for Type 2 DM in Adults.
*Casual=any time of day, regardless of the interval since the last meal....
ADVISORY COMMITTEE
Diabetes Care
Effective Date: September 1, 2010
Scope
This guideline describes the care objectives for the prevention, diagnosis and management ofdiabetes mellitus (DM) in non-pregnant adults. It focuses on the approaches and systems that are ideally in place to improve care for the majority of patients the majority of the time. Diagnostic Code:250 – Diabetes mellitus
Prevention and Risk Factors
Safe and effective therapies for the prevention of type 1 DM have not yet been identified.1 The risk for developing type 1 DM is influencedby family history of type 1 DM and other autoimmune diseases. A large proportion of type 2 DM can be prevented using lifestyle modification and/or pharmacologic intervention.1 Lifestyle modification isparticularly important for persons considered at high-risk, and pharmacologic therapy with metformin or acarbose can also be considered for patients with impaired glucose tolerance (IGT).2,3 Riskfactors for type 2 DM include but are not limited to: obesity; age ≥40 years; close relative with type 2 DM; member of a high risk population (Aboriginal, Hispanic, South Asian, Asian, or Africandescent); history of IGT or impaired fasting glucose (IFG) and other conditions associated with insulin resistance (e.g. dyslipidemia, hypertension, abdominal obesity, vascular disease, schizophrenia and useof antipsychotic medications).4
Diagnosis
The classic diagnostic symptoms for DM are polyuria, polydipsia, and unexplained weight loss with a “casual”* plasma glucose (PG) ≥11.1 mmol/L. In theabsence of classic symptoms, a fasting† plasma glucose (FPG) is the recommended initial test in the diagnosis of diabetes. Glycosylated hemoglobin (A1C) has been proposed as a diagnostic test for type2 diabetes; however, has not universally been adopted.5 See Appendix A Screening Algorithm for Type 2 DM in Adults.
*Casual=any time of day, regardless of the interval since the last meal....
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